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101. Drug introduction

from: http://www.opsi.gov.uk/si/si1989/Uksi_1989019 2_en_1.htm. 2 HM Government. The Prescription Only Medicines (Human Use) Amendment Order 2003. Statutory Instrument 2003 No. 696: London: HMSO. Available from: http://www.opsi.gov.uk/si/si2003/20030696.htm 3 Joint Formulary Committee, editor. British National Formulary. 50th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2005. APPENDIX 1 – Some common abbreviations 4 ac ante cibum (before food) approx (...) Drug introduction Adrenaline (epinephrine) ADM/ADX Drugs October 2006 Page 1 of 2 Drugs Drug Introduction Drugs October 2006 Page 1 of 2 This section outlines the common drugs currently available for administration by Ambulance Clinicians (refer to speci?c drug protocols). Legal Considerations Drugs administered by Ambulance Clinicians fall into two categories: 1. non-prescription drugs such as aspirin 2. drugs under the Medicines Act 1968 1 designated prescription-only medicines (POMs). Under

2006 Joint Royal Colleges Ambulance Liaison Committee

102. Drug and Alcohol Abuse amongst Anaesthetists - Guidance on Identification and Management 2

professional. Critical Care Medicine 2007; 35 (Suppl 2): S106-16. 25. O’Connor P, Spickard Jr A. Physician impairment by substance abuse. Medical Clinics of North America 1997; 81: 1037-52. 26. Berge K, Seppala MD, Schipper AM. Chemical dependency and the physician. Mayo Clinic Proceedings 2009; 84: 625-31. 27. American Society of Anesthesiologists Committee on Occupational Health. Model curriculum on drug abuse for residents in anesthesiology. www.asahq.org/clinical/curriculum.pdf (accessed 15/10/2009 (...) of Disease (ICD) is termed ‘harmful use’, and is defined as “A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected drugs) or mental, (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).” [40] The term ‘substance’ is used to cover alcohol, illicit drugs and prescription medications taken inappropriately. It is used to describe: • The use of a substance that leads

2011 Association of Anaesthetists of GB and Ireland

103. Guidance on competencies for intrathecal drug delivery

competencies, a programme of continuous professional development appropriate to IDD therapies and regular assessment and peer review of outcome data. After care requires that emergency full spine MRI scanning must be available. Arrangements must be in place for urgent referral for neurosurgical or spinal surgical opinion. 2 IDD is delivered by a variety of different medical and surgical specialists and teams. Intrathecal drugs may be delivered by external or fully implantable/programmable systems (...) , screening and preparation for therapy a. physical b. psychological c. social d. balanced assessment of benefits and risks e. comprehensive understanding of alternatives to IDD therapy f. management of patient, family and carer expectations g. delivering IDD as part of wider rehabilitative intervention 4. Interactions of IDD systems with a. Medical, electrical and magnetic equipment e.g. diathermy, physiotherapy equipment b. MRI scanners c. other implanted devices e.g. cardiac pacemakers 5. Indications

2010 Faculty of Pain Medicine

104. Drugs - Thrombolytics (Reteplase, Tenecteplase)

Drugs - Thrombolytics (Reteplase, Tenecteplase) Drugs October 2006 Page 1 of 5 Drugs Thrombolytics (Reteplase, Tenecteplase) – HEP Rpa/Tnk and Adjunctive Heparin PRESENTATION Vials of reteplase 10 units for reconstitution with 10ml water for injection. Vials of tenecteplase 10,000 units for reconstitution with 10ml water for injection, or 8,000 units for reconstitution with 8ml water for injection. NOTE: Whilst the strength of thrombolytics is traditionally expressed in ‘units’ these units (...) are unique to each particular drug and are NOT interchangeable. ACTIONS Activates the fibrinolytic system, inducing the breaking up of intravascular thrombi and emboli. INDICATIONS Acute myocardial infarction within six hours of symptom onset. Ensure patient fulfils the criteria for drug administration following the model checklist (below). Variation of these criteria is justi?able at local level with agreement of appropriate key stakeholders (e.g. cardiac network). JRCALC MODEL CHECKLIST PRIMARY

