Avoid most calcium channel blockers in patients with heart failure with reduced ejection fraction
Rate-limiting calcium-channel blockers (verapamil hydrochloride, and diltiazem hydrochloride) and short-acting dihydropyridines (e.g. nifedipine, or nicardipine hydrochloride) should be avoided in patients who have heart failure with reduced ejection fraction...
Emergency supplies
The criteria for an emergency supply at a patient’s request are; Interview the patient Must be an immediate need Must have been previously prescribed by a UK, EEA or...
DOAC contra-indications
DOACs (apixaban, edoxaban, dabigatrin, rivaroxaban) are contraindicated in antiphospholipid syndrome and in patients with prosthetic heart valves. For these patients warfarin is the oral anticoagulant of choice. https://bnf.nice.org.uk/drug/rivaroxaban.html#contraIndications...
NEWS2 scoring system for assessing acutely ill patients in hospital including sepsis
A score is allocated to physiological measurements, already recorded in routine practice, when patients present to, or are being monitored in hospital. Six simple physiological parameters form the basis...
Sepsis risk factors
You should ‘Think Sepsis’ if a patient has one or more risk factor(s) for sepsis, and looks unwell Risk factors for sepsis include extremes of age (under one year or...
Sepsis-symptoms
Sepsis as a life-threatening condition in which the body’s response to infection causes injury to its tissues and organs Symtoms in children fast breathing convulsion mottled, bluish or pale...
New Medicines Service (NMS)- new categories added from 1st September
From 1st September, the NMS has been expanded to allow community pharmacies to provide this service to more patients. We can now provide NMS to up to 1% of...
PPI doses used in H.pylori triple therapy
Proton pump inhibitor Dose Esomeprazole 20 mg Lansoprazole 30 mg Omeprazole 20–40 mg Pantoprazole 40 mg Rabeprazole 20 mg All given twice daily for 7 days https://pathways.nice.org.uk/pathways/dyspepsia-and-gastro-oesophageal-reflux-disease/helicobacter-pylori-testing-and-eradication-in-adults#content=view-node%3Anodes-first-line-treatment...
First line treatment choices for H.pylori
No penicillin allergy Oral first line for 7 days: A proton pump inhibitor, plus amoxicillin, and either clarithromycin or metronidazole (treatment choice should take into account previous treatment with...
Antihypertensive choice in breastfeeding
Enalapril is first line choice Nifedipine or amlodipine should be considered first line in women of black Caribbean or African family origin https://www.nice.org.uk/guidance/ng133/resources/antihypertensive-treatment-during-the-postnatal-period-pdf-313945610004 https://bnf.nice.org.uk/treatment-summary/hypertension.html ...
