Call for Papers npj Primary Care Respiratory Medicine is an online-only, EDITOR-IN-CHIEF open access journal, publishing papers representing Professor Aziz Sheikh important advances of significance to specialists within The University of Edinburgh, Edinburgh, UK the fields of primary care and respiratory medicine. DEPUTY EDITOR-IN-CHIEF Submit your manuscript, and benefit from: Professor Kamran Siddiqi • Comprehensive and rigorous peer review. University of York, York, UK • Wide visibility through inclusion in leading indexing All content is indexed within PubMed, PubMed and abstracting services. Central, MEDLINE, Scopus and Web of Science • Manuscripts submitted to npj Primary Care Respiratory Medicine do not need to adhere to our formatting 2015 IMPACT FACTOR* requirements at the point of initial submission; Primary Care Respiratory Journal: 2.434* formatting requirements only apply at the time npj Primary Care Respiratory Medicine: 1.447** of acceptance. 2015 Journal Citation Report (Thomson Reuters, 2016) • Professionally written Editorial Summaries accompany * Due to the change of title in April 2014, the journal has been assigned two Impact Factors: one relating to the old title and one relating to the each article, opening up your research to the wider new title. ** npj Primary Care Respiratory Medicine has only received a partial primary care community. Impact Factor due to its launch midway through the Impact Factor calculation. Published in partnership with Part of the Nature Partner Journals series nature.com/npjpcrm
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 52 Primary Care Respiratory UPDATE 50 Volume 4 Issue 1 SPRING 2017
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 53 Primary Care Respiratory UPDATE Volume 4 Issue 1 SPRING 2017 51
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 54 Primary Care Respiratory UPDATE 52 Volume 4 Issue 1 SPRING 2017
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 55 Primary Care Respiratory UPDATE Volume 4 Issue 1 SPRING 2017 53
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 56 Primary Care Respiratory UPDATE 54 Volume 4 Issue 1 SPRING 2017
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 57 Primary Care Respiratory UPDATE Volume 4 Issue 1 SPRING 2017 55
SPRING ISSUE 6_Layout 1 19/04/2017 12:14 Page 58 Primary Care Respiratory UPDATE 56 Volume 4 Issue 1 SPRING 2017
Education for Health Quality Assured Spirometry training Spirometry is an essential tool in the diagnosis and management of respiratory disease but do you feel confident or assured when you or your team are performing this? Education for Health has a range of Spirometry courses written by experts, including: * Performing and Interpreting Quality Assured Spirometry Level 6 module - a professional qualification to perform and interpret Spirometry. Successful students are entered onto the National Register at Full Level. * Performing and Interpreting Quality Assured Spirometry module - a professional qualification to perform and interpret Spirometry and has no academic assignment. Successful students are entered onto the National Register at Full Level. * Performing Quality Assured Spirometry Level 5 module - a professional qualification to perform Spirometry. Successful students are entered onto the National Register at Foundation Level. * Performing Quality Assured Spirometry module - a professional qualification to perform Spirometry and has no academic assignment. Successful students are entered onto the National Register at Foundation Level. Our Spirometry modules are developed with the Association of Respiratory Technology & Physiology (ARTP) and supported by the British Thoracic Society (BTS). Depending on which module you take, you may also earn academic credits with The Open University. Visit our website at www.educationforhealth.org/spirometry to see every course we run, including our new Interpretation of Spirometry workshop, or contact us at [email protected] to bring training to your area. Not sure which course is for you? Contact us for friendly advice on [email protected]
20% WHEN PRESCRIBED SAVING 2 vs Seretide ® Accuhaler ®† † † BY BRAND NEW ASTHMA INDICATION Now indicated for the regular treatment of severe ASTHMA and COPD. AirFluSal Forspiro is indicated in the regular treatment of severe asthma in ® ® adults where use of a combination product (long-acting ß -agonist and inhaled 2 corticosteroid) is appropriate (patients not adequately controlled on a lower strength corticosteroid combination product or patients already controlled on a high dose inhaled corticosteroid and long-acting ß -agonist) and for the 2 symptomatic treatment of adults with Chronic Obstructive Pulmonary Disease (COPD) with a FEV <60% predicted normal (pre-bronchodilator) and a history 1 of repeated exacerbations and who have significant symptoms despite regular bronchodilator therapy. 1 Device not actual size AirFluSal Forspiro is only intended for use by adults 18 years of age and older. ® ® ® Prescribing Information: AirFluSal Forspiro ® (Please refer to the full Summary of Product Characteristics patients with COPD include current smoking, older age, benefits outweigh potential risk. β 2 adrenergic blockers may (SPC) before prescribing) AirFluSal ® Forspiro ® 50/500 low body mass index (BMI) and severe COPD. Paradoxical weaken or antagonise the effect of salmeterol. Potentially (50 mcg salmeterol xinafoate and 500 mcg fluticasone bronchospasm post-dose. Severe unstable asthma: Warn serious hypokalaemia may result from β 2 -agonist therapy, propionate) Indications: For use by adult patients aged patients to seek medical advice if short-acting inhaled particular caution is advised in acute severe asthma. This 18 years and older only. Asthma: Regular treatment of bronchodilator use increases. Consider