2007 Joint Royal Colleges Ambulance Liaison Committee

105. Drugs - Naloxone Hydrochloride (Narcan)

is reversed by naloxone. Unconsciousness associated with respiratory depression of unknown cause, where opioid overdose is a possibility. (Refer to depressed level of consciousness guideline). CONTRA-INDICATIONS 1. Neonatal patients of opioid addicted mothers, as serious withdrawal effects may occur – emphasis should be on bag-valve-mask ventilation and oxygenation. SIDE EFFECTS In patients who are physically dependent on narcotic drugs, violent withdrawal symptoms, including cardiac arrhythmias, may (...) Drugs - Naloxone Hydrochloride (Narcan) Naloxone Hydrochloride (Narcan) NLX Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Naloxone Hydrochloride 400 micrograms/1ml ampoule. ACTIONS Antagonism of the effects (including respiratory depression) of opioid drugs. ADDITIONAL INFORMATION Naloxone may be administered intramuscularly, undiluted, (into the outer aspect of the thigh or upper arm) when IV access is impossible, but absorption may be slow. Wherever possible, the IV route should be used

2007 Joint Royal Colleges Ambulance Liaison Committee

106. Drug-Induced Liver Injury

andpathologicalphenotypesandthecurrentabsenceofspeci?c biomarkers. This makes the diagnosis of drug-induced liver injury an uncertain process, requiring a high degree of aware- ness of the condition and the careful exclusion of alternative aetiologies of liver disease. Idiosyncratic hepatotoxicity can be severe, leading to a particularly serious variety of acute liver failure for which no effective therapy has yet been developed. These Clinical Practice Guidelines summarize the available evi- dence on risk factors, diagnosis, management and risk (...) . Clinical trials produce reliable information about the devel- opment of abnormal liver biochemistries and DILI if the inci- dence is high. However, such trials usually include a limited number of patients and are therefore underpowered to detect rare adverse effects such as idiosyncratic hepatotoxicity. Conse- quently,themajorityofdataareprovidedbyretrospectivestud- ies of databases from pharmacovigilance centres and/or pharmaceutical companies, aimed to determine the most fre- quently associated drugs

2019 European Association for the Study of the Liver

107. Drug Misuse and the Emergency Department

Drug Misuse and the Emergency Department Drug Misuse and the Emergency Department, May 2019 1 The Royal College of Emergency Medicine Best Practice Guideline Drug Misuse and the Emergency Department May 2019 Drug Misuse and the Emergency Department, May 2019 2 Contents Summary of recommendations 3 Scope 4 Reason for development 4 Introduction 4 Considerations 5 NICE recommendations 5 Refer patients 5 Medical history 6 Illicit drug screening questions 6 Written information 6 Existing resources 6 (...) to the patient’s death. The aim of the guidance is to provide recommendations for clinicians with regard patients who potentially misuse drugs. Introduction Substance abuse or drug misuse may formally be defined as the continued misuse of any mind-altering substance that severely affects person's physical and mental health, social situation and responsibilities. Alcohol dependence is the most common form of substance misuse, but any drug, including heroin, cocaine, crack and cannabis, comes into this category

2019 Royal College of Emergency Medicine

108. Unhealthy Drug Use: Screening

feasible in busy primary care settings. Longer tools (eg, the 8-item ASSIST [Alcohol, Smoking and Substance Involvement Screening Test]) that assess risks associated with unhealthy drug use or comorbid conditions. The PRO (Prenatal Risk Overview) for pregnant people. Providers should be aware of state requirements and best practices on informed consent for screening, documenting screening results in medical records, and confidentiality protections. For adolescents: Evidence is insufficient, so (...) or the U.S. Department of Health and Human Services. Many people in the US experience problems related to unhealthy drug use, defined in this recommendation statement as the use of illegal drugs and the nonmedical use of prescription psychoactive medications (ie, use of medications for reasons, for duration, in amounts, or with frequency other than prescribed or use by persons other than the prescribed individual). In 2018, an estimated 12% of US residents 18 years or older reported current unhealthy

