Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the impetigo service under Pharmacy First. Discussion includes how patients with impetigo usually present, differential diagnoses, advice to prevent the spread of impetigo and information about how what to when first line treatments are out of stock, including information about the SPS Medicines Supply Tool. (11m)

Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member

Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS

Liz Kramer – Community Pharmacist

Useful links:

Information on how to stop impetigo spreading available via: Impetigo - NHS (www.nhs.uk)

Patient information leaflet from the British Association of Dermatologists

https://www.nhs.uk/conditions/impetigo/

SPS Medicines Supply Tool

https://www.sps.nhs.uk/wp-login.php?redirect_to=https%3A%2F%2Fwww.sps.nhs.uk%2Fhome%2Ftools%2Fmedicines-supply-tool%2F&reauth=1

Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the shingles service under Pharmacy First. Discussion includes the link between chickenpox and shingles, typical presentation of shingles, dermatomal distribution of shingles and how to respond to requests for video consultations. (20m 23s)

Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member

Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS

Liz Kramer – Community Pharmacist

Useful links:

Post exposure prophylaxis for chickenpox and shingles - GOV.UK (www.gov.uk)

Images of shingles:

NHS shingles resources

https://www.nhs.uk/conditions/shingles/

DermNet shingles resources

https://dermnetnz.org/topics/herpes-zoster

Primary Care Dermatology Society shingles resources

https://www.pcds.org.uk/clinical-guidance/herpes-zoster

Black & Brown skin resources (including images on diverse skin tones)

https://www.blackandbrownskin.co.uk/campaigns

DermNet dermatomes

https://dermnetnz.org/topics/dermatomes

Shingles immunisation programme: information for healthcare practitioners

https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals/shingles-immunisation-programme-information-for-healthcare-practitioners

John Oliver, a quality assurance specialist, presents a summary of the resources published by SPS between 20th December and 3rd January.

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.

Quick links to highlighted resources:

Considering interactions with local anaesthetics in dentistry

Interpreting significance of drug interactions with dental local anaesthetic (LA) cartridges and why most aren’t clinically relevant in general dental practice.

https://www.sps.nhs.uk/articles/considering-interactions-with-local-anaesthetics-in-dentistry/

Managing interactions with local anaesthetics in dentistry

Most drug interactions with local anaesthetics (LA) cartridges are not clinically relevant in general dentistry. We advise on management options where needed.

https://www.sps.nhs.uk/articles/managing-interactions-with-local-anaesthetics-in-dentistry/

Understanding unlicensed medicines

An understanding of the different types of unlicensed medicine will help in meeting patients' special clinical needs

https://www.sps.nhs.uk/articles/understanding-unlicensed-medicines/

Explaining the licensed status of medicines

Medicines may be licensed or unlicensed. Some substances that look like medicines may not be legally classed as medicines

https://www.sps.nhs.uk/articles/explaining-the-licensed-status-of-medicines/

Annual medicines planning publication, Prescribing Outlook – Log in required

Our annual output to support managed entry and budget planning for new medicines, new indications and patent expiries in the NHS.

https://www.sps.nhs.uk/articles/annual-planning-advice-for-new-medicines-prescribing-outlook/

We want to hear from you:

To help us evaluate the Medication Safety Update resource, we would be grateful if anyone who uses the Medication Safety Update could complete this short feedback survey.

https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3iy69MtABWsFCjFDc3yJffiRUM1NNSzVZRFNMVFA5RFlYSDdLQzJFNkhZVy4u

Next events – forthcoming webinars and conferences

https://www.sps.nhs.uk/home/events/next-events/

Podcast description:

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.

Madeleine Foster, Chief Pharmaceutical Officer’s Clinical Fellow, presents a summary of the resources published by SPS between 14th and 20th December.

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.

Quick links to highlighted resources:

Swallowing difficulties

https://www.sps.nhs.uk/home/guidance/swallowing-difficulties/

Treating acute hypomagnesaemia in adults

https://www.sps.nhs.uk/articles/treating-acute-hypomagnesaemia-in-adults/

Shelf lives of aseptically prepared medicines in NRFit syringes

https://www.sps.nhs.uk/articles/shelf-lives-of-aseptically-prepared-medicines-in-nrfit-syringes/

Patient Group Directions: Gadopiclenol contrast agent

https://www.sps.nhs.uk/articles/gadopiclenol-contrast-agent/

Patient Group Directions: Sodium chloride 0.9% in multi injector devices

https://www.sps.nhs.uk/articles/sodium-chloride-0-9-in-multi-injector-devices/

Patient Group Directions: Legal mechanisms and contrast agents

https://www.sps.nhs.uk/articles/legal-mechanisms-and-contrast-agents/

Understanding Patient Group Directions and Integrated Care Boards

https://www.sps.nhs.uk/articles/understanding-patient-group-directions-and-integrated-care-boards/

