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NoECSU Prescribing Newsletter
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NECS prescribing newsletter - September 2013
Welcome to the new prescribing newsletter from the NECS Medicines Optimisation Team.

This newsletter will be produced every other month to inform GPs and practice staff of medicines related issues that impact upon primary care prescribing.  Please cascade this newsletter as appropriate within your practice.

PGD and vaccines update
PGD and vaccines update

In 2013 a number of significant changes have been made to the national immunisation programmes. In July the Rotavirus vaccine was introduced for infants requiring some changes to the childhood immunisation programme. The MMR catch-up and Pertussis for pregnant women programmes are still ongoing. 

The intranasal flu vaccine Fluenz® is to be introduced for healthy children, beginning with 2 and 3 year olds. Also Shingles vaccination has been introduced for 70 year olds, with a catch-up programme for 79 year olds. The complete national immunisation schedule, including these significant changes has been published by DH and can be accessed by clicking here.

Read more >
Jext® adrenaline pens - the story so far
Jext® adrenaline pens - the story so far

Starting in May of this year most of the North East region switched to the Jext® brand of adrenaline pen, with Cumbria currently in the process of switching patients.  The decision was taken because Jext® has a longer shelf life from point of manufacture (latest delivered pens have an expiry date of Feb 2015) and using one device across the North is safer and makes training easier.

So far all GP practices, community pharmacies and Foundation Trusts have received packs. These include information for both patients and staff about the Jext® pen, as well as DVDs for training and demo pens. With the support of the pharmacy practice teams all patients with pens have been identified and contacted to explain about the switch that will happen when they next need a pen. This process has uncovered many incidents of concern such as patients with expired pens, no knowledge of how to use the pen or being prescribed an incorrect dose. 

Read more >
CCG locality medicines optimisation updates

Please click on your CCG below for the latest medicines optimisation relevant to your area.

Please note: the NECS Medicines Optimisation Team supporting Gateshead, South Tyneside, Newcastle, North Tyneside and Northumberland CCGs moved to Riverside House, Newburn on 27th August.  To contact the team please telephone 0191 217 2983 or 0191 217 2681.

Controlled drugs - reporting incidents and concerns and requests for CD destructions
Controlled drugs - reporting incidents and concerns and requests for CD destructions

The Controlled Drug Accountable Officers for NHS England DDT and CNTW Area Teams have entered into interim arrangements with NECS for the management of controlled drugs.

Any Controlled Drug Incidents and concerns should be reported to the Accountable Officer via the following contacts in NECS and requests for a visit by an authorised witness for the destruction of controlled should be made to the same contact.

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Misuse of gabapentin, pregabalin and tramadol

Prescribers, practice staff and pharmacists are reminded to exercise caution when prescribing and dispensing pregabalin, gabapentin and tramadol, especially in patients with a history of substance misuse, due to a growing illicit market in these drugs.

Recent reports indicate increased prevalence of misuse of gabapentin and pregabalin in the North East, with evidence of parenteral misuse, in some cases in conjunction with tramadol to enhance psychiatric side effects.

Any suspicions or incidences of prescription diversion or misuse should be reported to your local contact for controlled drugs.

Read more >
Medicines safety alerts and warnings

Key drug safety updates this month:

  • Metoclopramide – risk of neurological adverse effects – restricted dose and duration of use 
  • Oral ketoconazole – do not prescribe or use for fungal infections – risk of liver injury outweighs benefits
  • Nitrofurantoin – be aware of current renal function when prescribing, especially for elderly patients
  • Codeine for analgesia – reminder of restricted use in children and adolescents due to reports of morphine toxicity
  • Risk of suicide with antidepressants – be aware of the potential for suicidal thoughts and acts during the early weeks of treatment
Read more >
Product updates and price changes

Key product updates this month:

  • Hyoscine hydrobromide (Scopoderm TTS) patches – supply problem until October 2013.
  • Price increases
    • Sertraline tablets
    • Indapamide tablets
    • Senna tablets
    • Temazepam tablets
Read more >
Arrangements for registering new prescribers

Arrangements for registering new prescribers and amending prescriber and practice details have recently changed in some areas.

For non-medical prescribers practices can download forms from the NHS Prescription Services website, which should then be returned to contractorservicesdepartment@nepcsa.nhs.uk for authorization (please note this is a different email address to the address on the form).

For GPs and GP practices notification forms can be obtained on request by emailing contractorservicesdepartment@nepcsa.nhs.uk.  Please note: the Area Team require at least 28 days’ notice in respect of a GP joining or leaving a practice. 

Prescribing news from the Regional Drug & Therapeutics Centre

The Regional Drug & Therapeutics Centre (RDTC)’s newsletter is now available.  Key points in the newsletter include:

  • NICE guidance for familial breast cancer – new and updated recommendations surrounding surveillance, counselling and risk reduction.
  • EMA review of GLP-1 therapies and pancreatitis
  • Growth in prescribing expenditure – impact of category M and patent expiries

Read more… 

Did you know?

Only TWO effervescent paracetamol/co-codamol tablets contain more sodium than FOUR packets of ready salted crisps!

NHS North of England Commissioning Support (NECS)
Tel: 0191 374 4121
2012 All Rights Reserved

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