Www.northernlincolnshireapc.nhs.uk



Chapter 2: Cardiovascular system2.1 Positive Inotropic Drugs2.1.1 Cardiac GlycosidesNice CG180 Atrial FibrillationRemain on formulary Remove from formulary Other Information Digoxin Tablets, Elixir, InjectionG *Npsa alert Guidelines for preventing fatalities from medication loading does *Bioavailabilities are Injection 100% Liquid80% Tablets 70% Digoxin 500micrograms/ml injectionRed Digoxin 100micrograms/ml injection. Hospital, Paediatrics Only (SP)RedHospital paediatrics only.2.1.2 Phosphodiesterase Type-3 InhibitorsRemain on formularyRemove from formularyOther InformationEnoximone 100mg/20ml Injectionred2.2 Diuretics2.2.1 Thiazides and Related DiureticsNice cg127: hypertension: clinical management of primary hypertension in adults Remain on formulary Remove from formularyOther InformationBendroflumethiazide TabletsgIndapamide 2.5mg TabletsgIndapamide 1.5mg SR TabletsRemove *Possibly used in stroke –dr banargee*Chlortalidone 50mg TabletsRemoveMetolazone Tablets. Consultant?Only (unlicensed medicineChlorothiazide 250mg/5ml Suspension. Hospital, Paediatrics Only (U)Hospital / paediatrics only 2.2.2 Loop DiureticsRemain on FormularyRemove from formularyOther InformationFurosemide Tablets, LiquidTablets and Liquid formulary.- Green Furosemide Injection Bumetanide Tablets, Bumetanide tablest Green Bumetanide injectionInjection is discontinued in UK – but unlicenced import can be found 2.2.3 Potassium-Sparing Diuretics and Aldosterone AntagonistsRemain on Formulary Remove from formulary Other InformationSpironolactone Tablets, SuspensionGreen1st choice Amiloride TabletsGreenTriamterene CapsulesRemove Eplerenone Tablets. Hospital, Consultant OnlyWas red / now possibly amber? Green Restricted use Second line in those intolerant to spironolactone Propose amber (no shared care protocol.- disc at APC -2nd line after spiro has been trialed Criteria 2.2.4 Potassium-Sparing Diuretics with Other DiureticsRemain on FormularyRemove from FormularyOther InformationCo-amilofruse (amiloride/furosemide) TabletsCo-amilozide (amiloride/hydrochlorothiazide) TabletsremoveTriamterene/Furosemide TabletsremoveAmiloride/Bumetanide TabletsremoveSpironolactone/Furosemide Capsules Primary care initiated, only when necessaryremove2.2.5 Osmotic DiureticsRemain on FormularyRemove from FormularyOther InformationMannitol Infusionred2.2.8 Diuretics with PotassiumRemain on Formulary Remove from Formulary Other InformationFurosemide/Potassium Tablets. Primary care initiated, only when necessaryRemove from formulary 2.3 Anti-Arrhythmic Drugs2.3.2 Drugs for ArrhythmiasRemain on Formulary Remove from Formulary Other InformationAmiodarone Tablets, InjectionInjection hospital only Flecainide Tablets, Syrup, Tablets as amber Syrup as red and restricted Injection is red Restricted use of syrups Stipulation on when syrup can be used. Flecainide injectionyesDisopyramide CapsulesyesDisopyramide MR TabletsyesPropafenone TabletsyesDronedarone Tablets. Hospital OnlyyesMexiletine Capsules, Injectionyes**need to add on net formulary** no format for it yetAdenosine InjectionyesProcainamide InjectionyesLidocaine InjectionyesAjmaline Injection 50mg/10ml. Consultant cardiologist only for diagnosis of Brugada syndromeyes**need to add on net formulary** no format for it yet2.4 Beta-Adrenoceptor Blocking DrugsRemain on FormularyRemove from FormularyOther InformationAtenolol Tablets, SyrupGreen Injection is red Atenolol InjectionyesBisoprolol TabletsyesPropranolol TabletsyesPropranolol Oral solutio, SR CapsulesGREEN ACCEPT INJECTION IS RED AND SR capsules we are proposing as restricted use Propranolol Injection yesCarvedilol TabletsyesSotalol TabletsyesMetoprolol TabletsyesNebivolol TabletsAmber restricted as still used Better effect less side effects worsening of peripheral vascular disease . or plasmatic problemLabetalol TabletsyesCeliprolol TabletsyesCo-tenidone TabletsyesRemoveOxprenolol TabletsyesRemove Labetalol InjectionyesEsmolol Injection / Infusionyes2.5 Hypertension and Heart Failure2.5.1 Vasodilator and Antihypertensive DrugsRemain on FormularyRemove from Formulary Other InformationHydralazine Tablets, yesHydralazine Injection yesMinoxidil TabletsyesDr thakray wants it as amber but to be discussed with clinical leads of NLCC Sodium Nitroprusside Injectionyes2.5.2 Centrally Acting Antihypertensive DrugsRemain on Formulary Remove from Formulary Other InformationMethyldopa TabletsyesMoxonidine TabletsyesClonidine Injection, TabletsyesClonidine tablets yes2.5.3 Adrenergic Neurone Blocking DrugsRemain on Formulary Remove from formularyOther InformationGuanethidine Injectionyes2.5.4 Alpha-Adrenoceptor Blocking DrugsRemain on formulary Remove from Formulary Other InformationDoxazosin TabletsyesTerazosin TabletsnoNo useage data in secondary care – clarify primary care data.. potentially removePrazosin TabletsyesIndoramin TabletsyesPhenoxybenzamine Capsules, InjectionyesPhentolamine Injection. Hospital Onlyyes2.5.5 Drugs affecting the Renin Angiotensin System2.5.5.1 Angiotensin Converting Enzyme InhibitorsRemain on FormularyRemove from FormularyOther informationRamipril Tablets, CapsulesGreen Lisinopril TabletsyesEnalapril TabletsyesCaptopril Tablets,yesCaptopril Oral solution Yes- restricted Perindopril Tabletsyes2.5.5.2 Angiotensin-II Receptor AntagonistsRemain on FormularyRemove from FormularyOther InformationLosartan TabletsyesValsartan Capsules, TabletsyesIrbesartan TabletsyesOlmesartan TabletsRemove Candesartan TabletsyesValsartan with Hydrochlorothiazide CapsulesRemove 2.5.5.3 Neprilysin Inhibitors with Angiotensin-II Receptor AntagonistsRemain on FormularyRemove from FormularySupportingInformationSacubitril-Valsartan Tablets. As Per NICE TA388. Specialist Initiation Only. Patient must be stabilised?before primary care prescribing. See PathwayRed Working towards amber with no shared care yes agreement Hypertension and Heart Failure MiscellaneousRemain on FormularyRemove from FormularySupport InformationTolazoline Injection. Hospital, Paediatrics Only (S)red2.6 Nitrates, Calcium Channel Blockers and Potassium Channel Activators2.6.1 NitratesRemain on Formulary Remove from FormularySupporting InformationIsosorbide Mononitrate TabletsyesGlyceryl Trinitrate TabletsyesGlyceryl Trinitrate Injection yesGlyceryl Trinitrate Spray yesGlyceryle trinitrate patches yesPatches to be kept as red and restricted Glyceryl trinitrate ointment Isosorbide Dinitrate Injectionyes2.6.2 Calcium Channel BlockersRemain on FormularyRemove from FormularySupporting InformationAmlodipine Tabletsyes1st choice Nifedipine Capsules, MR Tablets. Prescribe by BrandyesFelodipine MR Tablets2nd line but dr thakray agreed for it to be removed from the formulary Diltiazem MR (12hour) Tablets, Capsules. Prescribe by brandyesDiltiazem XL (24 hour) Capsules. Prescribe by brandyesVerapamil Tablets, MR CapsulesyesVerapamil injectionyesLacidipine TabletsyesLercanidipine TabletsRestricted use Is it more cost effective then felodipine Nicardipine Capsules, MR TabletsQuery with renal failure pts*Nimodipine Tablets,yesNimodipine injection yes2.6.3 Other Antianginal DrugsRemain on formularyRemove from formularySupporting information Nicorandil TabletsyesIvabradine Tablets. Consultant Initiation OnlyyesRanolazine MR Tablets. As Agreed Pathwayyes2.6.4 Peripheral Vasodilators and Related DrugsRemain on FormularyRemove from FormularySupporting InformationNaftidrofuryl oxalate CapsulesNice guidance Pentoxifylline 400mg MR Tablets. Consultant Immunologist Initiated for BehcetsNB No restrictions for licenced indications.Speak to hazel around commissioning and if dr sull still uses it Amber Rutosides CapsulesCilostazolInositol nicotinate Tablets2.7 Sympathomimetics2.7.1 Inotropic SympathomimeticsRemaining on FormularyRemove from FormularySupporting InformationDopexamine 10mg/ml InjectionYes Dobutamine InjectionYes Dopamine InjectionYes 2.7.2 Vasodilator SympathomimeticsRemaining on FormularyRemove from formularySupporting