NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update Acute

Therapeutics Handbook for Adults: Update March 2016

Since August 2015 the content of the Therapeutics Handbook has only been available online via the GGC Medicines website and the App.  This allows greater flexibility to update guidelines during the year rather than at one point in time for all. All guidelines are still reviewed annually but at different set times over the course of the year.  Some of the main changes from this first review period are outlined below. 

  • Cardiopulmonary resuscitation and peri-arrest arrhythmia: updated treatment algorithms from the Resuscitation Council (UK).
  • Decompensated liver disease: more detailed advice on the management of ascites with paracentesis. (For the management of malignant ascites see separate guideline).
  • Constipation: includes guidance (and the associated Formulary restrictions) on using linaclotide for patients with constipation associated with moderate to severe irritable bowel disease.
  • Severe exacerbation of inflammatory bowel disease: patients with low haemoglobin should no longer be transfused.  The current advice is to replace deficient haematinics and to discuss the use of parenteral iron with specialists.
  • Reversal of anticoagulant therapy:  The reversal of antiplatelet therapy section has been updated with further advice on when to administer platelet transfusions to patients with a life-threatening bleed whilst on combination antiplatelets.
  • Warfarin use in the peri-operative period: guideline rewritten to reflect changes to both the risk statification groups and the dosing schedule for LMWH. The layout has also been changed to improve readability.
  • Management of hypomagnesaemia:  magnesium aspartate dehydrate (Magnaspartate®) is the first licensed oral preparation and is now the preferred product for oral replacement.

 Please note: 

  1. Minor updates have also been made to other sections and users are encouraged to familiarise themselves with the sections relevant to their area of practice.

  2. Access the App via the Apple App Store or Google Play (the username and password required upon instillation of the App can be found on the Clinical Info page of StaffNet).