2020 U.S. Preventive Services Task Force

109. Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence

to communicate with their healthcare professional than others. 1.1.1 Healthcare professionals should adapt their consultation style to the needs of individual patients so that all patients have the opportunity to be involved in decisions about their medicines at the level they wish. 1.1.2 Consider any factors such as physical or learning disabilities, sight or hearing problems and difficulties with reading or speaking English, which may affect the patient's involvement in the consultation. 1.1.3 Establish (...) they might benefit from the treatment. Clearly explain the disease or condition and how the medicine will influence this. 1.1.9 Explain the medical aims of the treatment to patients and openly discuss the pros and cons of proposed medicines. The discussion should be at the level preferred by the patient. 1.1.10 Clarify what the patient hopes the treatment will achieve. 1.1.11 Avoid making assumptions about patient preferences about treatment. T alk to the patient to find out their preferences, and note

2009 National Institute for Health and Clinical Excellence - Clinical Guidelines

110. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes

medicines-related patient safety incidents 16 1.2 Medicines-related communication systems when patients move from one care setting to another 18 1.3 Medicines reconciliation 20 1.4 Medication review 21 1.5 Self-management plans 23 1.6 Patient decision aids used in consultations involving medicines 24 1.7 Clinical decision support 26 1.8 Medicines-related models of organisational and cross-sector working 27 2 Research recommendations 28 2.1 Medication review in children – suboptimal use of medicines (...) and medicines-related patient safety incidents 28 2.2 Medication review – suboptimal use of medicines and patient-reported outcomes 30 2.3 Clinical decision support systems 33 2.4 Cross-organisational working 35 3 Other information 38 3.1 Scope and how this guideline was developed 38 3.2 Related NICE guidance 38 Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes (NG5) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

111. Position Statement on the medicinal use of Cannabinoids in Pain Medicine

’ approach is of considerable concern, as is diversion to non-medical use. Therefore, only products produced to pharmaceutical standards should be considered. Patients living with chronic pain often have complex comorbidities and a multidisciplinary approach to management that includes physical and psychological therapy rather than reliance on medicines alone is more likely to be effective. With this in mind: ? The Faculty supports the setting up of robust trials to look at potential benefits (...) Position Statement on the medicinal use of Cannabinoids in Pain Medicine Faculty Position Statement on the medicinal use of Cannabinoids in Pain Medicine Update following the publication of NICE Guidance NG144 (11 November 2019) This statement is focused on the issues relating to cannabis derived medicinal products in relation to Pain Medicine. It does not comment on other areas of medical practice or recreational use, which lie outside our remit. The issue of cannabis, its extracts

2020 Faculty of Pain Medicine

112. Faculty Position Statement on the medicinal use of Cannabinoids in Pain Medicine

to pharmaceutical standards should be considered. Patients living with chronic pain often have complex comorbidities and a multidisciplinary approach to management that includes physical and psychological therapy rather than reliance on medicines alone is more likely to be effective. With this in mind: • The Faculty supports the setting up of robust trials to look at potential benefits in Pain. • The Faculty is unclear how a committee of “Medical Experts” could advise on the use of any cannabis-related products (...) Faculty Position Statement on the medicinal use of Cannabinoids in Pain Medicine Faculty Position Statement on the medicinal use of Cannabinoids in Pain Medicine This statement is focused on the issues relating to cannabis derived medicinal products in relation to Pain Medicine. It does not comment on other areas of medical practice or recreational use, which lie outside our remit. The issue of cannabis, its extracts, formulations and synthetics has very much been on the radar of pain medicine

