We bring you the latest news from the healthcare about the health care in the United Kingdom.

zondag 30 september 2018

DTB: Sildenafil - from POM to P

  • Sildenafil 50mg tablets (Viagra Connect) are available as a pharmacy medicine for use by men aged ≥18 years who have erectile dysfunction.

  • In fixed-dose studies three times as many men reported that 50mg sildenafil improved their erections compared with placebo (74% vs. 25%).

  • The market authorisation holder (Pfizer Consumer Healthcare Ltd.) has published training materials and a checklist to help pharmacists assess whether a patient is suitable for Viagra Connect.

  • As part of the assessment process, pharmacists are advised to take into consideration a patient's cardiovascular health, other medical conditions and all medicines that the patient is...

  • Sildenafil - from POM to P

    Generic name: Sildenafil

    Brand name: Viagra Connect

    Formulation: 50mg film-coated tablets

    Market authorisation holder: Pfizer Consumer Healthcare Ltd

    Indication: Viagra Connect is indicated in adult men with erectile dysfunction

    Dose: 50mg approximately one hour before sexual activity (maximum 50mg daily)

    Classification: Pharmacy medicine (P)

    Key learning points

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  • Opioids are valuable in the management of acute pain, pain related to cancer and for pain management at the end of life.

  • There is a lack of robust evidence on the benefit of long-term opioids in the management of chronic pain.

  • Inappropriate use of long-term opioids in chronic pain is associated with serious adverse effects.

  • The risk of harm from opioids increases significantly above a dose equivalent to 120 mg/day of oral morphine.

  • In conjunction with the patient, regularly review the effect of opioid treatment and consider whether there is a need to reduce the dose or stop the opioid.

    Introduction

    Chronic pain has always been and will remain difficult to manage. There have been important developments in our understanding of the neurobiology of pain, but perhaps the greatest advance is our ability to analyse trial data more...

  • Where now for opioids in chronic pain?

    Key learning points

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    Diclofenac inferior to norfloxacin for symptom relief of lower UTIs

    Review of: Kronenberg A et al. Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial. BMJ 2017; 359: j4784.

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    Ambulatory versus clinic blood pressure measurement - more evidence

    Review of: Banegas J et al. Relationship between clinic and ambulatory blood pressure measurements and mortality. New Engl J Med 2018; 378: 1509�C20.

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    Evaluation of herpes zoster vaccine programme

    Review of: Amirthalingam G et al. Evaluation of the herpes zoster vaccination programme 3 years after its introduction in England: a population-based study. Lancet 2018; 3: e82-90.

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    Improving adherence to medicines in people with heart disease

    Review of: Fuller RH et al. Improving medication adherence in patients with cardiovascular disease: a systematic review. Heart 2018;104:1238-43.

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    AF screening: who is calling the tune?

    In 2014, the UK National Screening Committee recommended against population screening for asymptomatic atrial fibrillation (AF) in those over the age of 65 years.1 The committee's decision was informed by concerns over suboptimal treatment pathways for AF, the need for more evidence over whether AF detected at screening carries the same long-term risk of stroke as AF found in the context of other conditions, and uncertainty over the cost-effectiveness of screening. A Cochrane review, published in 2016, concluded that there was moderate-quality evidence from one study that systematic and opportunistic screening of people aged 65 years and over increased the rate of detection of new cases of AF compared with normal practice.2 It is important to note that the screening trial (conducted between 2001 and 2003) was not designed to assess improvements in clinical outcomes associated with screening.3 There is a paucity of...

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