January 2018's Minutes

Minutes January 2018

Hello Everyone and welcome to January’s meeting’s minutes.

We had the pleasure of welcoming Jenna Walker, Pharmacist at Cardiff and Vales Health Board at the Heath Hospital, who came to talk about the Yellow Card Scheme.

The yellow card scheme is the program that records all reported side effects of medication.

A side effect is defined as being anything that prevents you from conducting your normal day to day activity.

The Yellow card scheme is funded by the MHRA which is the UK Government body responsible for medicines safety and licensing. The YCC Wales id funded by the MHRA to promote understanding, reporting and research of side effects to medicines.

The Yellow Card Scheme is open to anyone to report, in the form of a form, website, phone call or mobile app, details of which I will add at the base of these minutes.

A side effect is an unpleasant and unintended response to a drug, they can happen when medicine is used as instructed in the patient information leaflet, or, when the medicine is used off label, taken in overdoes, misused, abused or if there is a medication error.

Side effects are relatively common for example

Penicillin: A common side effect is rash, nausea and diarrhea this can effect between 1 in 10 to 1 in 100

                   An uncommon side effect is kidney damage effecting 1 in 100 to 1 in 1000

                    A rare side effect is Severe skin reactions, anaphylaxis, colitis effecting 1 in 1000 to 1 in 10,000

                     A Very rare side effect is Liver damage effecting less than 1 in 10,000

Not all clinical trials find all the side effects so it is important to report anything you consider to effect your day to day living. New drugs are trialed in 1000 -  3000 people and trials can detect common and uncommon side effects but not always rare or very rare ones until the drug in available on the market.

Yellow Card report can find things that drug trails miss such as rare and very side effects, effects of the drug in real world conditions and with real people who may be taking these drugs in combination with other medications. It also picks up side effects in children and any possible side effects in pregnancy.

People over 65 do not tend to clear drugs from their systems very quickly and therefore more susceptible to accumulating drugs in their systems and causing more side effects. The very young are also at risk of developing side effects, namely in children under 3.

People with multiple conditions are more likely to have side effects because of the combination of drugs they could be taking and that their different conditions may affect the drugs being taken. Women generally have smaller internal organs and as such may experience side effects more readily, they also have hormonal states which make women more susceptible to side effects.

People with allergies such as asthma or eczema may have more serious reactions that the rest of the population. Also if you are taking more than 5 different drugs to have a 50% chance of experiencing a side effect.

Drugs commonly causing side effects are NSAIDs (including low does aspirin and ibuprofen), water tables, Warfarin, ACE inihibitors and Angiotensin II blockers for BP, Antidepressants, Beta blockers, Opiates such as morphine and codeine, Digoxin and Prednisolone.

Your prescriber be in Doctor, Nurse, Specialist etc will have carefully considered the therapeutic benefit against the risk to the patient and it really is about placing your trust in your medical professional.

So are side effects avoidable? 70% of them are potentially avoidable and this can be done by

  • Only using medicines in needed or prescribed,
  • Stick to the same brand if advised (e.g. antiepileptics)
  • Follow the instructions and don’t take more than prescribed or chew if to be swallowed whole.
  • Always follow instructions about timing and taking with food.
  • Always check for drug interations before taking something new (including herbal and purchased meds or alcohol)

If you are worried about a symptom you think might be a side effect

  • Check the patient information leaflet
  • Talk to your doctor or pharmacist

The yellow card scheme was introduced in 1964 after the thalidomide tragedy, it receives spontaneous reports of suspected side effects, it acts as an early warning system to identify side effects and risk factors. It has also received 800,000 confidential reports in the UK.

The yellow card scheme in an important role in patient safety giving continual safety monitoring of new and old drugs, it allows new drugs to be reported on if needed and to detect rare and very rare side effects.

You should report ALL suspected side effects for new drugs, a new drug being intensively monitored will have a small black triangle marked on its patient information leaflet.

New diabetes medication under intensive monitoring (under a black triangle).

  • Invokana (canaglifozin)
  • Jardiance (empaglifozin)
  • Fiasp (Insulin aspart)
  • Xultophy (Insulin degludec + liraglutide)
  • Abasaglar (Insulin glargine
  • Alogliptin
  • Trulicity (Dulaglatide)

Report all serious suspected side effects to established medicines that are serious enough to interfere with daily activities. Not already listed in the patient information leaflet that comes with the medicine

You can report to the Yellow card scheme by completing a paper copy and returning it to the FREEPOST address listed, (these are available from GP surgeries, pharmacies and from our group meeting)

You can call the yellow card hotline on 0800 100 3352

You can complete it online at www.yellowcard.mhra.gov.uk

You can also report using the mobile Yellow Card App

 

The Yellow card scheme also confirms safety, the latest medication for acid reflux (Nexium) is now available with out prescription, it has low numbers of reported side effects since 2000 (relative to the large number of people who have taken in). Most side effects reported were mild, not serious and short lived, they also showed no significant risk of the threatening side effects.

A huge thank you to Jenna for taking the time to come along and share this information with us.

Thursday 15th February is our next meeting where we welcome Barbara Moore from Health and Care Research Wales who is coming to talk about public involvement.

Please also bring your reviews of the spoons, plates and books from Lisa who left them with us in December for review.

See you there

Sarah