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Medicines Information

Medicines Information. Useful sources Basic enquiry answering. September 2015. Session aims. Increase awareness of the Medicines Information (MI) services UK Wales Increase awareness of the questions to ask an enquirer

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Medicines Information

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  1. Medicines Information Useful sources Basic enquiry answering September 2015

  2. Session aims • Increase awareness of the Medicines Information (MI) services • UK • Wales • Increase awareness of the questions to ask an enquirer • Have practical experience using some resources which will be useful throughout pre-reg year

  3. What is Medicines Information? • A service that • supports the safe, effective and efficient use of medicines by the provision of evidence-based information and advice on their therapeutic use • UKMi • Local centres • Regional centres • Specialist centres • Virtual national network

  4. UKMi Wales

  5. Who uses MI services in Wales? • Total enquiries taken in 2014 = 5,593

  6. What do they ask? • Total enquiries taken in 2014 = 5,593

  7. Taking in enquiries • A nurse contacts you asking • “Is cinnarizine alright to take during pregnancy?” • What else do you need to know?

  8. Another enquiry • Patient on the Medical Admissions Unit • admitted with GI bleed • Consultant suggests may be due to citalopram • Junior Dr wants more information on this AE • What further information do you need?

  9. Where to look for information

  10. eMC • Access via www.medicines.org.uk/emc • SPCs and PILs • Only for products registered with the ABPI (members supply ~90% of UK medicines) • Free access – no login required • Useful links, e.g. X-PIL

  11. BNF / BNFc • Access via www.medicinescomplete.com/mc • Apps also available to download • Same content and layout as books • Monthly updates

  12. Medicines Complete • Access via www.medicinescomplete.com/mc • Subscription required • AHFS • Stockley’s Drug Interactions • Stockley’s Herbal Medicines Interactions • Handbook of Drug Administration via enteral feeding tubes • Herbal Medicines • Dietary Supplements

  13. MicroMedex • Access via NHS Wales elibrary http://www.wales.nhs.uk/sitesplus/878/home • Basic access with NHS Athens password • DrugDex / AltMedex • Martindale • Drug Interaction Checker • Trissel IV compatibility • Reprotox / TERIS / Shepard’s (MI only access)

  14. UKMi website • Access via www.ukmi.nhs.uk • Some areas password protected • Fridge stability database • Drugs in lactation database • UKMi Q&As • Medicines compliance aid database • General guidance for MI services

  15. NICE Evidence Search • https://www.evidence.nhs.uk/ • Evidence on treatments, medicines and safety • Can search the latest key medicines and prescribing information in one place • Enter a term into the search bar • Use filters to narrow down search results • Register for email updates

  16. Review our enquiry

  17. Yellow Card Scheme • Introduced in 1964 after thalidomide tragedy • Spontaneous reports of suspected ADRs • Acts as an early warning system to identify ADRs and risk factors • Over 31,500 confidential reports received in UK in 2014 • MHRA can detect duplicate reports www.yellowcardwales.org

  18. Why report ADRs? • Important role in patient safety • Allows continual safety monitoring of drugs • old and new • New drugs – lack of experience on ADRs • exposure in ~1500 people only for short duration • unlikely to detect frequency <1/1500 or long latency • lack of experience in special patient groups • elderly, children, pregnancy, >1 disease / drug • Detect rare adverse effects www.yellowcardwales.org

  19. Completing a Yellow Card • Online www.yellowcard.mhra.gov.uk • simple and fast • drop-down menus • can register to save time in the future • can be saved part way through • App for use via tablets or smartphones • Paper • available in BNF, MIMs, ABPI • available from YCC Wales • download from MHRA website www.yellowcardwales.org

  20. What to report? • Report: • all ADRs for new drugs (marked ▼) – even if mild • serious ADRs for established drugs when serious – even if well recognised • Serious ADRs include: • Vaccines / Unlicensed / Herbal medicines Causality does not need to be established

  21. Examples of ADRs identified by Yellow Card Scheme • Domperidone – risk of cardiac SEs • use now restricted to N&V indication • limited duration • Voriconazole – liver toxicity • Strontium ranelate – risk of cardiac Ses • C/I in those with cardiac problems • use restricted to severe osteoporosis, last resort • Risk of switching between branded and generic anti-epileptics www.yellowcardwales.org

  22. Our enquiry • Should a yellow card be completed regarding our patient with the GI bleed?

  23. Reflective learning • In your own time, consider the following points: • What have I learnt today? • What do I need clarification on? • How am I going to go about clarifying that?

  24. Thank you for listening

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