Medicines And Stuff: Recent Episodes
George Jiri Kempny
Creatine is a chemical found naturally in the body. It is often used to improve exercise performance and muscle.
The episode is about its use and properties.
From July 2021 trainee pharmacists are assessed against the GPhC interim learning outcomes. These describe the knowledge, skills and attributes a trainee must demonstrate by the end of their foundation training year and reflect current pharmacy practice.Source:
The Foundation Trainee Pharmacist Programme | Health Education England (hee.nhs.uk)
Sources:
https://www.hee.nhs.uk/sites/default/files/documents/Foundation%20Trainee%20Pharmacist%20Assessment%20Strategy%20v3%20June%202023%20FINAL.pdf
https://www.hee.nhs.uk/our-work/pharmacy/transforming-pharmacy-education-training/initial-education-training-pharmacists-reform-programme/foundation-trainee-pharmacist
Antiplatelet treatment is drug treatment that decreases platelet aggregation and inhibit thrombus formation in the arterial circulation. Episode includes general information about indications and recommended drug choices.
© NICE [2022] Antiplatelet treatment: Summary. Available from https://cks.nice.org.uk/topics/antiplatelet-treatment/ All rights reserved. Subject to Notice of rights
Neuropathic pain is a symptom that develops as a result of damage to, or dysfunction of, the somatosensory system.
CKS NICE provides guide on treatment options.
© NICE [2022] Neuropathic pain - drug treatment. Available from https://cks.nice.org.uk/topics/neuropathic-pain-drug-treatment/ All rights reserved. Subject to Notice of rights
The SDW 100 is a 100 mile foot race taking in the entire South Downs Way national trail. This episode is a race report summarising my experience during this fantastic event.
Content: supporting people taking a dependence-forming medicine or antidepressant, making decisions about prescribing and taking, starting, reviewing and withdrawing these medicines.
NICE guideline [NG215] Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults. Available from https://www.nice.org.uk/guidance/ng215 All rights reserved. Subject to Notice of rights
The asthma control test (ACT) is a validated symptom measure which can be used with or without peak flow monitoring to aid diagnosis and assess the impact of asthma symptoms on patients’ lives.
It can be found here:
https://www.asthmacontroltest.com/en-gb/welcome/
'© NICE [April 2023] Anaemia - B12 and folate deficiency: Summary. Available from https://cks.nice.org.uk/topics/anaemia-b12-folate-deficiency/ All rights reserved. Subject to Notice of rights
The Arc of Attrition is a point-to-point extreme coastal race taking in 100 miles of the stunning and dramatic Cornish coast-path.
Hope this episode will be useful for runners who plan to complete this race :)
Oxybutynin is a medicine used to treat symptoms of an overactive bladder. Episode contains general information about pharmacological properties, indications, side effects and dosage. Source: BNF, www.nhs.uk, EMC
Main recommendations to consider during asthma review about self-management, decreasing maintenance therapy and monitoring.
© NICE [2017] Asthma: diagnosis, monitoring and chronic asthma management. Available from https://www.nice.org.uk/guidance/ng80 All rights reserved. Subject to Notice of rights
Short episode about points to consider during initial clinical assessment in people with suspected asthma.
© NICE [2017] Asthma: diagnosis, monitoring and chronic asthma management. Available from https://www.nice.org.uk/guidance/ng80 All rights reserved. Subject to Notice of rights
Source:
© NICE [2017] Asthma: diagnosis, monitoring and chronic asthma management. Available from https://www.nice.org.uk/guidance/ng80 All rights reserved. Subject to Notice of rights
Sources:
https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/
https://ginasthma.org/gina-reports/
https://www.nice.org.uk/guidance/ng80
Yoga Nidra or Non-sleep deep rest (NSDR), is the kind of rest when the body is in a relaxed state, but the mind is still awake.
It usually involves following guided meditation that helps to slow down the brain wave frequency, similar to what happens during sleep, only that in this case person is awake.
Sources:
https://www.youtube.com/@hubermanlab
https://www.joinvitalhealth.com/blog/non-sleep-deep-rest
- VO2 max (also maximal oxygen consumption, maximal oxygen uptake or maximal aerobic capacity) is the maximum rate of oxygen consumption attainable during physical exertion.
