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  • Urogram of urine in normal human bladder

    Managing the symptoms of overactive bladder Subscription

    Overactive bladder can be distressing and embarrassing. Understanding the symptoms, diagnosis and evidence-based management can significantly improve quality of life.

  • Angiogram of a calf showing deep vein thrombosis

    Prevention of venous thromboembolism in hospitalised patients Subscription

    Pharmacists should note the National Institute for Health and Care Excellence’s updated guidance on use of pharmacological thromboprophylaxis in a range of hospitalised patient groups.

  • Illustration of cytochrome P450. Enzymes within the cytochrome P450 superfamily are essential for the metabolism of many medicines

    Tobacco smoking and its potential drug interactions Subscription

    Smoking and smoking cessation treatments have a pharmacological impact on some commonly used drugs and should be taken into account during the selection, introduction and cessation of medicines.

  • Heart failure fluorescent micrograph

    Pathophysiology and management of heart failure

    Ensuring patients are optimised on maximum tolerated doses of medicines in heart failure with reduced ejection fraction is essential in minimising the burden of the condition.

  • Close up of an IV drip

    Intravenous fluid management Subscription

    An introduction to fluid management for adults in hospitals, covering replacement during resuscitation, malnourished patients and following large electrolyte losses.

  • Patient with post operative vomiting

    Management of post-operative nausea and vomiting in adults Subscription

    The evidence base supporting pharmacological and non-pharmacological interventions for nausea and vomiting after surgery.

  • Intestinal ulcer

    Management of acute upper gastrointestinal bleeding Subscription

    An overview of the assessment process for acute upper gastrointestinal bleeding in the hospital setting and the treatment options available.

  • Liver cirrhosis micrograph

    Palliative management in end-stage liver disease Subscription

    Early palliative interventions, including reviewing regular medicines and managing common symptoms, enables patients to remain comfortable during end-of-life care.

  • Blood sample

    Diagnosis and management of anaemia in adults with chronic kidney disease Subscription

    An overview of the treatments for anaemia in chronic kidney disease and the tests needed to prescribe and assess their effectiveness.

  • Brain activity in Parkinson's disease, SPECT scans

    Parkinson’s disease: management and guidance Subscription

    An overview of Parkinson’s disease management, including discussion of the updated National Institute for Health and Care Excellence guidelines.

  • Insulin injection for type 1 diabetes

    Diagnosis and management of type 1 diabetes mellitus

    An overview of management options for type 1 diabetes, the types of insulin, insulin regimens and strengths available for its day-to-day management as well as how to adjust doses and the role of carbohydrate counting and blood glucose monitoring.

  • SEM of tumour in lung

    Lung cancer: advances in management and therapy Subscription

    An overview of traditional and emerging immunotherapy-based targets and treatments available for lung cancer, their side effects and the impact immune checkpoint inhibitors have had on the treatment of non–small-cell lung cancer.

  • PET scan of an epileptic brain

    Refractory epilepsy: management in tertiary care Subscription

    Epilepsy is a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness or convulsions, associated with neurones exhibiting abnormally high electrical excitability in the brain.

  • Back of young school girl's head in class

    Depression in children and young people: identification and management Subscription

    As one of the most common paediatric psychiatric disorders, pharmacists and healthcare professionals need to be aware of the symptoms of depression and be able to assess children and young people who may be at risk.

  • Plaque type psoriasis

    Assessment and management of psoriasis in adults in primary care Subscription

    Psoriasis is a complex, multifactorial, inflammatory disease associated with a significantly impaired quality of life. Around 80% of patients with plaque psoriasis have mild-to-moderate disease that is amenable to treatment in primary care, particularly through pharmacy, with topical therapies.

  • Scanning electron microscope of lung tissue

    Diagnosis and management of hospital-acquired pneumonia in older adults Subscription

    Hospital‑acquired pneumonia increases the length of in-patient hospital stay and is associated with high mortality rates, particularly in older people. Pharmacists and healthcare professionals need to know how to diagnose and manage the condition, and be cognisant of the gaps in the evidence base.

