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that are out of stock.
Online visual guides to help you identify, compare, and recommend diabetes and respiratory devices.
Figure 2.3 Home page of MIMS online.
(Source: www.mims.co.uk).
MIMS provides concise summaries of prescribing information for branded and generic products that can be prescribed in the UK, including devices listed in the section on permitted appliances within the Drug Tariff. Drugs that are blacklisted (i.e. not on the Drug Tariff and therefore not prescribable on the NHS) are not listed and no information is given on the unlicensed or off‐label use of drugs.
The print edition of MIMS also includes a selection of the most popular drug reference tables. The full range of tables and drug listings are available online, together with at‐a‐glance summaries of national treatment guidance and helpful visual guides to diabetes and respiratory devices; there is also a prescribing resource centre for specific disease areas. The legal class categories in MIMS are the same as those within the BNF and listed in Table 2.2.
How to use MIMS online
When you visit the home page of MIMS online (see Figure 2.3), you are able to search for drugs (by drug name or drug class), browse news and resources by disease areas (from an A to Z list), or search for news, tables or guidance on any condition or drug. You are also able to search for drugs by manufacturer. Searching for a drug only returns a list if there is more than one hit (i.e. multiple drugs matching the search term and/or drugs matching the search term appearing in multiple sections), otherwise you are taken to the drug entry. Clicking on a drug will display all the different preparations, legal class, indications and dose recommendations for adults and children (where appropriate). The drug listing page will also display helpful links to any related guidelines or related conditions.
Skills in practice
1 Search for paracetamol within the drug search box.
2 You will see that paracetamol‐containing products can be used for a number of different clinical conditions (migraine, pain and fever), with different strengths, formulations and combinations.
3 When paracetamol is combined with another product it is still important to understand the strengths of the individual compounds.Clink on co‐codamol: you can see there is always 500 mg of paracetamol within one co‐codamol capsule, but the dose of codeine phosphate could be 8, 15 or 30 mg.
4 Each form of paracetamol is only licensed for specific indications.Clink on paracetamol infusion: you can see this would only be used as a short‐term treatment for moderate pain and fever when other routes are inappropriate.
5 For each paracetamol preparation, there may be different contraindications.Click on paracetamol/ibuprofen (combogesic): you will see the contraindications are alcoholism, aspirin/anti‐inflammatory allergy, active or history of gastrointestinal bleeding or peptic ulcer, severe cardiac, hepatic or renal failure, cerebrovascular or other active bleeding, blood formation disturbances and pregnancy (third trimester).
Searching within news and resources, you will find links to relevant tables and summaries of national guidelines, as well as any information about the condition that has been in the news. You can use the filters on the right‐hand side to find the results of a particular type (for example, news) or from a particular year.
Many abbreviations are used in healthcare and it is important that you familiarise yourself with these to ensure you understand what they mean. Abbreviations are used within prescribing guides and in practice and it is always best to check what an abbreviation means if you are unsure. A list of the abbreviations used in MIMS can be found at the front of every print issue and online.
Clinical considerations
You are asked to administer a medication in ‘S‐C’ form.
Do you get a glass of water for your patient, or an injection/infusion set?
What would the implications be of not understanding the correct abbreviation?
Be aware that sometimes the same abbreviation is used to mean different things. For some healthcare practitioners, the abbreviation ‘s‐c’ or ‘s/c’ could be colloquially used to mean subcutaneous; but within the BNF ‘s/c’ represents sugar coated, and in MIMS ‘s‐c’ is used for sugar coated. Note here that the abbreviation is not used to represent the route of administration. It is paramount that you are aware of the formal abbreviations in use and not colloquial, historical interpretations or slang. This is explored further in Chapter 4 of this book, Medicines Management and the Role of the Healthcare Provider.
Electronic Medicines Compendium
The electronic medicines compendium (emc) contains up‐to‐date, easily accessible information about medicines licensed for use in the UK and can be found at www.medicines.org.uk/emc. The emc has more than 14 000 documents, all of which have been checked and approved by either the UK or European government agencies which license medicines. These agencies are the UK MHRA and the European Medicines Agency (EMA). The emc is updated continually and you are able to browse for medicines, or active ingredients, using the A–Z buttons. The emc contains regulated and approved information on medicines available in the UK including:
1 Summaries of Product Characteristics (known as SPCs or SmPCs).A SmPC informs healthcare professionals on how to prescribe and use a medicine correctly. A SmPC is based on clinical trials that a pharmaceutical company has carried out and gives information about dose, use and possible side effects. A SmPC is always written in a standard format.
2 Patient Information Leaflets (PILs, Package Leaflets or PLs).A PIL is the leaflet that is included in the pack with any medicine. The PIL is a summary of the SmPC and is written for patients.
3 Risk Minimisation Materials (RMMs).RMMs are resources for healthcare professionals that aim to optimise the safe and effective use of a medicine. RMMs can come in a number of forms, such as educational programs, prescribing or dispensing guides, patient brochures, or alert cards.
4 Safety Alerts.Safety alerts are issued by the Regulator and/or marketing authorisation holder and contain important public health messages or safety critical information about a medicine.
5 Product Information.This is any additional information about a product. It may include important information such as change of packaging or issues related to stock levels.
Within the emc, there are also audio and video resources that provide additional information in a user‐friendly manner, promoting the safe an effective use of a medicine. For example, a video clip may demonstrate how to administer a certain medicine correctly.
What can be prescribed on an NHS prescription?
There are hundreds of medicinal products and devices (or appliances) available to treat and manage illnesses, conditions and diseases. A medicinal product is defined as an item which is not considered to be appliance and could be a drug, food, toiletry or type of cosmetic (Pharmaceutical Services Negotiating Committee (PSNC) https://psnc.org.uk/dispensing‐supply/dispensing‐a‐prescription/medicinal‐products). An approved medical device