informationEphedrine Injection. Hospital OnlyYes Noradrenaline (Norepinephrine) Injection. Hospital OnlyYes Metaraminol Injection. Hospital OnlyYes Midodrine Tablets (U, S).. Specialist Initiated OnlyYes 2.7.3 Cardiopulmonary ResuscitationRemain on formularyRemove fom formularySupporting InfomationAdrenaline (Epinephrine) InjectionYes2.8 Anticoagulants and Protamine2.8.1 Parental AnticoagulantsRemain on FormularyRemove from formularySupporting informationTinzaparin SyringesLeave as red Discussion with apc Fondaparinux Sodium Acute Coronary SyndromeYes Epoprostenol InjectionYes Heparin InjectionYes Heparin flush InjectionYes Heparinised Saline InjectionYes Iloprost Injection (NP, U)Yes Lepirudin Injection. Hospital OnlyYes TauroLock. Hospital, Chemotherapy OnlyYes Bivalirudin. Hospital Only NICE TA230Yes 2.8.2 Oral Anticoagulants ?Remain on FormularyRemove from FormularySupporting informationWarfarin TabletsDabigatran Capsules – Available for all appropriate NICE Technology Appraisals. See Pathway for TA AdviceRivaroxaban Tablets – Available for all appropriate NICE Technology Appraisals. See Pathway for TA AdviceApixaban Tablets ?– Available for all appropriate NICE Technology Appraisals. See Pathway for TA AdviceEdoxaban? – Available for all appropriate NICE Technology Appraisals. See Pathway for TA AdvicePhenindione TabletsAcenocoumarol2.8.3 Protamine SulphateRemain on formularyRemove from formularySupporting informationProtamine sulphate injectionyes2.8.4?Anticoagulation Reversal OptionsRemain on formularyRemove from formularySupporting informationIdarucizumab Injection. Hospital Only. For reversal of dabigatran anticoagulation only. Not suitable for Anti Xa agentsyes2.9 Antiplatelet DrugsRemain on formularyRemove from formularySupporting InformationAspirin Soluble TabletsyesClopidogrel TabletsyesDipyridamole MR Capsules, yesDipyridamole SuspensionyesDipyridamole injection yesAspirin & Dipyridamole MR Capsules (Asasantin Retard)yesPrasugrel Tablets. As per cardiac network protocolsyesTicagrelor Tablets. As per cardiac network protocols – TA420yesEptifibatide Injection. Hospital OnlyyesTirofiban Injection. Hospital OnlyyesAbciximab Injection. Hospital Onlyyes2.10 Stable Angina, Acute Coronary Syndromes and Fibrinolysis2.10.2 Fibrinolytic DrugsRemain on formularyRemove from formularySupporting informationAlteplase Injection. Hospital OnlyyesStreptokinase Injection. Hospital OnlyyesTenecteplase Goole. Hospital OnlyyesUrokinase Injection. Hospital Onlyyesi) Tranexamic Acid Tablets, InjectionyesTranexamic acid injectionyes ii) Etamsylate Tablets iii) Factor VIIa (Novo-seven)yes iv) Octaplexyes2.12 Lipid-Regulating DrugsRemain on formularyRemove from formularySupporting InformationSimvastatin TabletsyesAtorvastatin TabletsyesPravastatin TabletsyesEzetimibe TabletsLimited clinical value, but coming off patent soon therefore will be cheaper Discuss with clinical lead and propose it becomes non formulary Rosuvastatin TabletsKeep as red- working going on about changing about changing patients from rosuvastatin to atorvastatin – propose green restricted restricted -Bezafibrate TabletsyesBezafibrate MR TabletsyesColestyramine SachetsyesFish oils (Maxepa) CapsulesGemfibrozil Tablets, CapsulesNicotinic Acid TabletsAlirocumab Pre-Filled Pen 75 mg only ?(NICE TA 393)yesAnootate has high costs Evolucamab nice ta yesAnnotate as high cost 2.13 Local sclerosantsRemain on formularyRemove from formularyEthanolamine Oleate Injection. Hospital OnlyyesPhenol in Oil Injection. Hospital OnlyyesPhenol in Water Injection. Hospital OnlyyesSodium Tetradecyl Sulphate Injection. Hospital Onlyyes2.14 Drugs affecting the ductus arteriosusRemain on formularyRemove from formularySupporting Information Ibuprofen Injection (Pedea). Hospital Only (U)yesOther drugs used in diagnosticsRemain on formularyRemove from formularySupporting informationAcetylcysteine Effervescent Tablets 600mg. Hospital Only (U)yes ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download