SPS Spotlight Monthly Digest

https://www.sps.nhs.uk/articles/sps-spotlight-monthly-digest/

Medication Safety Update

https://www.sps.nhs.uk/articles/medication-safety-update/

We want to hear from you:

To help us evaluate the Medication Safety Update resource, we would be grateful if anyone who uses the Medication Safety Update could complete this short feedback survey.

https://forms.office.com/Pages/ResponsePage.aspx?id=VpftQ_9Bv0yVm0BqQIO3iy69MtABWsFCjFDc3yJffiRUM1NNSzVZRFNMVFA5RFlYSDdLQzJFNkhZVy4u

Prescribing available medicines to treat ADHD

https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/

Prescribing available HRT products

https://www.sps.nhs.uk/articles/prescribing-available-hrt-products/

Prescribing and ordering available pancreatic enzyme replacement therapies

https://www.sps.nhs.uk/articles/prescribing-and-ordering-available-pancreatic-enzyme-replacement-therapies/

Next events – forthcoming webinars and conferences

https://www.sps.nhs.uk/home/events/next-events/

Podcast description:

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.

Sheetal Ladva, Senior Medicines Advice Pharmacist at SPS, presents a summary of the resources published by SPS between 7th and 13th December.

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.

Quick links to highlighted resources:

Using and prescribing thiamine in alcohol dependence

Intramuscular and intravenous thiamine can be used to prevent complications of alcohol dependence such as Wernicke’s encephalopathy.

https://www.sps.nhs.uk/articles/using-and-prescribing-thiamine-in-alcohol-dependence/

Prescribing available medicines to treat ADHD

The availability of medicines used to treat Attention Deficit Hyperactivity Disorder (ADHD) varies currently. Supply content is maintained regularly by DHSC.

https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/

We want to hear from you

Safer use of time critical medicines - national scoping review

To share your work or to be involved contact [email protected]

Safe use of insulin

Help us guide our work by answering this short survey: https://forms.office.com/pages/responsepage.aspx?id=slTDN7CF9UeyIge0jXdO45X8LFrmUg1GkTOIj8H5YE5UNVowNVc0MjBVU1lTMkFGU0xNMzNESVRRVi4u&route=shorturl

Next events – forthcoming webinars and conferences

https://www.sps.nhs.uk/home/events/next-events/

Podcast description:

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.

Penny and Andy discuss new resources to support NHS procurement teams manage medicine shortages. They are joined by Sally and Andrew who talk about using the resources to navigate supply issues in their Trusts. The resources include a checklist with where to find information and how to escalate problems.

Speakers:

Penny Daynes, Associate Regional Pharmacy Procurement Specialist, North East and Yorkshire, NHS Specialist Pharmacy Service

Andy Stewart, Associate Regional Pharmacy Procurement Specialist, North West, NHS Specialist Pharmacy Service

Sally Parker, Senior Pharmacy Technician - Procurement, Calderdale and Huddersfield NHS Foundation Trust

Andrew Philpot, Principal Pharmacy Technician - Procurement and Outsourcing, NHS Humber Health Partnership

John Oliver, a quality assurance specialist at SPS, presents a summary of the resources published by SPS between 30th November and 6th December.

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.

Quick links to highlighted resources:

Travel health: resources to support answering questions

Suggested resources to help primary care healthcare professionals find information to answer travel-related questions about medicines

https://www.sps.nhs.uk/articles/travel-health-resources-to-support-answering-questions/

Managing the risk of using effervescent tablets in children

Careful use of effervescent or soluble tablets to deliver part tablet doses for children and neonates can minimise risks of toxicity or suboptimal therapy.

https://www.sps.nhs.uk/articles/managing-the-risks-of-using-effervescent-tablets-in-children/

New Medicines News

New Medicines News is produced by the SPS Horizon Scanning Service. It highlights recent new product launches and significant medicines regulatory changes.

https://www.sps.nhs.uk/articles/new-medicines-news/

Medicines Monitoring – Lithium monitoring

https://www.sps.nhs.uk/monitorings/lithium-monitoring/

Using oral anticoagulants during breastfeeding

Warfarin is the preferred choice during breastfeeding; rivaroxaban or dabigatran may also be used. Recommendations apply to full term and healthy infants.

https://www.sps.nhs.uk/articles/using-oral-anticoagulants-during-breastfeeding/

Prescribing available medicines to treat ADHD

The availability of medicines used to treat Attention Deficit Hyperactivity Disorder (ADHD) varies currently. Supply content is maintained regularly by DHSC.

https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/

We want to hear from you

Safer use of time critical medicines - national scoping review

To share your work or to be involved contact [email protected]

Safe use of insulin

Help us guide our work by answering this short survey: https://forms.office.com/pages/responsepage.aspx?id=slTDN7CF9UeyIge0jXdO45X8LFrmUg1GkTOIj8H5YE5UNVowNVc0MjBVU1lTMkFGU0xNMzNESVRRVi4u&route=shorturl

Next events – forthcoming webinars and conferences

https://www.sps.nhs.uk/home/events/next-events/

Podcast description:

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.

