ROTHERHAM
AREA PRESCRIBING COMMITTEE NEWSLETTER
BULLETIN NO 37 MAY-JULY 2011
Following the APC meeting held on 18 May 2011 and 20 July 2011
HOT TOPIC 94 Capsaicin
Accepted for restricted use for the treatment of peripheral neuropathy. APC approved that prescribing should remain with the specialist until further evidence is available. Traffic lighted as red
HOT TOPIC 95 Filgrastim
Used for neutropenia patients in haematology and patients receiving treatment for HIV infection. Traffic lighted as red.
HOT TOPIC 96 Ranolazine
Restricted for use in patients with stable angina and initiated by the cardiologist. Traffic lighted as amber.
HOT TOPIC 97 Erbulin
Used for patients with locally advanced or metastatic breast cancer. Traffic lighted as red.
HOT TOPIC 98 Tapentadol
A new analgesic for people with moderate to severe pain. Traffic lighted as red.
HOT TOPIC 99 Melatonin
It was agreed that melatonin (Circadin® (MR) formulation) would be amber lighted with a Shared Care Protocol. As the unlicensed formulations of melatonin have high costs in primary care it was agreed that prescribing of these products would remain with the hospital at the moment, and an arrangement made such that the hospital would be reimbursed for costs they accrue for making this agreement work.
HOT TOPIC 101Dronedarone
As no additional safety concerns have arisen, it was agreed to amber light this drug.
HOT TOPIC 100 Shared Care Protocols for Treatment of Dementia
A revised shared care protocol for the prescribing of Acetylcholinesterase inhibitors for Alzheimer’s disease dementia has been approved by RDaSH Medicines Management Committee and agreed by Rotherham APC.
A shared care protocol for the prescribing of Memantine for Alzheimer’s disease dementia has been approved by RDaSH Medicines Management Committee and agreed by Rotherham APC.
Integrated care pathways (ICPs) for the Initiation and Monitoring of Treatment with Acetylcholinesterase inhibitors and Memantine have also been agreed to ensure RDaSH has been requested to audit compliance with the protocols and ICPs. A condensed version of the ICPs will be available to ensure that GPs are aware of how the initiation and monitoring will be implemented.
Management of Behavioural and Psychological Symptoms (BPSD) in Patients with Dementia
An algorithm has been approved by RDaSH Medicines Management Committee and agreed by Rotherham APC for management of BPSD. This identifies primary care and secondary care responsibilities and gives guidance on the use of pharmacological interventions in patient management. This should assist in the review of patients with dementia on an antipsychotic. A copy of this is enclosed with the newsletter as a separate attachment and is available on the Prescribing and Medicines Management webpage.
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