Useful links:
https://www.runnersworld.com/uk/training/a773975/what-is-running-economy/
https://www.healthline.com/health/vo2-max
The Effect of Training Intensity on VO2max in Young Healthy Adults: A Meta-Regression and Meta-Analysis - PMC (nih.gov)
Survival of the fittest: VO2max, a key predictor of longevity? - PubMed (nih.gov)
Orlistat is a medication used to treat obesity. Episode include pharmacological properties, indication, contraindications, cautions, side effects.
Sources:
https://www.nhs.uk/
https://www.medicines.org.uk/emc/
https://bnf.nice.org.uk/
Candesartan is a medicine called angiotensin 2 antagonist widely used to treat hypertension and heart failure. Episode is description of main properties of Candesartan.
Sources:
https://bnf.nice.org.uk/
https://www.nhs.uk/
https://www.medicines.org.uk/emc/
Metformin is a medicine used mainly to treat type 2 diabetes and gestational diabetes.
Episode contains general information about pharmacological properties, indications, contraindications, side effects doses and history.
Sources:
https://bnf.nice.org.uk/
https://www.medicines.org.uk/emc
https://www.nhs.uk/
Semaglutide is an antidiabetic medication used for the treatment of type 2 diabetes. Episode includes general information about pharmacological properties, indication, side effects, contraindications and cautions.
HAS-BLED and ORBIT are tools developed to assess risk of bleeding in people taking anticoagulants for atrial fibrillation.
Available online:
https://www.mdcalc.com/
Source:
© NICE (revised in July 2022): Angiotensin-converting enzyme inhibitors. Available from https://cks.nice.org.uk/topics/hypertension/prescribing-information/angiotensin-converting-enzyme-inhibitors/ All rights reserved. Subject to Notice of rights
https://www.nice.org.uk/re-using-our-content/uk-open-content-licence#licence
Magnesium is a chemical element with the symbol Mg and atomic number 12.
It is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation. Magnesium is required for energy production, oxidative phosphorylation, and glycolysis.
Source:
https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
Digoxin is one of the oldest medications used in the field of cardiology. It was first isolated in 1930 from the foxglove plant - Digitalis lanata. Episode is about main pharmaco-therapeutical properties of Digoxin.
Alendronic acid is a type of medicine called a bisphosphonate. Bisphosphonates prevent the breakdown of bone and are used to treat osteoporosis and to prevent fractures. Episode contains information about indications, dose, side effects, contraindications and other properties of Alendronic acid.
Source:
'© NICE [2021] Hypothyroidism. Available from https://cks.nice.org.uk/topics/hypothyroidism/ All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.’
Source:
Physiology, Sleep Stages Aakash K. Patel; Vamsi Reddy; John F. Araujo.
https://www.ncbi.nlm.nih.gov/books/NBK526132/#:~:text=Sleep%20occurs%20in%20five%20stages,spent%20in%20the%20N2%20stage.
Used part of the article, no changes made.
Prochlorperazine is a medicine that belongs into the pharmacotherapeutic group called phenothiazines with piperazine structure. It is mainly used for sickness. The episode is about main properties.
Spironolactone is a type of medicine called a diuretic. This episode is about indications and main properties if this drug.
Amlodipine is a calcium channel blocker medication which helps to treat high blood pressure and angina. Episode includes indications, dosage, pharmacokinetic properties, side effects and contraindications.
FMEA is a common process analysis tool which begun in the 1940s by the U.S. military. It is a step-by-step approach for identifying all possible failures in a design, a manufacturing or assembly process, or a product or service.
Source:
https://www.nice.org.uk/guidance/ng80/resources/inhalers-for-asthma-patient-decision-aid-pdf-6727144573
Source:
'© NICE [2017] Asthma: diagnosis, monitoring and chronic asthma management
NICE guideline [NG80]Published: 29 November 2017 Last updated: 22 March 2021. Available from https://www.nice.org.uk/guidance/ng80 All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.’
Methotrexate is a type of medicine called an immunosuppressant. It slows down the body's immune system and helps reduce inflammation. The episode include pharmacological properties, indications, dosage, side effects, monitoring and cautions for use.
Losartan is a medicine widely used to treat hypertension.
Episode is about dosage, indications, side effects and other properties of Losartan.
Dapagliflozin is a medication mainly used to treat type 2 diabetes mellitus but it can also be used to treat heart failure.
This episode contains information about main properties, dosage, indications and side effects.
