All Guidance

For the symptomatic treatment of chronic stable angina or chronic heart failure Information for prescribers - to be read in conjunction with the SPC

The Lancashire and South Cumbria Self-Care and Access to OTC Medicines – Template policy has been developed for use by care homes in Lancashire and South Cumbria. The policy must be reviewed by each care home for suitability and finalised prior to use.

This policy MUST be read in conjunction with the local or care home medicines policy

Treatment of active rheumatoid arthritis and active psoriatic arthritis.

Please note: a standard operating procedure for switching Keppra preparations to generic levetiracetam preparations is available in support of the position statement below. This is for use by practice supporting pharmacy teams across Lancashire and South Cumbria ICB ONLY

For the treatment of pneumonia or complicated skin and soft tissue infections on the recommendation of a microbiologist when used as a 10-14-day course 

**Please refer to attached prescriber information sheet for more detail prior to prescribing**

Licensed Indications

1. In the management of acute mania or hypomanic episodes
2. In the management of episodes of recurrent depressive disorders where treatment with other antidepressants has been unsuccessful
3. In the prophylaxis against bipolar affective disorders
4. Control of aggressive behaviours of intentional self-harm.

This guidance has been produced to facilitate the safe prescribing of LMWHs in primary care. It provides an overview of points to be considered when initiating LMWHs and when transferring prescribing responsibilities to or from another organisation.

LSCMMG have developed a menopause product relative price list to be used in conjunction with the LSCMMG primary care management of menopause guideline - available below. 

This is a summary document intended for Primary Care, taken from a more comprehensive document ‘Guidelines for the Management of Behavioural and Psychological Symptoms of Dementia (BPSD) in Primary and Secondary Care. This document should be accessed for additional resources such as the Leaflet for Care Home Staff, assessment forms and flow chart for responding to BPSD.

Information contained within this document is largely taken from the PrescQIPP toolkit ‘Reducing Antipsychotics in Dementia and documents available on the Alzheimer’s Society website.

This guideline comprises a flow chart outlining a stepwise approach to the management of psoriasis in adults and in children and young people. The guideline also includes relevant treatment review periods and referral criteria.

Rheumatoid arthritis, severe psoriasis, severe active juvenile idiopathic
arthritis, severe psoriatic arthritis, mild to moderate Crohn’s disease
Unlicensed: Severe Eczema, Lichen Planus, Felty’s syndrome, severe Crohn’s disease

N.B. Not all brands/formulations are licensed for all indications – please refer to individual SPCs

This protocol only applies to the unlicensed indications listed below. Transplant protocols should be followed for licensed indications.

Unlicensed: Severe rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, connective tissue diseases with severe / organ-threatening manifestations, interstitial lung disease (not to be used in idiopathic pulmonary fibrosis IPF), vasculitidies, as maintenance post cyclophosphamide in patients for whom azathioprine is contra-indicated or is inappropriate.

For Nebulisation in Adult Patients with Non-Cystic Fibrosis Bronchiectasis

• Age related Macular Degeneration   

• Diabetic Macular Oedema 

• Macular Oedema secondary to Central Retinal Vein Occlusion

• Macular Oedema secondary to Branch Retinal Vein Occlusion

• CNV associated with pathological myopia

• Vitreomacular Traction