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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 15: Anaesthesia - Full Chapter
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15.01.03  Expand sub section  Antimuscarinic drugs
Atropine
(injection)
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Formulary
Red
At SFH available as:
- Injection 600micrograms in 1mL
- 1mg in 5 ml prefilled syringe.
 
   
Glycopyrronium
(injection - palliative care)
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Formulary

Injection (200micrograms in 1mL and 600micrograms in 3mL)

  • for palliative care use as a 2nd line option after hyoscine (APC Jan 15). Other indications are classified
  • For information on use in hypersalivation or hyperhidrosis see other entries.
  • May be used in palliative care if supply problems with hyoscine. 20mg hyoscine butylbromide is approximately equal to 200micrograms of glycopyrronium.
 
Link  Link to reviews
   
Hyoscine Hydrobromide
(injection)
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Formulary
Amber 2

Injection 400micrograms in 1mL

  • Amber 2: Palliative care use although hyoscine butylbromide generally preferred (less sedating and less expensive).
  • See section 4.6 for sublingual/patch hypersalivation treatment information.
 
Link  SFH: Hyoscine butylbromide rather than hydrobromide memo (October 2002)
   
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Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Grey

Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
  

Red

Medicines which should normally be prescribed by specialists only. eg hospital only.
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
  

Amber 1

Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
  

Amber 2

Medicines suitable to be prescribed in general practice after specialist* recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
*Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
  

Amber 3

Primary care/ non specialist may initiate as per APC guideline.
The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
  

Green

Medicines suitable for routine use within primary care.
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

OTC

  

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