Greater Glasgow and Clyde Medicines

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• A new NHSGGC guideline has been published on the Right Decision Platform: Management plan for patients on warfarin and direct oral anticoagulants (DOACs) in the peri-operative period.
• The new NHSGGC guideline includes:
• Updated recommendations on thrombosis risk categories for elective procedures.
• A clear presentation of different DOACs and the time frame between the last dose and high bleeding risk procedures.
• Updated recommendations on low molecular weight heparin (LMWH) dose in the peri-operative period.
• Updated CHADS-VA score in line with new recommendations from the European Society of Cardiology.

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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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• 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®).