  • 3D scan showing brain haemorrhage stroke

    Stroke: classification and diagnosis Subscription

    In light of the many pressures currently facing the NHS, as well as an ever increasing ageing population, pharmacists and healthcare professionals should be aware of the risk factors for stroke, its classification and diagnosis.

  • Bronchiectasis, light photomicrograph showing dilated and distorted bronchus containing pus

    Bronchiectasis: diagnosis, treatment and management Subscription

    Bronchiectasis is a common chronic disease where the airways of the lungs become abnormally widened. Patients present with recurrent cough, sputum production and are at risk of respiratory tract infections. Pharmacists and healthcare professionals need to be aware of the latest management strategies.

  • Pharmacogenomics concept

    Pharmacogenomics: an overview Subscription

    With the NHS working towards the integration of personalised medicine, in particular, aiming for whole-genome sequencing to be standard for specific conditions by 2020, it is important for pharmacists and healthcare professionals to be aware of the principles of pharmacogenomics and its evolving application into clinical practice.

  • pregnant woman diabetes finger prick lancet blood ss 17

    Managing diabetes in women during preconception and pregnancy Subscription

    Diabetes in pregnancy is associated with risks to the woman and to the developing foetus. Pharmacists and healthcare professionals need to be able to support and educate women who are planning pregnancy and those who are already pregnant to manage their diabetes.

  • Clinician check a man's foot using a mirror

    The diabetic foot Subscription

    Diabetes-related foot problems are common, and negatively impact patients’ quality of life, so it is important that pharmacists are aware of symptoms and the relevant care pathways for these patients to ensure they receive the best care and education regarding how to manage their condition. Produced in partnership with RB.

  • Micrograph of non-alcoholic fatty liver (NAFL)

    Non-alcoholic fatty liver disease and diabetes: diagnosis, assessment and management

    Non-alcoholic fatty liver disease is the term for a range of conditions caused by a build-up of fat in the liver. The condition is thought to be highly prevalent; however, the dearth of symptoms during early disease and the lack of a specific diagnostic test make it difficult to detect and manage at an early stage. This presents a considerable challenge for healthcare professionals.

  • SEM of activated platelets

    Heparin-induced thrombocytopenia Subscription

    Heparin is widely used for thromboprophylaxis or as a treatment in many clinical situations, however, it can cause serious adverse effects. Heparin-induced thrombocytopenia (HIT), an immune-mediated adverse drug reaction, is associated with high morbidity and mortality if undiagnosed.

  • Xray showing chronic oedema in the lower limb

    Chronic oedema: treatment and the impact of prescribed medicines Subscription

    Early diagnosis of lower limb oedema is crucial to prevent early oedema becoming chronic. Pharmacists and other healthcare professionals are ideally placed to identify patients on certain medicines at higher risk of oedema, and should be aware of signs of chronic oedema when assessing patients to allow for prompt referral.

  • Scanning electron micrograph (SEM) of tuberculosis (TB) bacteria infecting macrophages

    Fluoroquinolones for treating tuberculosis Subscription

    Tuberculosis (TB) remains a significant global health and socioeconomic challenge. The duration of current anti-TB therapies, the adverse effects of certain anti-TB drugs and the growing problem of drug-resistant TB on an international scale mean that it is imperative for new, effective and safe treatment regimens to be developed. Fluoroquinolones are a class of drugs that have been used in the treatment of TB for several decades. This article provides an overview of the current treatment ...

  • Action of serotonin reuptake inhibitors

    Depression in adults: recognition and management Subscription

    Pharmacists and healthcare professionals should be able to recognise the symptoms of depression in people who use their services and direct them towards accessing treatment. This article examines how a diagnosis of depression is made, the pharmacological and non-pharmacological treatments available, specific considerations for different patient groups, self-management approaches, and the role of the pharmacy team in managing and supporting patients who have symptoms of depression.

