Archive for the 'Pharmacy' Category

The safety of antidepressants in pregnancy

Maternal antidepressants are implicated in ADHD, but so is maternal depression

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The safety of antidepressants in pregnancy is controversial, partly because of profound methodological difficulties in separating the fetal effects of antidepressants from those related to maternal depression (confounding by indication). One central concern is the potential impact of these drugs on fetal brain development. Such effects may be subtle and possibly only detectable years after exposure, such as an increased susceptibility to (multifactorial) neurodevelopmental conditions.

Routine use of beta blockers in MI patients without heart failure is questioned

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Patients who have had a myocardial infarction (MI) but do not have heart failure or left ventricular systolic dysfunction do not seem to benefit from beta blockers, a large UK study published in the Journal of the American College of Cardiology has found

NICE recommends ixekizumab for persistent severe plaque psoriasis

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The National Institute for Health and Care Excellence (NICE), in its final draft guidance issued this week, has recommended ixekizumab, an antibody that inhibits interleukin-17A, as an option for treating adults with severe plaque psoriasis that doesn’t respond to standard therapies.

Solanezumab and the amyloid hypothesis for Alzheimer’s disease

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Solanezumab’s failure is a wake-up call to look elsewhere for an answer to dementia

Is the amyloid cascade hypothesis of Alzheimer’s disease too big to fail? It proposes that brain deposition of β amyloid protein is the critical early event in the pathogenesis of Alzheimer’s disease and has been the centrepiece of dementia research for decades. The hypothesis suggests that removing β amyloid will reverse or prevent the clinical expression of dementia. However, in all phase III clinical trials to date, treatments targeting β amyloid have failed to improve cognitive outcomes despite reducing brain β amyloid.

Here’s why we need evidence

evidently-cochrane-logoEveryday nursing requires the appropriate use of evidence and this website  from Evidently Cochrane provides useful insights. The article about pressure ulcers illustrates why evidence is needed for everyday practice.

Evidence can be found from a variety of sources and with busy workloads and winter pressures coming, you may find it is hard to find time to search for reliable evidence.

Don’t worry – we can help you!

Your Library and Knowledge Service has skilled  outreach specialists who can help you, either by running an evidence  search or training you to do it effectively. So get ahead and get in touch with us if you are based at East Cheshire NHS Trust.

Women are unaware of pregnancy risks linked with sodium valproate

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Doctors are being asked to make sure that women and girls with epilepsy know about the risks of taking sodium valproate during pregnancy, after a survey found that half of those questioned were unaware that it could harm the fetus.

The charities Epilepsy Action, Epilepsy Society, and Young Epilepsy conducted a survey earlier this year, in conjunction with the Medicines and Healthcare Products Regulatory Agency (MHRA), of 2788 women aged 16 to 50 with epilepsy.

Overwhelmed by information?

cas-poster

BMJ Infographics

Highlighted resource:

BMJ INFOGRAPHICS

These are great visual summaries of a variety of conditions, their management and treatments, and visual overviews of article recommendations. They are found attached to a variety of articles and editorials, and some of the key infographics are found on the infographics page. For example, the infographic of the NICE sepsis guidance or a visual guide to recognising past congenital heart surgery in adults.

Does health literacy matter?

 

Health Literacy is defined by World Health Organisation (2015) as “The personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”

This interesting news article, from NHS England, discusses its merits, the importance of health literacy and better health. Read the article here

New books

NewBooksThe Library & Knowledge Service purchased a large number of new books last month ~ view a selection of the new titles here.

All members of East Cheshire NHS Trust staff, students on placement and volunteers are able to borrow books from the Library.

Contact the Library for more information: ecn-tr.stafflibrary@nhs.net / 01625 66 1362.

 

SSRI exposure in pregnancy linked to speech disorders in offspring

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A significant rise in the risk of speech and language disorders was found among children born to mothers prescribed selective serotonin reuptake inhibitors (SSRIs) during pregnancy, a study published in JAMA Psychiatry has found.

New books

NewBooks

The Library & Knowledge Service purchased a large number of new books last month ~ view a selection of the new titles here.

All members of East Cheshire NHS Trust staff, students on placement and volunteers are able to borrow books from the Library.

Contact the Library for more information: ecn-tr.stafflibrary@nhs.net / 01625 66 1362.

 

Combined HRT may raise breast cancer risk, study finds

Women taking combined hormone replacement therapy (HRT) are 2.7 times more likely to develop breast cancer than non-users, and the risk may increase with longer use, a study published in the British Journal of Cancer has found.

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The researchers, from the Institute of Cancer Research in London, said that previous studies may have substantially underestimated the risk of breast cancer from combined HRT, as they did not update information about a woman’s HRT use or analyse accurately to allow for her age at menopause.

The new research was part of the Breast Cancer Now Generations Study, which is following more than 100 000 women for 40 years to investigate the causes of breast cancer.

Paracetamol is no more likely to exacerbate asthma in children than ibuprofen, shows study

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Using paracetamol to treat fever or pain is no more likely than ibuprofen to exacerbate asthma in children with mild persistent asthma, a randomised trial has shown (in the New England Journal of Medicine).

Observational data have previously linked paracetamol and asthma symptoms to decreased lung function, so some doctors have recommended avoiding the drug in children with asthma. But data from randomised trials have been limited.