Two of our experienced Medicines Advice Pharmacists, John Minshull and Luke Elliott, talk about answering queries regarding the dosing of medication in patients with renal impairment. They discuss when to use eGRF and Cockcroft and Gault when estimating creatinine clearance, recommended resources to support decision making, and where to get further advice.

Quick Links

The Renal Drug Database

https://www.renaldrugdatabase.com/s/about-rdd-2

Assessing the impact of renal impairment on medicines safety

https://www.sps.nhs.uk/articles/assessing-the-impact-of-renal-impairment-on-medicines-safety/

UKMI Enquiry Answering Guidelines

https://www.ukmi.nhs.uk/Resources?ContentID=69688558-86cc-4062-b5fa-a12f48b02830

Madeleine Foster, Chief Pharmaceutical Officer’s Clinical Fellow at SPS, presents a summary of the resources published by SPS between 23rd and 29th November.

To easily find a list of newly published pages go to sps.nhs.uk, select ‘search’, click in the search bar, and press enter.

Quick links to highlighted resources:

Liver Disease podcast series

Pharmacy colleagues and expert clinical speakers talk about liver disease and drugs in liver impairment.

https://www.sps.nhs.uk/articles/liver-disease-podcast-series/

Vitamin B12 deficiency: treatment during pregnancy

Intramuscular hydroxocobalamin and oral cyanocobalamin are treatment options for the management of clinically relevant vitamin B12 deficiency during pregnancy.

https://www.sps.nhs.uk/articles/vitamin-b12-deficiency-treatment-during-pregnancy/

Using generic liposomal amphotericin B

Learn about differences between generic Amphotericin B Tillomed Liposomal and Amphotericin B Gilead Liposomal, previously branded AmBisome.

https://www.sps.nhs.uk/articles/using-generic-liposomal-amphotericin-b/

SPS Spotlight Monthly Digest

A slide deck summarising SPS outputs and resources. It should be distributed to relevant healthcare professionals and their teams.

https://www.sps.nhs.uk/articles/sps-spotlight-monthly-digest/

Medication Safety Update

A resource collating the latest medication safety communications and publications to inform, support and inspire medication safety improvements.

https://www.sps.nhs.uk/articles/medication-safety-update/

Prescribing available medicines to treat ADHD

The availability of medicines used to treat Attention Deficit Hyperactivity Disorder (ADHD) varies currently. Supply content is maintained regularly by DHSC.

https://www.sps.nhs.uk/articles/prescribing-available-medicines-to-treat-adhd/

We want to hear from you

Safer use of time critical medicines - national scoping review

To share your work or to be involved contact [email protected]

Safe use of insulin

Help us guide our work by answering this short survey: https://forms.office.com/pages/responsepage.aspx?id=slTDN7CF9UeyIge0jXdO45X8LFrmUg1GkTOIj8H5YE5UNVowNVc0MjBVU1lTMkFGU0xNMzNESVRRVi4u&route=shorturl

Next events – forthcoming webinars and conferences

https://www.sps.nhs.uk/home/events/next-events/

Podcast description:

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines. Our motto is 'do once and share'.

Kieran Reynolds talks to Aimee Francisco about drugs in liver impairment. Discussion includes key issues to consider when prescribing in liver disease, medicines to avoid (or use with caution) in liver disease, drug induced liver injury and herbal medicines. (13m 29s)

Aimee Francisco - Advanced Specialist Gastroenterology Pharmacist at Gloucestershire Hospitals NHS FT and primary care lead at the British Hepatology Pharmacy Group (BHPG)

Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS

Useful Links

SPS medicines monitoring tool

https://www.sps.nhs.uk/home/tools/drug-monitoring/

Questions to ask when giving medicines advice in liver impairment

https://www.sps.nhs.uk/articles/questions-to-ask-when-giving-medicines-advice-in-liver-impairment/

Information resources for managing medicines in liver impairment

https://www.sps.nhs.uk/articles/information-resources-for-managing-medicines-in-liver-impairment/

Symptom control in adults with advanced liver disease

https://www.basl.org.uk/index.cfm/content/page/cid/33 (available under Resources)

Prescribing weight adjusted oral paracetamol in adults BASL position statement

https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)

LiverTox

https://www.ncbi.nlm.nih.gov/books/NBK547852/

Memorial Sloan Kettering Cancer Center's About Herbs database

https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search