Prescribing

Nice | Empagliflozin in Type 2 Diabetes

This is a new guideline from Nice. Empagliflozin is a selective sodium-glucose cotransporter-2 (SGLT-2) inhibitor, which blocks glucose reabsorption in the kidneys and so causes increased urinary excretion. For other SGLT-2 inhibitors have been approved by NICE, see my posts about Dapagliflozin and Canagliflozin. Empagliflozin use in Type 2 Diabetes as a 2nd drug in…
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FSRH | Depot contraception

This is an updated guideline on the injectable contraceptive from the FSRH. The main new advice is that although women should be advised to swap to an alternative form of contraception after age 50, they can continue it if they prefer and are appropriately counseled. I am listing the main things that were new for me.  Failure…
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Nice | Vitamin D supplementation

This public health guideline from NICE summarises the actions needed to increase the use of Vitamin D supplementation. This guidance was released by the Chief Medical Officer a couple of years ago. This link advises what doses should be taken too and who is eligible for Surestart vitamins and how they can be accessed. As it's already…
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Raising concerns about poor prescribing

MPS Medicolegal Consultant Dr Rachel Birch shares a case scenario involving a locum GP who was working in a practice with poor prescribing issues Dr L was working three days a week as a maternity locum at a busy medical practice. Every day she was asked to manage the acute prescription requests, even though she…
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Nice | Diagnosis and management of drug allergy

This is a new guideline from NICE which tries to rationalise how we manage potential drug allergy. There is a useful section on when to refer to a specialist and there is also a good outline of what different reactions may look like. Sadly it can't answer that question of whether the kid with a rash on…
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Nice | Lubiprostone for treating chronic idiopathic constipation

This is guideline from NICE on a newly recommended treatment for chronic idiopathic constipation. The medication is Lubiprostone, which works by activating chloride channels in the GI tract, thus increasing intestinal secretions and improving constipation. It has a different method of action to prucalopride, which NICE released guidance on in 2011. Lubiprostone is more cost-effective than…
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