Medicine Pathways, Guidelines And Position Statements

Information for vaccinators

• Information for vaccine consenters
  • Pfizer-BioNTech vaccine: FAQ
  • AstraZeneca vaccine: FAQ
  • Moderna vaccine: FAQ
• Flow charts for assessing individual vaccine appropriateness including:
  • AstraZeneca
  • Pfizer
  • Moderna
  • All three together (useful for Ops, or HCPs making decisions about where to direct a patient, or vaccination centres who offer >1 vaccine each day)
• Flow charts for managing allergy including:
  • Management of patients with a history of allergy (pre-first dose)
  • Management of patients who reacted to the first dose of COVID-19 vaccine
• Definition of Clinically Extremely Vulnerable (and who should receive 2nd dose 2-3 weeks after their first)
• Procedures
  • Using Pinnacle at large-scale vaccination sites
  • Clinical assessment / consent for Pfizer vaccine
  • Clinical assessment / consent for AstraZeneca vaccine
  • Clinical assessment / consent for Moderna vaccine
• Data on vaccine stability in the event of accidental temperature excursion

Medicines for the treatment and prevention of COVID-19

• Nebulised Prostacyclin for Acute Respiratory Distress Syndrome.(iloprost and epoprostenol)
• Vitamin D for adults (excluding pregnant and breastfeeding women)

Monitoring for medicines during COVID-19 pandemic

NCL

• Primary care recommendations for monitoring of ADHD medications (approved by JFC)
• Clozapine and blood dyscrasias (approved by CIFT and BEH-MHT)
• Lithium (approved by CIFT and BEH-MHT)
• Adult antipsychotic monitoring (excluding clozapine) (approved by CIFT and BEH-MHT)

Camden and Islington NHS Foundation Trust

Depot or long-acting antipsychotic injections (approved by CIFT)

Managing medicines during the COVID-19 pandemic

• Vitamin B12 injections (Maintenance)

Ulcerative colitis High Cost Drugs pathway

Crohn’s Disease High Cost Drugs pathway

Supply disruption of oral ranitidine: Statement for NCL Trusts

Supply disruption of oral ranitidine: Statement for Primary Care

Direct Oral Anticoagulants (DOACs)

The documents below have been agreed by the stakeholders working in North Central London and have been approved by the NCL Joint Formulary Committee (NCL JFC). They should be used to refer appropriate patients to his/her local anticoagulation clinic for initiation of anticoagulation.
Where appropriate, local anticoagulation clinics should add their own contact details on the relevant paperwork (i.e. referral proformas, notification and transfer of care forms)
Please note that these documents may be updated intermittently. Users are also reminded that the prescribing guidance is not definitive and that other sources such as the electronic medicines compendium (SPCs) should be used for the most recent drug information. This can be found at the following link: http://www.medicines.org.uk/emc/default.aspx

• DOAC Anticoagulation referral
• DOAC Counselling checklist
• DOAC GP communication
• DOAC Prescribing support
• DOAC Interaction guide

VTE: Choice of DOAC (Position Statement)

Other

Summary of Antiplatelet Options in Cardiovascular Disease
Sacubitril valsartan for heart failure position statement (NEL and NCL joint positioning)
Statin prescribing & lipid modification guideline
Stable angina prescribing guideline
Omega-3 Fatty Acids Position Statement
Guidance for the review of Omega-3 fatty acids
Guidance for the management of hypertriglyceridaemia

Asthma adult inhaler choice

The following COPD guideline has been produced by the Camden, Haringey and Islington Responsible Respiratory Prescribing Group and applies to organisations that are constituent members. It has not been ratified by the NCL Joint Formulary Committee and does not apply to all organisations in NCL.

Stable COPD Treatment Guideline

Parkinsons disease prescribing guideline
Lidocaine 5% Patch Position Statement
Co-proxamol Tablets Position Statement
Clozapine management for patients admitted to acute hospitals guidance
Cannabis-based medicinal products Position Statement
Cannabis-based medicinal products Patient Information

NICE and Public Health England (PHE) have brought together their information on managing common infections into a summary table.

The North Central London Medicines Optimisation Committee (NCL MOC) agreed to remove their localised ‘Management and treatment of common infection’ guidance and support the use of the NICE Managing Common Infections summary table.

Fluoroquinolones safe prescribing Position Statement
Treatment of Infections due to Multi-Drug Resistant Gram Negative Pathogens

Type 2 diabetes

Antihyperglycaemic agents for Type 2 diabetes
Insulin for Type 2 diabetes

Diabetes meters (finger-prick testing)

Blood glucose and Ketone monitoring

Diabetes meters (flash glucose monitoring)

See ‘Flash glucose monitoring‘ page

Other

Liothyronine position statement

Use of Flash Glucose Monitoring in North Central London (includes FSL and FSL2)

• Switching patients from FSL to FSL2
• Position statement
• Implementation guide (based on LPP/LDCN recommendations)

Forms – for use by diabetes specialists (includes FSL and FSL2)

• Blueteq forms for NCL patients (on-site access only)
• Patient-prescriber agreement (complete after training session)

Information sheets – for patients and primary care (FSL only)

• Patient Frequently Asked Questions (FAQ)
• Primary care Information sheet
• Community pharmacy Information sheet

Training materials (FSL only)

• Training pack for health care professionals
• Training pack for patients

Competencies (FSL only)

• Initiating clinicians
• Patients
• Continuing prescribers (including GPs)

Over active bladder prescribing guideline (primary care)
Daily Tadalafil Tablets Position Statement

Direct Oral Anticoagulants (DOACs)

See ‘Cardiovascular‘

Other

Low Molecular Weight Heparin (LMWH) prescribing guideline

Oral Nutritional Supplement Formulary in Adults – Primary Care Guidance

Calcium + vitamin D (CaVitD) supplements for prevention of osteoporotic fragility fractures guideline
Vitamin D deficiency in adults with low bone mineral density guideline
Rheumatoid arthritis (RA) biologic pathway
Psoriatic arthritis (PsA) biologic pathway
Bisphosphonate treatment duration in women position statement
Summary of MHRA alerts for bisphosphonates and denosumab
Glucosamine & Chondroitin Supplements Position Statement
Rubefacients Position Statement
Etoricoxib Position Statement 

Glaucoma prescribing guideline
Ocular lubricants (Dry eye) prescribing guideline
DMO pathway
BRVO pathway
CRVO pathway
wAMD pathway
Lutein and Antioxidant Position Statement

Psoriasis High Cost Drugs (abbreviated pathway)
Psoriasis High Cost Drugs (full guideline)
Treatment of Chronic Spontaneous Urticaria

Oral Nutritional Supplement Formulary in Adults – Primary Care Guidance
Ensure Plus Advance Position Statement
Calogen Position Statement

Herbal Supplements Position Statement
Homeopathy Position Statement
Dental Products Position Statement