(精选)Prescribing Leads Clinical Update教学课件.pptVIP

Significant traffic light updates -BLACK Insulin glargine 300 units per ml (Toujeo) - BLACK Not bioequivalent to Lantus Potential for confusion due to different strength Evolocumab – BLACK Human monoclonal antibody, SC injection for hypercholesterolaemia and FH. NICE TA expected April 16 Significant Safety Updates Drug safety Update – Sep 15 Proton Pump Inhibitors – very low risk of subacute cutaneous lupus erythromatosus. SCLE is a non-scarring dermatosis that can develop in sun-exposed areas accompanied by arthralgia. Drug induced SCLE can occur weeks, months or years after exposure to the drug. Affected patients should be advised to avoid exposure to sun-light and stop PPI if possible (and avoid future PPI treatment). Symptoms usually resolve with PPI withdrawal. Topical or systemic steroids may be required if symptoms don’t resolve after a few weeks or months. Drug safety Update – Sep 15 Yellow Card App Can be used to easily report suspected adverse drug reactions. Can also create a watch list of medicines of interest and receive regular updates and alerts. Drug safety Update – Oct 15 Mirabegron – risk of severe hypertension and associated cerebrovascular and cardiac events. Mirabegron is a beta-3 adrenoceptor agonist used in over-active bladder syndrome. Already known that mirabegron can increase blood pressure, but cases of severe hypertension have been reported including reports of TIA or stroke. Mirabegron is now contra-indicated in patients with uncontrolled hypertension (systolic ≥ 180 or diastolic ≥110 or both). Use with caution in patients with stage 2 hypertension (systolic ≥ 160 or diastolic ≥100) Drug safety Update – Oct 15 Blood pressure should be measured before starting treatment and regularly during treatment, especially in patients with hypertension. Reminder that in patients taking strong inhibitors of cytochrome P450 e.g. itraconazole, ketoconazole, ritonavir or clarithromycin, mirabegron is not recommended if eGFR is below 30ml/min and