Crisis response 0161 716 3806
Crisis team CMHT [home treatment] 0161 778 2094
Mile Lane pharmacy 0161 764 5054
Netpharm 0161 764 4401

Bury Coroner's Office 01706 924815

Hope Hospital 0161 789 7373
more


 

Advice  report any possible side effects to the doctor. If you develop a blistering skin rash, or jaundice (yellowing of your skin or the whites of your eyes), you should speak with your doctor straightaway. These are rare but possibly serious side-effects of terbinafine.

If you GAIN 2kg [about 4 pounds] in weight
  in 2 days
then let the doctor know straight away
You may also be able to double your water tablets
if that happens.

Drinking orange juice or taking other vitamin C-containing foods with 
iron tablets can help you absorb them better.
Avoid taking tea until 2 hours after a meal containing iron, where possible. 
 
You should take iron for a few months. 
This will build up your stores of iron in your body. 
You may need a blood test after having had iron for a few months.

Some people have side-effects like nausea,constipation, or diarrhoea. 
Speak to the doctor if these are troublesome. 
To try and reduce side-effects try:
 - taking the tablets with meals. [Food reduces iron absorption so a longer
course will then be needed]
 - taking a lower dose or miss some days out [a longer course will then be
needed]
 - drinking plenty of fluids.

Iron tablets may make your stools black. This is sometimes confused with blood 
in the stools from internal bleeding, which can also make your stools black. 
If you suspect a bleed speak to the doctor
 
IMPORTANT - Iron tablets are dangerous for children. Store them safely. 

Foods that contain iron include:

• Red meat
• Egg yolks
• Dark, leafy greens 
• Dried fruit (prunes, apricots,  raisins)
• nuts
• Iron-fortified cereals and 
• wholegrains e.g. brown rice
• Molluscs (oysters, clams, scallops)
• Beans, lentils, chick peas and soybeans
• Liver
• Artichokes

  →  Back to the top

Caution: susceptibility to osteoporosis.
Assess bone mineral density before treatment and at regular intervals.

Start malarone 1or 2 days before entering endemic area and continue until 1
week after leaving,
Remember the importance of avoiding mosquito bites and taking your
prophylaxis regularly
See a doctor immediately if you fall ill within 1 year and especially within
3 months of return.

Ultrasound scan referral form

[Reports of blood dyscrasias (including fatalities) and liver cirrhosis with low-dose methotrexate]
 
Check full blood count and renal and liver function tests [FBC, U+E, LFT]
before starting treatment and 
every 1 to 2 weeks until therapy stabilised, 
then every 2 to 3 months 
 
Advice to patients from patient.co.uk - 
Important: If you develop any of the following, let your doctor know straight away:

 * Sore throat, unusual bruising, mouth ulcers
 * Sickness, abdominal pain, dark urine
 * Shortness of breath, cough

Safe prescribing of methotrexate [bury] 

There is a temporary supply problem with some isosorbide mononitrate tablets.
We will be prescribing an alternative but the total daily dose may change.
If you get symptoms, we may need to alter the dose, so please let us know.
If you are unsure about any of this, please check with the pharmacist or doctor.

Take this tablet as soon as possible. 
Please inform a clinician if you vomit within 2 hours of this tablet [this
doesn't happen often].
Your next period may be late.
Use a barrier method till your next period.
Contact a clinician if you get any lower abdominal pain [ectopic pregnancies
can occur infrequently].
See a clinician in 3-4 weeks if your next period is unusual [lighter,
heavier, short, missed or if there is any doubt about your period - in this
case a pregnancy test may be needed].
Please consider a long acting reversible method of contraception such as the
pill, injection, implant or coil.

For further guidance click here.

[NB- Before initiating treatment with pioglitazone, patients should be assessed for risk factors of bladder cancer (including age, smoking status, exposure to certain occupational or chemotherapy agents, or previous radiation therapy to the pelvic region) and any macroscopic haematuria should be investigated. The safety and efficacy of pioglitazone should be reviewed after 3–6 months and pioglitazone should be stopped in patients who do not respond adequately to treatment.

Patients already receiving treatment with pioglitazone should be assessed for risk factors of bladder cancer and treatment should be reviewed after 3–6 months, as above.]

 As well as a blood test, he will also need to have a rectal examination.
 Screening can fail to detect some prostate cancers.
 If test positive → will need a biopsy [can be painful and risk of infection and bleeding in approx 11-5%].
 A repeat biopsy may be required (e.g. if PIN is identified).
 Only one third of patients with a positive test turn out to have cancer.
 We do not yet know if early treatment actually saves lives.
 The treatments that would be offered can have unpleasant side effects.
 The stress and anguish of knowing that you have cancer is severe and 
 a positive diagnosis may adversely affect applications for certain types of insurance (e.g. health, life, travel).

Guidelines recommend that longterm treatment with quinine should be avoided if possible. 
You can try calf stretching exercises which can be very helpful for cramps.
Quinine can be toxic and can have side effects on the heart. 
It is recommended to have a trial of stopping quinine, after every 3 months, 
to see if the symptoms are acceptable without it.

FOR HEAD LICE:
apply the liquid to dry hair and rub it into your scalp. Let your hair dry naturally.
LEAVE IT ON FOR 8-12 hours (or overnight) and then shampoo it out.
Comb through your hair, using a 'nit comb', while it is still wet to remove the dead lice and eggs (nits).
REPEAT the process 7 DAYS LATER.

FOR SCABIES:
Apply the liquid all over including your face, neck, scalp and ears. but DO NOT get any into EYES.
Include awkward places such as your back, the soles of your feet, between your fingers and toes,
under your fingernails, and your genitals.
Pay special attention to the areas where mite burrows most commonly occur
- the front of your wrists and elbows, beneath your breasts, your armpits, and around the nipples in women.
Apply when your SKIN IS COOL and DRY, so after a bath/shower, wait for your skin to cool before applying.
Let it dry naturally.
Leave it on for 24 HOURS, and then wash it off.
If you wash your hands with soap during the 24 hours, reapply the liquid to your hands afterwards.
REPEAT the process 7 DAYS LATER.

Please report promptly any persistent, severe abdominal pain when on sitagliptin
[pancreatitis is a rare side effect].

Please report promptly any unexplained muscle pain tenderness or weakness
whilst on statins.

cautions for statins
notes on statins

Please ensure taht every prescription you get for vitamin D has been hand-written
as 'dekristol'.

Take two dekristol [colecalciferol 20,000unit] capsules once a day for a week.

In 1 months time
Get a blood test to check calcium levels. 
[Vitamin D treatment can sometimes cause Calcium levels to go too high].
If your calcium remains normal then you can continue on dekristol 
2 capsules once a month.
[these are a high strength and 2 capsules once a month are usually enough].

In 3 months time
Get a blood test to check vitamin D levels and see the doctor for a review
and to see if treatment needs to continue.
Please report if your symptoms have improved.

NOTE - vitamin D medications MAY CONTAIN PEANUT OIL.
Speak to the doctor if you have a peanut allergy.

Guidelines from Kirklees with a useful management flowchart