2018 Faculty of Pain Medicine

113. Position statement on the use of antiretroviral therapy to reduce HIV transmission

transmission, measured from the time of randomization into the study, when the plasma viral load of the HIV-infected partner was below the limit of detec- tion [1]. For individuals initiating ART, it can be antici- pated that the majority of people starting an effective regimen based on their pretreatment viral genotype (i.e. their virus is sensitive to all the drugs taken) will achieve an undetectable viral load within 6 months of initiating therapy [11]. What is the actual risk of HIV transmission (...) Position statement on the use of antiretroviral therapy to reduce HIV transmission Position statement on the use of antiretroviral therapy to reduce HIV transmission, January 2013: The British HIV Association (BHIVA) and the Expert Advisory Group on AIDS (EAGA) S Fidler, 1 J Anderson, 2 Y Azad, 3 V Delpech, 4 C Evans, 5 M Fisher, 6 B Gazzard, 5 N Gill, 4 L Lazarus, 4 R Lowbury, 7 K Orton, 8 B Osoro, 9 K Radcliffe, 10 B Smith, 11 D Churchill, 6 K Rogstad 12 and G Cairns 13 1 Imperial College

2013 Publication 4880703

114. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen ultraviolet A (PUVA) therapy

psoralen–ultraviolet A therapy (PUVA) Advantages of oral PUVA Advantages of topical PUVA Shorter overall outpatient attendance times No risk of gastrointestinal adverse effects Less staff involvement Drug interactions unlikely Less risk of phototoxic reactions from natural UV exposure (lower concentration of psoralen in the skin after treatment) Eye protection not always required Only practical option for whole-body treatment for units with inadequate bath facilities Shorter periods in treatment (...) or almost clear’ by 8 weeks 45 65% (44% to 86%) Ellis 18 1991 Ciclosporin 3 mg/kg/day ‘clear or almost clear’ by 8 weeks 50 36% (17% to 55%) Saurat 19 2008 Methotrexate PASI 75% reducon 163 17% (3% to 30% Systemic better Placebo better Fig 3. Randomized controlled trials comparing conventional systemic therapies with placebo for psoriasis. CI, con?dence interval; PASI 75%, 75% reduction in Psoriasis Area and Severity Index. Biological drug n (number treated with biological) % more reaching PASI 75

2016 British Association of Dermatologists

115. Interventional Therapies, Surgery, and Interdisciplinary Rehabilitation for Low Back Pain

; **Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI; ††Department of Orthopedic Surgery , Stanford University, Stanford, CA; ‡‡Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, The Institute for Rehabilitation and Research, Houston, TX; §§Department of Community Health, Rhode Island Spine Center, Alpert Medical School of Brown University, Pawtucket, RI; ¶¶Department of Neurosurgery, University of Wisconsin, Madison, WI; ∥∥Department of Physical Medicine (...) and disabling low back pain are presented. From the *Department of Medicine, Oregon Evidence-based Practice Center, Oregon Health and Science University, Portland, OR; †Department of Neurological Surgery , University of Washington, Seattle, WA; ‡Veterans Affairs Medical Center, Palo Alto, CA; §Stanford University, Stanford, CA; ¶Department of Anesthesiology, University of Iowa, Iowa City, IA; ∥Medical Services,General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA

2009 Publication 1228

116. Guidelines for the Administration of Electroconvulsive Therapy

that electroconvulsive therapy is a continually evolving practice. Conclusion: The guidelines provide up-to-date advice for psychiatrists to promote optimal standards of electroconvul- sive therapy practice. Keywords Guidelines, electroconvulsive therapy, monitoring, depressive disorders, schizophrenia 1 School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Australia, Callaghan, NSW, Australia 2 School of Psychiatry, Faculty of Health and Medical Sciences, The University (...) medical conditions, a second opinion should be obtained from a psychiatrist experienced in ECT practice, as well as from the anaesthe- tist and other relevant specialists. There should be a spe- cific plan documented by the psychiatrist to address the management of medical comorbidity during ECT, which may include appropriate specialist medical support. All patients receiving ECT should be closely monitored to detect the development of any adverse physical or cogni- tive effects.4 ANZJP Articles

