Formulary Chapter 9: Nutrition and blood - Full Chapter
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Chapter Links... |
County Durham and Tees Valley Guidance for Prescribing & Monitoring Post Bariatric Surgery |
County Durham and Tees Valley Guidelines for recognition and management of non- IgE cow’s milk allergy in children |
Guidance for the Prescribing of Vitamins and Minerals in Primary Care in County Durham and Tees Valley |
North of Tyne, Gateshead and North Cumbria - Recommendations for symptom management in renal patients (including symptom management at the end of life) |
South Tees Pathway for the Management of Undernutrition (ADULTS) |
South Tees Pathway for the Management of Undernutrition (Nursing/Care Homes) |
Details... |
09.02.01 |
Oral preparations for fluid and electrolyte imbalance |
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09.02.01.01 |
Oral potassium |
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Potassium Chloride (Sando-K®)
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First Choice
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- Effervescent tablets (12mmol potassium 8 mmol chloride)
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Potassium Chloride
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Alternatives
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5mmol in 5ml sugar-free syrup (Kay-Cee-L)
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09.02.01.01 |
Potassium removal |
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Calcium Resonium®
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Formulary
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- Powder (Calcium polystyrene sulphonate)
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Patiromer calcium (as Patiromer sorbitex calcium)
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Formulary
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- Approved for the treatment of hyperkalaemia in adults in line with NICE
- Approved for emergency acute treatment
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NICE TA623: Patiromer for treating hyperkalaemia
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Potassium Removal Polystyrene Sulphonate Resin Powder (Calcium polystyrene sulphonate) (Sorbisterit)
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Formulary
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Resonium A®
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Formulary
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- Powder (Sodium polystyrene sulphonate)
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Sodium zirconium cyclosilicate (Lokelma®)
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Formulary
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- 5g and 10g oral powder
- Approved for the treatment of hyperkalaemia in adults in line with NICE
- Approved for emergency acute treatment
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NICE TA599: Sodium zirconium cyclosilicate for treating hyperkalaemia
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09.02.01.02 |
Oral sodium and water |
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Sodium Chloride
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Formulary
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- 600mg m/r tablets (Slow Sodium) - approx. 10 mmol sodium & chloride per tablet
- 1mmol/ml oral solution
- Treatment should only be initiated with the advice of a specialist.
- 5mmol/1ml oral solution
- Treatment should only be initiated with the advice of a specialist in accordance with NPPG/RCPCH Position Statement
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RCPCH & NPPG Position Statement - Using Standardised Concentraions of Unlicensed Liquid Medicines in Children
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St Marks solution
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Restricted
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- Specialist initiation for use in patients with a short bowel.
- Usually prepared at home
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Using St Mark’s electrolyte solution
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09.02.01.02 |
Oral rehydration therapy (ORT) |
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Dioralyte® Oral Rehydration Salts
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Formulary
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09.02.01.03 |
Oral bicarbonate |
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Sodium Bicarbonate
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Formulary
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- 500mg capsules (500mg contains approx. 6 mmol each ofsodium and bicarbonate)
- 1mmol/ml oral solution unlicensed
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Sodium hydrogen carbonate (Nephrotrans)
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Formulary
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Capsules: 500 mg
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.
In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.
For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing. |
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Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement.
The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber.
If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care. |
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Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs. |
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Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care. |
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NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria. |
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UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review. |
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NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status. |
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