Saliva Substitutes: Choosing and prescribing the right product
Source: North West Medicines Information Centre
Area: Evidence > Medicines Q & A
. Dry mouth is a complaint often presented to dental practitioners.
. There are a number of products available to manage this condition, however not all are suitable for every individual.
. Dentate patients in particular should avoid preparations with an acidic pH, due to increased risk of dental decay. A fluoride containing preparation is preferable for these patients.
. Dental practitioners should be aware that not all preparations may be prescribed on a dental NHS prescription. All the available products ...
Source: NeLM - Medicines Q and A - February 28, 2013 Category: Drugs & Pharmacology Source Type: news
How is acute hyperphosphataemia treated in adults?
Source: Leeds Medicines Information Centre
Area: Evidence > Medicines Q & A
There are no national guidelines for the treatment of acute hyperphosphataemia, and practice varies widely between hospital Trusts. The guidance in this Medicines Q&A reflects practice at Leeds Teaching Hospitals NHS Trust.
The cause of the hyperphosphataemia should be established and treated.
Most patients with hyperphosphataemia are asymptomatic. If symptoms are present, they are usually reflective of underlying contributory pathologies.
Acute severe hyperphosphataemia with symptomatic hypocalcaemia can be life-threatening and di...
Source: NeLM - Medicines Q and A - February 26, 2013 Category: Drugs & Pharmacology Source Type: news
What is the evidence to support the use of IV paracetamol for the short-term treatment of moderate to severe pain?
Source: South West Medicines Information and Training
Area: Evidence > Medicines Q & A
Intravenous (IV) paracetamol is licensed for the short-term treatment of moderate pain, especially following surgery, and for the short-term treatment of fever, when administration by the IV route is clinically justified by an urgent need to treat pain or hyperthermia and/or when other routes of administration are not possible.
The main advantages of IV paracetamol are: when GI motility is reduced in the immediate post -operative period or when rapid establishment of analgesia is required. Studies have shown a reduction in morphin...
Source: NeLM - Medicines Q and A - February 21, 2013 Category: Drugs & Pharmacology Source Type: news
What is the evidence for subcutaneous mistletoe extract in the treatment of cancer?
Source: Regional Drug and Therapeutics Centre
Area: Evidence > Medicines Q & A
Whilst in vitro testing has been promising, showing a number of mechanisms by which mistletoe may be helpful in cancer treatment, clinical evidence of the effectiveness of mistletoe preparations is lacking. There are no licensed mistletoe products available in the UK.
Until more high quality evidence is available, there is currently no compelling evidence to support the use of mistletoe extracts in cancer therapy.
Currently available positive evidence is confounded by poor study design, with more high q...
Source: NeLM - Medicines Q and A - January 28, 2013 Category: Drugs & Pharmacology Source Type: news
When can dentists supply medicines?
Source: North West Medicines Information Centre
Area: Evidence > Medicines Q & A
The Human Medicines Regulations 2012 allows dentists to issue any medicine (PoM, P or GSL) directly to a patient but this only applies if patients are receiving private treatment.
The current NHS terms of service do not allow dentists to supply any medicines, other than those for immediate use before the issue of a prescription, directly to a patient.
The NHS regulations as set out in the NHS Act 2006 do not allow dentists providing an NHS service to provide any form of pharmaceutical service.
Prescription only medicines issued by...
Source: NeLM - Medicines Q and A - January 28, 2013 Category: Drugs & Pharmacology Source Type: news
What factors need to be considered when dosing patients on renal replacement therapies?
Source: South West Medicines Information and Training
Area: Evidence > Medicines Q & A
There are a number of factors that need to be considered when dosing patients on renal replacement therapy (RRT). Consider the drug, the patient and the type of RRT.
Alteration of drug dosage is only necessary if renal clearance exceeds 25% of total body clearance.
Drugs which are cleared by the kidneys are usually dialysed, and vice versa, although there are some anomalies.
Dose adjustment for RRT is only necessary for drugs that require dose adjustment because of the presence of renal failure. No RRT is as effective as the n...
Source: NeLM - Medicines Q and A - January 22, 2013 Category: Drugs & Pharmacology Source Type: news
Can acitretin be given to patients with renal impairment or patients on renal replacement therapies?
Source: South West Medicines Information and Training
Area: Evidence > Medicines Q & A
There are very few data to support the use of acitretin in patients with renal impairment (RI) or in those undergoing renal replacement therapy (RRT) and further studies are needed. The information that is available is conflicting.
Acitretin should only be prescribed by, or under the supervision of a dermatological specialist. The decision to prescribe acitretin to a patient with RI or on RRT lies with the physician and should be based on an appropriate assessment of the likely risk versus benefit ratio. If acitretin is prescribe...
Source: NeLM - Medicines Q and A - January 8, 2013 Category: Drugs & Pharmacology Source Type: news
How should conversion from oral morphine to fentanyl patches be carried out?
Source: South West Medicines Information and Training
Area: Evidence > Medicines Q & A
Data from a small study has shown that conversion of oral morphine to transdermal fentanyl with a ratio of 100:1 is safe and effective. This ratio is also endorsed by the Palliative Care Formulary and the British National Formulary. This differs from ratios recommended in some UK Summary of Products Characteristics . The decision regarding which conversion ratio to use should be based on patient specific factors, the level of patient monitoring which can be offered and the clinical setting.
Comparative doses of oral morphine and t...
Source: NeLM - Medicines Q and A - December 31, 2012 Category: Drugs & Pharmacology Source Type: news