increased inhaled/ effect may be potentiated by concomitant treatment with severe asthma where use of a combination of LABA and additional corticosteroid therapy. Acute symptoms: Not for xanthine derivatives, steroids and diuretics. Pregnancy and ICS is appropriate, i.e. patients not adequately controlled acute symptoms. Use short-acting inhaled bronchodilator. lactation: Experience limited. Balance risks against benefits. on a lower strength corticosteroid combination product Systemic effects: Systemic effects of inhaled corticosteroids Side effects: Very Common: headache, nasopharyngitis. or patients already controlled on high dose ICS and LABA. may occur, particularly at high doses for prolonged periods, Common: candidiasis of the mouth and throat, hoarseness/ COPD: Symptomatic treatment of patients with COPD with but much less likely than with oral corticosteroids. May include dysphonia, throat irritation, pneumonia (in COPD patients), a FEV 1 <60% predicted normal (pre-bronchodilator) and Cushing’s syndrome, cushingoid features, adrenal suppression, bronchitis, hypokalaemia, sinusitis, contusions, traumatic a history of repeated exacerbations who have significant adrenal crisis, growth retardation in children and adolescents, fractures, arthralgia, myalgia, muscle cramps. Uncommon: symptoms despite regular bronchodilator therapy. Dosage decrease in bone mineral density, cataract, glaucoma and, respiratory symptoms (dyspnoea), anxiety, tremor, and administration: Inhalation only. Asthma: one inhalation more rarely, a range of psychological or behavioural effects palpitations, tachycardia, angina pectoris, atrial fibrillation, b.d. of AirFluSal Forspiro 50/500. Regularly review patients including psychomotor hyperactivity, sleep disorders, cutaneous hypersensitivity reactions, hyperglycaemia, and reduce dose to lowest that maintains effective symptom anxiety, depression or aggression. Tremor, palpitations and sleep disorders, cataract. Rare: angioedema, respiratory control. Once control of asthma is attained treatment should headache, have been reported with β 2 -agonist treatment. In symptoms (bronchospasm), anaphylactic reactions including be reviewed and consideration given as to whether titrate asthma, therapy should be down titrated under physician anaphylactic shock, Cushings syndrome, cushingoid features, downwards the dose of inhaled corticosteroid as appropriate supervision to lowest effective dose and treatment should adrenal suppression, growth retardation in children and to maintain disease control. AirFluSal is not available in not be abruptly stopped due to risk of exacerbation. Serious adolescents, decreased bone mineral density, oesophageal any strengths lower than salmeterol 50 mcg/fluticasone asthma-related adverse events and exacerbations may occur candidiasis, behavioural changes including psychomotor propionate 500 mcg per metered dose. Therefore, when during treatment with AirFluSal. Patients should not be hyperactivity and irritability, glaucoma, cardiac arrhythmias titrating down to a lower strength, a change to an alternative initiated on AirFluSal during an exacerbation or if they have and paradoxical bronchospasm. Not known: depression or fixed dose combination of salmeterol and fluticasone significantly worsening or acutely deteriorating asthma. Data aggression. Paradoxical bronchospasm: substitute alternative propionate containing a lower dose of the ICS is required. from a large clinical trial suggested patients of black African therapy. Prescribers should consult the SPC in relation to COPD: one inhalation b.d. of AirFluSal Forspiro 50/500. or Afro-Caribbean ancestry were at increased risk of serious other adverse reactions Legal category: POM. Presentation Paediatric population: not recommended for either children or respiratory-related events or deaths when using salmeterol. and Basic NHS cost: AirFluSal Forspiro 50/500 60 inhalations. adolescents. Contraindications: Hypersensitivity to the active All patients should continue treatment but seek medical £32.74. Product Licence (PL) no: PL 04416/1431. PL holder: ingredients or to any of the excipients. Precautions: Pulmonary advice if symptoms remain uncontrolled or worsen when Sandoz Ltd, Frimley Business Park, Frimley, Camberley, tuberculosis, fungal, viral or other infections of the airway, initiated on AirFluSal or using AirFluSal. In COPD cessation Surrey. GU16 7SR. Last date of revision: February 2017. UK/ severe cardiovascular disorders, heart rhythm abnormalities, of therapy may also be associated with decompensation MKT/AFS/17-0007. diabetes mellitus, hypokalaemia and thyrotoxicosis. An and should be supervised by a physician. Transfer from oral increase in the incidence of pneumonia, including pneumonia steroids: Special care needed. Consider appropriate steroid Adverse events should be reported. Reporting forms and requiring hospitalisation, has been observed in patients with therapy in stressful situations. Drug interactions: Avoid beta- information can be found at www.mhra.gov.uk/yellowcard COPD receiving inhaled corticosteroids. Physicians should blockers. Avoid concomitant administration of ketoconazole Adverse events should also be reported to Sandoz Ltd, remain vigilant for the possible development of pneumonia or other potent (e.g. itraconazole, telithromycin, ritonavir) 01276 698020 or [email protected] in patients with COPD. Risk factors for pneumonia in and moderate (erythromycin) CYP3A4 inhibitors unless References: 1. AirFluSal ® Forspiro ® SmPC. 2. MIMS UK December 2016. †AirFluSal ® Forspiro ® vs Seretide ® Accuhaler ® . Seretide ® and Accuhaler ® are registered trademarks of the GlaxoSmithKline Group of Companies. Date of preparation: February 2017 UK/MKT/AFS/17-0003c
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