nhs forth valley formulary 11 - Community Pharmacy

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Forth Valley Formulary Eleventh Edition 2012/13Appendix 4Forth Valley Acute Hospitals ServicesGuidelines For The Management Of Constipation In AdultsMode of action Preparation/Dose Time toeffectAcute constipationHard impaction Osmotic Micro-enema1 at nightOsmoticPhosphate enema1 in the morningOsmotic Laxido® 8 sachets in 1litre water over 6hoursStimulantSodium picosulphate (Picolax)Half to one sachet as requiredSoft impaction Stimulant Senna2-4 tablets at night Max 3 times a weekChronic constipation Bulk former Fybogel1 sachet twice a dayOpioid-inducedconstipationStimulantOsmoticOsmoticSoftener andstimulantStimulantSenna2-4 tablets at night Max 3 times a weekLaxido®1 sachet 2-3 times a day(elderly once daily)Lactulose10mls BDCo-danthramersuspension 5-10ml at nightSenna2-4 tablets at nightPage 54Price perday(£)15-30mins 0.41 Step <strong>11</strong>5-30mins 0.46 Step 2Additional info.1.85 Elderly pts.Max 3 days therapy3 hours 1.98 Stat dose to restore normal bowelfunction.Repeat as necessary8-12 hours 0.03-0.06 7 day course to restore normalbowel functionAvoid in Abdominal obstruction,acute surgical abdo, acute IBD andsevere dehydration1 -2 days 0.14 Mix with 1/4 pint of water and takeafter meals.Avoid in immobile, chronically ill anddisabled patientsCaution in atonic bowel, impactionand intestinal obstruction8-12 hours 0.03-0.06 Adjust to response.Avoid in Abdominal obstruction,acute surgical abdo, acute IBD andsevere dehydration0.47-0.70 Patients unable to tolerateFybogel/sennaReview after 2 weeks treatment. Canbe continued in resistant cases.Maintenance dose: 1sachet per dayor alternate days.24-48 hours 0.286-12 hours 0.19-0.38 Palliative care patients only8-12 hours 0.03-0.06 Non-palliative care patientsAvoid in Abdominal obstruction,acute surgical abdo, acute IBD andsevere dehydrationRefer to specialist in cases of chronic unresponsive constipation. Pharmaicst Lead: Pauline Morrison
Forth Valley Formulary Eleventh Edition 2012/13Appendix 5Forth Valley Lipid Lowering Guidelines v4 May 2010This guideline applies to people over 16 years of age. This guideline is not intended to serveas a standard of medical care or be applicable in every situation. Decisions regarding thetreatment of individual patients must be made by the clinician in light of that patient’spresenting clinical condition and with reference to current good medical practice.Date May 2010Date of Review May 2012AuthorL CruickshankFalkirk <strong>Community</strong> Health PartnershipAcute HeadquartersWestburn AvenueFalkirk FK1 5SDTel. (01324) 614651Page 55
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nhs forth valley formulary 11 - Community Pharmacy

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