2019 American Psychiatric Association

117. ASTRO Guideline on Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin

ASTRO Guideline on Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin Practical Radiation Oncology (2019) Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin: An ASTRO Clinical Practice Guideline Anna Likhacheva, MD, MPH, a* Musaddiq Awan, MD, b Christopher A. Barker, MD, c Ajay Bhatnagar, MD, d Lisa Bradfield, e Mary Sue Brady, MD, f Ivan Buzurovic, PhD, g Jessica L. Geiger, MD, h Upendra Parvathaneni, MBBS (...) , i Sandra Zaky, MD, j and Phillip M. Devlin, MD, k a. Sutter Medical Center, Sacramento, CA, Department of Radiation Oncology and Task Force Vice Chair b. Medical College of Wisconsin, Milwaukee, WI, Department of Radiation Oncology c. Memorial Sloan Kettering Cancer Center, New York, NY, Department of Radiation Oncology d. Alliance Oncology, Casa Grande, AZ, Department of Radiation Oncology e. American Society for Radiation Oncology, Arlington, VA f. Memorial Sloan Kettering Cancer Center, New

2020 American Society for Radiation Oncology

118. Compression therapy after invasive treatment of superficial veins of the lower extremities

Compression therapy after invasive treatment of superficial veins of the lower extremities Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology - Journal of Vascular Surgery: Venous and Lymphatic Disorders Email/Username: Password: Remember me Search JVS Journals Search (...) Terms Search within Search Access provided by Volume 7, Issue 1, Pages 17–28 Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology x Fedor Lurie Affiliations Jobst Vascular Institute of Promedica, Toledo, Ohio University of Michigan, Ann Arbor, Mich Correspondence

2019 American Venous Forum

119. Barrett's oesophagus: ablative therapy

for Health Economics, University of York Mr Robin Beal Mr Robin Beal Consultant in Accident and Emergency Medicine, Isle of Wight Mrs Ailsa Donnelly Mrs Ailsa Donnelly Lay member Mrs Sar Mrs Sarah Fishburn ah Fishburn Lay member Dr John Harle Dr John Harley y Clinical Governance and Prescribing Lead and General Practitioner, North T ees PCT Dr Mark Hill Dr Mark Hill Head of Medical Affairs, Novartis Pharmaceuticals UK Ltd Barrett's oesophagus: ablative therapy (CG106) © NICE 2018. All rights reserved (...) Barrett's oesophagus: ablative therapy Barrett's oesophagus: ablativ Barrett's oesophagus: ablative ther e therap apy y Clinical guideline Published: 11 August 2010 nice.org.uk/guidance/cg106 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

120. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV

to the medicines used to treat HIV. ART (antiretroviral therapy) refers to the use of a combination of three or more ARV drugs for treating HIV infection. ART involves lifelong treatment. Use of ARV drugs for HIV prevention refers to the HIV prevention benefits of ARV drugs and includes ARV drugs given to the mother or infant for preventing the mother-to-child transmission of HIV (PMTCT), ARV drugs to reduce the transmission of HIV among serodiscordant couples and ARV drugs to prevent people from acquiring HIV (...) Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV GUIDELINE ON WHEN TO START ANTIRETROVIRAL THERAPY AND ON PRE-EXPOSURE PROPHYLAXIS FOR HIV SEPTEMBER 2015 GUIDELINESThis early-release guideline will form part of the updated WHO consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection due to be published in 2016.GUIDELINE ON WHEN TO START ANTIRETROVIRAL THERAPY AND ON PRE-EXPOSURE PROPHYLAXIS FOR HIV SEPTEMBER

2015 World Health Organisation HIV Guidelines

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