What would you give?

[johnep]

1) Script for cfc, free breath, actuated beclometasone 50mcg. Noted that BNF p161 says cfc free inhalers should be prescribed by brand name. Pt was 24 and not had before.

2) One Alpha 0.25mcg one a day for three days a week. Pack is double wrapped and not keen on cutting open.
johnep

[DavidS]

Re: What would you give?

1) Script for cfc, free breath, actuated beclometasone 50mcg. Noted that BNF p161 says cfc free inhalers should be prescribed by brand name. Pt was 24 and not had before.

Well, I would give qvar if I was pushed, because its been around for the longest - so more likely to be the one the dr means, and is the stronger in the case where an underdose might be problematic. But realistically I would want to check with the surgery first.

2) One Alpha 0.25mcg one a day for three days a week. Pack is double wrapped and not keen on cutting open.
johnep

One alpha is a non-splittable pack of 30, according to my computer program, although I think this is rubbish and would give the closest number of sub-packs of 10.

[Steve G]

Re: What would you give?

It depends on the computer system - my local surgery produces scripts for beclometasone cfc-free extrafine particles, and for beclometasone cfc free.

[johnep]

Re: What would you give?

What about Qvar being approx double potency of standard inhalers?
johnep

[Jeff]

Re: What would you give?

1) Script for cfc, free breath, actuated beclometasone 50mcg. Noted that BNF p161 says cfc free inhalers should be prescribed by brand name. Pt was 24 and not had before

Inform surgery and PCT of BNF advice and current practice.
Did the script mention the number of doses? (That could hint at one of the dry powder devices - probably mistakenly).

Jeff

[Sir_Dispensalot]

Re: What would you give?

Correct me if I'm wrong (I frequently am ) but clenil is roughly bioequvalent to the old becotide inhalers - and the qvar is approx double strength - if the gp is starting them on it for the 1st time they'd probably want to start them on a lower strength...

[DavidS]

Re: What would you give?

Correct me if I'm wrong (I frequently am )...

me too, alas!

but clenil is roughly bioequvalent to the old becotide inhalers - and the qvar is approx double strength - if the gp is starting them on it for the 1st time they'd probably want to start them on a lower strength...

Well, its a tricky one this, but I would still give the qvar (if you could call this an emergency) because in this case a higher strength would be effective and the lower strength might not be.

[silnarnin]

Re: What would you give?

I'd contact the surgery. Even if it takes a day to get the answer, it should be fine because it doesn't start to work straight away. If pushed to dispense, I'd give Clenil because it is bioequivalent and Qvar is extrafine particles.

[johnep]

Re: What would you give?

Have not seen a b/a Clenil yet.
johnep

[howe928]

Re: What would you give?

Have not seen a b/a Clenil yet. But realistically I would want to check with the surgery first.
johnep

so will give QVAR either autohaler or easi breath

One alpha is a non-splittable pack of 30, according to my computer program, although I think this is rubbish and would give the closest number of sub-packs of 10.

special container rules apply, agreed with this