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Antiplatelets and anticoagulation in stroke - …
Ischaemic Stroke + AF Definite TIA + AF (no acute changes on CT and no residual neurological deficit) STOP WARFARIN, DABIGATRAN, APIXABAN if already taking for AF Consultant before stopping. Give: Aspirin 300mg daily for 2 weeks Initiate warfarin if no contra-indications: Start with 2mg daily for one week Aim for INR 2-3. Continue aspirin until
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Phosphate replacement IV - clinical guideline
mm.wirral.nhs.ukPhosphate replacement (intravenous) Approved as part of the Medicines Guide Review: Nov 2011 Clinical guideline Phosphate replacement (intravenous)
Therapeutic drug monitoring - mm.wirral.nhs.uk
mm.wirral.nhs.ukTherapeutic drug monitoring — Medicines Formulary, Version 7 Principal Author: Gareth Malson Updated with approvals from Wirral Drug and Therapeutics Committee: Nov 2010 Review: Nov 2013
Heart failure: Managing newly diagnosed and …
mm.wirral.nhs.ukHeart failure — managing newly diagnosed and decompensated patients in acute care — clinical guidelines, v1 Principal author: Dr P Saravanan Approved by Medicines Clinical Guideline Team: July 2013 Review by: July 2016 Page 1 of 27 If current Diagnosis confirmed by ...
Clinical guideline Massive pulmonary embolism ...
mm.wirral.nhs.uk6. If thrombolysis is contraindicated or not suitable, contact the on call thoracic surgeons at Liverpool Heart and Chest Hospital (Options: Surgical embolectomy / interventional embolectomy /clot fragmentation) References 1. British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group.
MHRA recommendations on simvastatin interactions: …
mm.wirral.nhs.ukMyopathy is an adverse effect associated with statins. The risk of myopathy increases with higher plasma levels ... • Use 40mg simvastatin or drug of similar efficacy and acquisition cost. ... Comparative costs for 28 days treatment (Drug Tariff September 2012) Amlodipine 10mg . Simvastatin 40mg .
Clinical Guideline Pain Management
mm.wirral.nhs.ukContinuous pain warrants continuous analgesia, avoid prescriptions for when required analgesia. Prescribe a regular dose. Intermittent pain warrants intermittent analgesia. Patients should have their pain control regularly assessed. Consider new presentations of pain eg: neuropathic pain - see Neuropathic Pain Guidelines.
STOPP START Tool to Support Medication Review
mm.wirral.nhs.ukother drug interactions or contra-indications not listed here. The final decision to stop the drug should be weighed against the daily symptomatic benefit or prevention of rapid worsening of symptoms. Where there is any doubt with the above information please check that it is in line with
VTE prophylaxis Trauma and Orthopaedics
mm.wirral.nhs.ukj) Lumbar puncture/epidural/spinal anaesthesia expected within the next 12 hours k) Lumbar puncture/epidural/spinal anaesthesia within the previous 4 hours l) No identified bleeding risk 2. Treatment recommendations Once the assessment form has been completed, the system will recommend a treatment
Wound dressings - Guidance for use
mm.wirral.nhs.ukDo not use in the presence of wound infection, unless an appropriate systemic antibiotic is given concurrently. Not appropriate for use on cavity wounds in the absence of a cavity filler. Dressings must be removed prior to radiation treatment (X-rays, ultrasonic treatment, diathermy and microwaves). Dressing change.
Melatonin for children
mm.wirral.nhs.ukAvailability: 2mg modified release tablets Circadin ® are available from local wholesaler, produced by: Flynn Pharma Limited, Alton House, 4 Herbert Street, Dublin 2, Republic of Ireland. Telephone +44 (0)1438 727 822. Cost of Circadin ® 2mg is £10.77 for 21 x 2mg tablets. 3mg capsules of melatonin are available from various suppliers.
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2-way cartridge valves, directional functions
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INSTALLATION MANUAL 25, 30, 40, 50 and 60 HP (4-Stroke)
www.motooff.ru25, 30, 40, 50 and 60 HP (4-STROKE) INSTALLATION MANUAL Page 4 of 26 Steering Cable Seal 1. Mark tilt tube 1/4 in. (6.4 mm) from end. Install seal components.
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INSTALLATION MANUAL 75, 90 AND 115 HP (4-Stroke)
www.motooff.ru25 in. (635 mm) for L models, 30 in. (762 mm) for XL models. Mounting the outboard higher may cause damage to the gear case components. NOTICE TO INSTALLER IMPORTANT (e) e a. b. a c b d c. d. e. Outboard Mounting Height (See NOTE Below) 75, 90 and 115 (4-STROKE) INSTALLATION MANUAL Page 5 of 18 Installing Outboard Determining Recommended ...