NICE recommends dropping two drugs from Cancer Drugs Fund

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Two drugs currently provided under the Cancer Drugs Fund (CDF) should cease to be available because they are not cost effective, the National Institute for Health and Care Excellence (NICE) has concluded.

Everolimus for breast cancer (Afinitor, Novartis) and ibrutinib for mantle cell lymphoma (Imbruvica, Janssen) do not meet the grade, says NICE in draft guidance now open for consultation.Nice_logo

Suspected sepsis: summary of NICE guidance

nice_logoGuidelines include:

  • “Think sepsis” in any person with suspected infection

  • Sepsis may present with non-specific symptoms and signs and without fever

  • Have a high index of suspicion of sepsis in those who are aged <1 year or >75 years, pregnant, or immunocompromised, and those who have a device or line in situ or have had recent surgery

  • Use risk factors and any indicators of clinical concern to decide if full assessment is required

  • Offer people at high risk of sepsis broad spectrum antibiotics and intravenous fluids in hospital

New books available

The Library & Knowledge Service purchased a large number of new books last month ~ view a selection of the new titles here. All members of East Cheshire NHS Trust staff, students on placement and volunteers are able to borrow books from the Library. Contact the Library for more information: ecn-tr.stafflibrary@nhs.net / 01625 66 1362.

Library books 2

Oral antifungal is associated with increased risk of miscarriage

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Use of the oral antifungal drug fluconazole during pregnancy was associated with an increased risk of miscarriage in an analysis of 1.4 million pregnancies in Denmark published in JAMA.

Vaginal candidiasis is common during pregnancy. Although intravaginal formulations of topical azole antifungals are the first line treatment for pregnant women, oral fluconazole is often used in cases of recurrence or severe symptoms or when topical treatment has failed.

Errors in the most recent BNF and BNFc

bnfappNationally it has been recognised that there are a small number of clinically significant errors in the most recent BNF (BNF 70) and BNF for Children.

Be aware that the BNF has not been circulated to Trust staff due to the errors contained within.

The online and app versions of both, accessed via an OpenAthens account, have already been corrected. Please contact the Library and Knowledge service for advice on downloading and accessing the app.

The BNFc is available to Trust staff with these errors – please contact your ward pharmacist if you require further information; the Library and Knowledge Service has printed a list of the errors.

Spotlight on……..Wiley Nursing and Medical Journals

Wiley journalsAll trust staff have access to a collection of over 200 online journals covering key medical and nursing titles. Our subscription provides full text access to articles published in these journals, giving access to published research and evidence which can support your workplace practice, CPD, research and educational activities.

The journal titles are linked into our healthcare databases, electronic journal lists and can be accessed from the library web pages when both on and offsite by using your Athens log in.

Please contact the library on 01625 661362 if you have any questions

Antibiotic Awareness Week 16-20th November

This week it is World Antibiotic Awareness Week. There has been much in the media regarding the threat of antimicrobial resistance and what we might do to respond to the threat. Various initiatives are being undertaken across the NHS  and yesterday was European Antibiotic Awareness Day. Which was used to promote important messages to patients, healthcare professionals and commissioners about the responsible and appropriate use of antibiotics and the need to prevent the spread of infections. You can read the UK5YR Antibiotic Resistance Strategy to find out more.

You can also sign up as an Antibiotic Guardian to ensure antibiotics remain effective in the future to combat infectionscombat the germs

Caring Together Induction Pack: now available online

Caring Together Eastern CheshireThe new Caring Together Induction Pack is now available online.

The intention is to promote the pack to all new starters with health and social care organisations commissioning or providing services for the people of Eastern Cheshire. Organisations include third sector partners and providers of social housing.

For the avoidance of doubt, the pack is not relevant to employees involved exclusively in commissioning or providing services outside Eastern Cheshire. This pack is to be made available with immediate effect to new recruits, either salaried or voluntary.

At the end of every third month, a member of the Caring Together team will send managers a link to a brief online survey for new recruits to complete. This will enable them to measure awareness of the pack and the extent to which it is achieving its aim of improving understanding of Caring Together. Consultees will have the option to remain anonymous as the purpose of the survey is not to test individuals’ knowledge or pay attention to people who don’t answer all the questions correctly!

While the principal aim of the survey is to ensure that new starters are introduced to Caring Together as soon as practicable, the pack can also be shared with colleagues more widely. Reference copies of the pack are also available in the Staff Library (Top Floor, New Alderley House).

Many thanks to all in anticipation of your support for this important initiative to promote understanding of – and engagement in – our transformation programme.

Older patients with diabetes are often overtreated, say researchers

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Older patients with diabetes whose treatment had resulted in very low blood pressure or haemoglobin A1c levels rarely had their medicines reduced or withdrawn, a US study published in JAMA Internal Medicine has found.

The authors said that this represents a lost opportunity to reduce overtreatment among older people that can put them at risk of serious adverse events.

Patient safety alert – Support to minimise the risk of distress and death from inappropriate doses of naloxone

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A patient safety alert has been issued by NHS England to support providers of NHS funded care to minimise the risk of distress and death caused by inappropriate doses of naloxone.

The new ‘Stage 2: Resource’ alert highlights a number of resources now available to help providers ensure their local protocols and training related to naloxone reflect best practice.

BNF app on Apple devices – issue now resolved

bnfappThe issue that was affecting the BNF app on Apple devices has now been sorted, and the app should be working normally. Android and other operating systems were unaffected.

For more information, please contact the Library and Knowledge Service


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