Greater Glasgow and Clyde Medicines

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• Over the next 18 months, a new Regional West of Scotland Formulary is being created which will replace the NHSGGC formulary over time
• A regular newsletter will be issued to keep staff in participating health boards up-to-date with project progress
• Nominations are being sought from health care professionals who consider themselves to be experts in particular therapeutic areas to be part of each chapter expert working group for both the paediatric and adult formularies, please complete this form to nominate yourself.

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Key messages for staff working in NHSGGC:

• Use NHSGGC validated calculators for creatinine clearance (CrCl) and for calculating doses of gentamicin and vancomycin in adult patients.
• Avoid using calculators from other health boards as this can result in doses of medicines being prescribed which do not follow NHSGGC guidelines.
• Only access NHSGGC calculators via the GGC Medicines app and do not use a search engine.

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New HEPMA oral antibiotic protocols for non-severe respiratory and urinary tract infections with no previous intravenous (IV) antibiotic treatment have been introduced to support prescribing and improve documentation of oral antibiotic stop dates on HEPMA. 

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• Medicines Update blogs have been presented in Microsoft Sway format since August 2023.
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• Two adrenaline auto-injector (AAI) devices should always be prescribed and supplied.
• Patients should carry two in-date AAI devices at all times.
• Patients and their carers should be trained on their particular device, as injection technique varies between brands (Epipen®, Jext®).

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• GMAWS is effective in managing alcohol withdrawal syndrome (AWS).
• The 2025 revised guidance allows easier estimation of alcohol units consumed.
• The Fast Alcohol Screening Tool (FAST) score is used to assess use disorder: a score of 5 or more suggests alcohol dependency.
• Prevention and treatment of Wernicke’s encephalopathy refers to ‘Vitamins B&C solution’ for intravenous infusion. Pabrinex® is no longer routinely available.
• The treatment of those at risk of Wernicke’s encephalopathy has been simplified.
• Oral thiamine should be continued for at least 6 weeks after becoming abstinent and having established a satisfactory diet. At that point thiamine discontinuation should be considered.
• Senior medical review of diagnosis and the need for possible adjunctive therapy if the patient:
• requires more than 120mg diazepam (or 12mg lorazepam) in 24 hours or
• is requiring full dose treatment 96 hours after last alcohol ingestion.
• Alterations to AWS treatment for patients with liver disease have been more clearly defined (see further details in Background section):
• All patients with evidence of advanced liver disease (cirrhosis) use symptom triggered treatment only.
• Patients with evidence of advanced liver disease and liver dysfunction: jaundice (bilirubin >80micromol/l), coagulopathy (INR/Prothrombin time ratio >1.5) or history of hepatic encephalopathy: use symptom triggered lorazepam: 1mg-2mg.