  • Micrograph of multiple myeloma tumour cells (green) and bone cells (red) growing on a scaffold made of silk protein (purple), designed to resemble bone material

    Multiple myeloma: pharmacological management Subscription

    Although multiple myeloma is currently regarded as being incurable in the majority of patients, the outlook for patients diagnosed with the condition has improved markedly over the last 40 years, with survival rates quadrupling. Significant advances in both treatment and supportive therapies have contributed to these improved outcomes and are discussed in this article.

  • Micrograph of Clostridium difficile bacteria

    Clostridium difficile: diagnosis and treatment update Subscription

    There are around 12,000 cases of Clostridium difficile infection (CDI) each year in the UK and during 1999 to 2007, deaths from CDI peaked at around 4,000 per year. This article summarises diagnosis and management, as well as the current therapeutic options for CDI, including faecal microbiota transplant.

  • coloured scanning electron micrograph (SEM) of bacterial blood infection (sepsis) caused by a rod shaped bacterium (blue)

    Sepsis: an update on identification and management Subscription

    All healthcare professionals, including pharmacists, should be aware of the clinical features and management of sepsis. This article summarises the recent changes in the definition of sepsis in adults, as well as its management.

  • Testing for blood clotting

    How to identify causes of a subtherapeutic INR Subscription

    Pharmacists and healthcare professionals are often involved in the management of patients with subtherapeutic international normalised ratios (INRs), the cause of which is important to identify because this will affect decisions and the subsequent management of the patient.

  • Boy with Down's Syndrome listens to a healthcare worker

    Reducing antipsychotic prescribing in people with learning disabilities Subscription

    Pharmacists and healthcare professionals are ideally placed to review and reduce inappropriate prescribing of psychotropic medicines in people with learning disabilities safely and effectively.

  • X-ray of the intestines of a patient with Crohn's disease

    Biosimilars and inflammatory bowel disease: a switch programme using CT-P13 Subscription

    How to plan and manage switching patients from a biologic to a biosimilar in inflammatory bowel disease, using the University Hospital Southampton NHS Foundation Trust’s experience as an example.

  • Illustration antibiotic destroying bacteria

    Principles of initiating antimicrobial therapy and empiric prescribing Subscription

    Healthcare professionals should be aware of the principles of antimicrobial treatment and the need to reduce inappropriate prescribing to retain the effectiveness of drugs currently available.

  • Urticaria rash on the upper chest of a woman

    Chronic spontaneous urticaria: clinical features, diagnosis and management Subscription

    Defined as the non-inducible recurrence of wheals, angioedema or both for six weeks or more, chronic spontaneous urticaria is a difficult to diagnose and debilitating skin condition. Pharmacists should be aware of the clinical features in order to identify and manage this condition effectively.

  • Close up of a leg with livedo reticular is

    Antiphospholipid syndrome: pathophysiology, diagnosis and treatment Subscription

    How antiphospholipid syndrome, also known as Hughes syndrome, is diagnosed and the appropriate therapeutic options for its management.

  • Illustration of chronic obstructive pulmonary disease (COPD)

    Chronic obstructive pulmonary disease: clinical phenotypes and implications for management Subscription

    Phenotyping patients with chronic obsructive pulmonary disease allows their separation into distinct categories that differentiate their prognosis and response to treatment, producing clinically meaningful outcomes.

  • Computer illustration of a low-density lipoprotein (LDL) molecule (round) bound to an LDL receptor (LDLR) protein, with a molecule of the enzyme proprotein convertase subtilisin/kexin type 9 (PCSK9, blue) bound to a PCSK9 inhibitor antibody (orange)

    Non-statin drugs for the management of dyslipidaemia in adults Subscription

    The role of non-statin drugs, including ezetimibe, fibrates, bile acid binders, nicotinic acid derivatives, omega-3 fatty acid supplements and PCSK9 inhibitors, for the management of dyslipidaemia in adults.