The Eatwell Guide represents UK government advice on a healthy, balanced diet. It is the key nutrition policy tool for health professionals and others working to improve dietary health.
Source:
https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/the-eatwell-guide/
Empagliflozin is a medication used for treatment of type 2 Diabetes and Heart failure.
This episode is about pharmacological properties, indications, dosage, contraindications and side effects.
The Global Initiative for Chronic Obstructive Lung Disease defines COPD as “a common, preventable and treatable disease that is characterised by persistent respiratory symptoms and airway limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles of gases”. This episode is about patophysiology, diagnosis and symptoms of COPD.
Dabigatran is a type of medicine known as an anticoagulant, or blood thinner. Episode contains info about pharmacological properties, indications, dosage, contraindications and side effects.
Edoxaban is a highly selective, direct and reversible inhibitor of FXa (enzyme in the coagulation cascade).
Episode contains info about pharmacological properties, indications, dosage, contraindications and side effects.
Apixaban is a type of medicine known as an anticoagulant, or blood thinner. This episode is about use, indications, dosage, side effects, contraindications and monitoring of Apixaban.
Rivaroxaban is a medication used to prevent or treat harmful blood clots. The episode includes information about pharmacological properties, indications, contraindications, side effects, cautions and prescribing considerations for dose adjustments.
The Renin-Angiotensin-Aldosterone System (RAAS) is a hormone system within the body that is essential for the regulation of blood pressure and fluid balance. The episode is a brief overview of main stages, chemicals involved and physiological effects.
Ramipril is a medication prescribed for a number of different reasons – mostly to reduce high blood pressure, to treat heart failure, or to protect the heart and blood vessels from further damage (following a heart attack, for example).
Formoterol is called a bronchodilator and it works by relaxing the smooth muscles in the airways so that air can flow into the lungs more freely. This helps to ease symptoms such as coughing, wheezing and feeling breathless. This episode is about general properties of Formoterol.
Breathing control is simply normal, gentle breathing, using the lower chest, with relaxation of the upper chest and shoulders.
Ref: https://www.blf.org.uk/support-for-you/breathlessness/how-to-manage-breathlessness
Sumatriptan is a medicine to treat migraines and cluster headaches.
The episode is about mode of action, indications, dosage, contraindications, cautions and side effects.
Assessment and treatment approach after request for Salbutamol inhaler for a patient with symptoms of allergic rhinitis.
Levothyroxine, also known as L-thyroxine, is a manufactured form of the thyroid hormone thyroxine. Episode is general overview of Levothyroxine.
Mindfulness is a state or ability of open, non-judgmental attention to the present moment and to contents of consciousness. This episode is an overview of principles and use of this practice.
Fluoxetine is a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor) and one of the most widely prescribed antidepressant drug in the world. The episode is about mode of action, indications, doses, contraindications, side effects etc.
Bisoprolol is a betablocker most commonly used for heart diseases. Episode includes mode of action, indications, dose, contraindications, interactions and side effects.
Rasagiline is a drug used in adults for the treatment of idiopathic Parkinson's disease. The episode covers main properties, mode of action, indications, contraindications, cautions, interactions and side effects.
Reference:
https://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:C:2013:343:0001:0014:EN:PDF
The MHRA is part of the Department of Health and it regulates medicines, medical devices and blood components for transfusion in the UK.
The episode is about the role of MHRA.
Amitriptyline is a tricyclic antidepressant and an analgesic. This episode is about mechanism of action, indications and dosage, contraindications, cautions for use, interactions and side effects.
Resources:
https://www.asthma.org.uk/advice/inhaler-videos/easyhaler/
https://www.rightbreathe.com/
https://www.medicines.org.uk/emc/
NHS has recently published PCNs plans for 2021/22 and 2022/23 specifying new service requirements.
One area of focus is to help create more sustainable NHS by improving inhaler prescribing.
Source:
https://www.england.nhs.uk/wp-content/uploads/2021/08/B0828-iii-annex-b-investment-and-impact-fund-21-22-22-23.pdf
Here is the link:
https://www.england.nhs.uk/publication/primary-care-networks-plans-for-2021-22-and-2022-23/
This episode is about the national protocol for the administration of Comirnaty® COVID-19 mRNA vaccine 30micrograms in 0.3ml to individuals in accordance with the national COVID-19 vaccination programme.
https://www.gov.uk/government/publications/national-protocol-for-comirnaty-covid-19-mrna-vaccine
Most commonly used Asthma guidelines in the UK are BTS/SIGN, NICE and GINA - despite largely following the same evidence base these guidelines differ in some recommendations.
