Greater Glasgow and Clyde Medicines

Drug-Induced QTc Prolongation - Interpretation of the QT Interval in Adults here

• Prolongation of the QT interval can lead to a life threatening arrhythmia known as Torsades de Pointes (TdP)
• QT interval needs to be adjusted for heart rate, generating the widely used QTc (the corrected QT interval)
• There are several calculations available to correct the QT interval, with Bazett being the most widely used formula and the one used by many ECG machines to calculate the automated QTc. Bazett is however associated with significant limitations, which should be taken into account when interpreting the QTc reported on ECG printouts
• When reviewing a patients’ ECG, it is important not to look at the QTc interval in isolation to ensure that other conditions such as bradycardia, tachycardia, myocardial infarction or cardiomyopathy are not responsible for any changes in QTc

Guideline News August 2023 here

New NHSGGC Guideline - Tetracycline and Fluoroquinolone Antibiotic Interactions here

New NHSGGC guideline to help raise awareness and management of the interaction between oral tetracycline and fluoroquinolone antibiotics with multivalent cation-containing products (e.g. iron and calcium)

Key Medicine Shortages September 2023 here

Includes: Disulfiram, Jext (adrenaline), Phenytoin sodium, Pilocarpine hydrochloride, Minims® Povidone Iodine, Reboxetine (Edronax®), Tacrolimus (Adoport®), Tacrolimus (Dailiport®), Rifampicin 150mg/Isoniazid 75mg/Pyrazinamide 400mg/Ethambutol 275mg (Voractiv®), products used in the treatment of scabies: Permethrin 5% dermal cream (Lyclear®) and Malathion 0.5% liquid

MHRA Drug Safety Update August 2023 here

Medicines linked to falls here

Certain drug classes and combinations of medicines confer greater risk for frail patients than the general adult population. Any medicine which can cause sedation, hypotension or hypoglycaemia can increase risk of falls. 

Guideline News July 2023 here

Off-label or unlicensed use of medicines here.

The MHRA and the NHS Circular PCA(P)(2015)17 recommend that ‘specials’ and imported unlicensed medicines should only be used where there is no suitable licensed alternative. Clinicians should not routinely use an unlicensed preparation when there is a licensed product available, unless there is a specific clinical reason.

Suspected defective medicines policy here

Guidance for reporting a suspected defective medicine is provided within this policy,
along with a reporting form. These can be found via GGC Medicines: Medicines Policies
under the miscellaneous section (8.1 and 8.1.1).

MHRA Drug Safety Update July 2023 here