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Clinical Focus

Children's spacers for the treatment of asthma: Top 10 tips

The purpose of the spacer device is to act as an intermediary chamber into which a pressurised metered dose inhaler (pMDI) can discharge the drug. This slows down the drug, which is propelled at force...

Drug interactions and hormonal contraception

CYP450 enzymes increase clearance of contraceptive hormones, making them less effective. This includes all combined hormonal contraceptives, all progestogen-only pills (POP), the etonogestrel implant...

Maintenance And Reliever Therapy (MART) for young people with asthma

MART as a regimen works because it allows for automatic self-titration. By its very nature, the patient will take more ICS doses when they are symptomatic and default to baseline (preventer therapy...

Medication for hypertension management

NICE (2019a) recommends a clinic BP target of below 140/90 mmHg or a home BP target of 135/85 mmHg. In people over the age of 80 years, a higher cut-off point of 150/90 mmHg in clinic, or 145/85 mmHg...

Supporting children, young people and families with eczema

Effective treatment of eczema demands good self-management which, if established early on, can lead to considerable improvements in quality of life (Ridd et al, 2017). Self-management can be...

Prescribing typhoid vaccines in the UK

Typhoid is almost exclusively transmitted by eating or drinking food and water contaminated with human faeces and urine from infected people or carriers. In addition, shellfish taken from...

Non-medical prescribing in mental health services

The alcohol liaison service in an inner-London hospital has developed a nurse-led service model to meet the needs of the patient population it serves. Experienced non-medical prescribers deliver the...

An evidence-based guide to smoking cessation therapies

Smoking is the single most preventable cause of premature mortality (Department of Health (DH), 1998; 2000). In recent decades, the UK government has introduced a range of initiatives to reduce...

Managing side effects of contraception

There are 14 methods of contraception, and side effects are usually associated with hormonal and intrauterine methods. These methods will now be considered individually by method, exploring the...

Pharmacological management of irritable bowel syndrome

Diagnosis of IBS can be challenging due to the wide range of symptoms patients may experience, and there are various triggers exacerbating symptoms, which can vary over time. There may also be no...

Prescribing for depression in primary care

Depression is mainly managed in primary care settings (Arroll et al, 2016). Treatment delivered in this setting include non-medicinal treatments and medication..

Managing infant and child skincare

Skin is a dynamic organ that performs several functions (Oranges et al, 2015). The skin has three layers: the epidermis, the dermis and the hypodermis. The main function of the epidermis is to act as...

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