  • Bipolar brain, 3D view of an MRI scan

    Bipolar disorder: pharmacotherapy options with a focus on women of childbearing age Subscription

    Bipolar disorder and its implications for women of childbearing age, with a focus on the use of valproate and how this compares to other available pharmacologic treatments.

  • Micrograph of a blood filled micrograph

    Bridging anticoagulation: perioperative management of patients on anticoagulants Subscription

    How patients on anticoagulants can be effectively managed in the perioperative period, including the evidence for the need for ‘bridging’ anticoagulation therapy and introduction of direct oral anticoagulants.

  • Gastric bypass surgery on obese patient

    Bariatric surgery and the effects on drug pharmacokinetics Subscription

    Understanding the types of bariatric surgery, their impact on drug pharmacokinetics and specific recommendations for drug regimens following surgery.

  • Targeted treatments for symptoms of selected behavioural disorders

    Chronic tic disorders: diagnosis, treatment and management Subscription

    How different types of tic disorders are diagnosed and the appropriate therapeutic options for their management, with a focus on Tourette syndrome.

  • When insulin fails to bind and Glut-4 is not activated, glucose cannot enter the cell (left) and returns to the bloodstream, elevating the blood-sugar level

    Insulin initiation in patients with diabetes Subscription

    How to select and start insulin in a patient with diabetes mellitus.

  • Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) is used to describe the pathophysiological changes that occur in the vascular and skeletal system in CKD and was previous called renal bone disease (light micrograph pictured)

    Chronic Kidney Disease – Mineral and Bone Disorder: pathophysiology and treatment Subscription

    How the pathophysiological mechanisms behind development of Chronic Kidney Disease - Mineral and Bone Disorder can be managed, using appropriate therapeutic interventions to prevent complications.

  • Helicobacter pylori infections and treatment remain an unsolved problem with around one-half of the world’s population still infected. In the image, micrograph of H. pylori bacteria on the surface of a human gastric epithelial cell

    Drug therapies for Helicobacter pylori infections Subscription

    Selecting the most appropriate treatment regimen for patients with Helicobacter pylori.

  • Selection of active treatments for sleep disorders mostly occurs in the absence of evidence-based protocols, with drug treatments recommended empirically. In the image, a man wears a CPAP mask to treat apnoea

    Sleep disorders: treatment Subscription

    Selecting the most appropriate drug treatments for sleep disorders in the absence of trial data or evidence-based protocols.

  • The spectrum of sleep disorders includes normal variants and rare phenomena, such as insomnia, sleep-related breathing disorders and hyper somnolence. In the image, a patient is tested in a sleep research clinic

    Sleep disorders: diagnosis Subscription

    Diagnosing insomnia, sleep-related breathing disorders and central disorders of hypersomnolence.

  • Management of migraines is individualised for each patient and there are a number of evidence and practiced-based treatments available. In the image, an elderly woman with a migraine consults with a doctor

    Migraine management Subscription

    Management of migraines is individualised for each patient and there are several evidence and practiced-based treatments available.

  • 5HT1 receptor agonists (triptans) are used to treat acute migraine attacks. Despite their widespread use, clinically relevant interactions with 5HT1 receptor agonists are not frequently encountered. In the image, SPECT scan of a brain during a migraine

    Triptan interactions Subscription

    A number of clinically relevant pharmacokinetic and pharmacodynamic interactions involving 5HT1 receptor agonists are known, although these are not frequently encountered in migraine treatment. 

  • Subfertility is defined by the failure of a heterosexual couple to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. In the image, an in vitro fertilisation (IVF) laboratory

    Subfertility: treatment options in women Subscription

    The causes of subfertility in women and the pharmacological and surgical options available.

  • Treatment of early stage prostate cancer and locally advanced disease involves surveillance, radical treatment or androgen deprivation therapy. As the disease progresses, these options change. CT scan of a patient with metastatic prostate cancer pictured

    Prostate cancer: treatment options Subscription

    When to consider each of the available treatment options for prostate cancer.

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