Propranolol belongs to the group of medicines known as beta-blockers (non-selective). The episode is mostly about mode of action, indications, contraindications, cautions, interactions and side effects.
Sertraline is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). The episode is about mode of action, indications, dosage, contraindications, interactions and side effects.
Mirtazapine is an atypical antidepressant used primarily to treat depression. This episode is mainly about pharmacological properties, indications, contraindications, interactions and side effects.
Solifenacin is a medicine used to treat symptoms of an overactive bladder. The episode is general overview of pharmacological properties, indications, contraindications, dosage and side effects.
Peak expiratory flow is a measurement of how quickly person can blow air out of the lungs. It’s measured by a portable, hand-held device called a peak flow meter. This episode is about PEF test and use of a peak flow meter.
Useful resources:
https://www.asthma.org.uk/
https://www.blf.org.uk/
Citalopram: history, mode of action, indications, properties, contraindications, interactions, side effects.
Warfarin overview - discovery, mode of action, indications, contraindications, interactions, side effects.
Anticoagulants are medicines that help prevent blood clots.
This episode covers main types of anticoagulants, their mode of action and use.
This guideline covers diagnosing and managing atrial fibrillation in adults. It includes guidance on providing the best care and treatment for people with atrial fibrillation, including assessing and managing risks of stroke and bleeding.
'© NICE [2021] Atrial fibrillation: diagnosis and management. Available from www.nice.org.uk/guidance/ng196 All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.’
https://www.nice.org.uk/re-using-our-content/uk-open-content-licence#licence
This guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes.
'© NICE [2019] Hypertension in adults: diagnosis and management. Available from www.nice.org.uk/guidance/ng136 All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.’
Ciprofloxacin is a 2nd generation quinolone antibiotic used to treat variety of bacterial infections. This episode is about main properties of this widely used antibiotic.
The full blood count (FBC) is one of the most commonly requested tests and evaluates the types and numbers of cells in the blood: red blood cells, white blood cells and platelets.
Anticholinergic drugs are associated with increased risks of impaired cognition, falls and death in patients over the age of 65 years. Combining treatments with anticholinergics might have cumulative harmful effects when given to patients with more than one condition. Rating scales called ACB (anticholinergic burden scale) have been developed in 2008 ranking drugs according to their anticholinergic activity – it’s a practical tool for optimising prescribing for older patients. Anticholinergic burden (ACB) is calculated by totalling the scores for all anticholinergic medicines that the patient is taking. Link to ACB calculator: http://www.acbcalc.com/
Anticholinergic drugs are prescribed for a variety of conditions, including Parkinson’s disease, overactive bladder, chronic obstructive pulmonary disease, nausea and vomiting, depression, psychosis and this episode is a general overview of their effects, properties and use.
Duloxetine is a drug widely used for depression, anxiety, nerve pain and urinary incontinence.
This episode is about use and properties of this medication.
Amiodarone is a drug used to treat irregular heartbeats and this episode is about properties, indications, side effects and monitoring.
STOPP/START criteria or toolkit is a medication review tool designed to identify medication where the risks outweigh the benefits in the elderly and vice versa
STOPP/START stands for: screening tool of older person’s prescriptions and screening tool to alert to right treatment and were first published in 2008 by 18-member expert panel from academic centres in Ireland and the UK. It was reviewed, updated and expanded in 2015 for the purpose of minimizing inappropriate prescribing in older people (>65y old).
STOPP/START version 2 consists of 114 criteria (80 STOPP and 34 START criteria).
An overview of Structured Medication Reviews (SMRs) - focused on the NHS England Guidance on the implementation of SMRs by Primary Care Networks (PCNs). Link to NHS England Structured medication reviews and medicines optimisation: guidance https://www.england.nhs.uk/wp-content/uploads/2020/09/SMR-Spec-Guidance-2020-21-FINAL-.pdf
General overview of Antidepressants. Useful links for more information: https://bnf.nice.org.uk/ https://www.medicines.org.uk/emc https://cks.nice.org.uk/topics/depression/ https://www.rcpsych.ac.uk/
General overview of painkillers featuring main drug classes with individual drugs and their properties.