Proposed medicines for registered nurse prescribing in community health September 2016

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1 Proposed medicines for registered nurse prescribing in community health September 2016 Prescription medicines Medicine Route Duration/ Anti-infective skin preparations Fusidic acid Topical Not ocular 5 days Skin infections, impetigo refer to guideline for example Mupirocin Topical 5 days Recurrent skin infections refer to guideline for example Antibacterials - systemic Amoxicillin 7 days only Otitis media in children, Otitis media and sinusitis in adults, Pharyngitis Amoxicillin with clavulanic acid 7 days only Skin infections from human or animal bites Flucloxacillin only 7 days Skin infections, cellulitis, impetigo, mastitis Otitis media refer to guideline for example For Pharyngitis Specific education on rheumatic fever required. Refer to National Guideline: Heart Foundation of New Zealand. Group A Streptococcal Sore Throat Management guideline Update. Auckland, Heart Foundation of New Zealand. Educational preparation to address principles of drug resistance, adverse effects (liver and idiopathic responses) and contraindications. Need to understand principles of dosing considerations and short term use. Refer to guideline for example refer to guideline for example 1

2 Medicine Route Duration/ Benzathine benzylpenicillin Phenoxymethylpenicillin (Penicillin V) IM injection According to Guideline Only according to Guideline Cefalexin Only according to guideline. 7 days Ceftriaxone IM injection Only according to Guideline Single dose Rheumatic fever secondary prophylaxis Group A Streptococcal Sore throat management Rheumatic fever prophylaxis, Group A Streptococcal Sore throat management Skin infections: boils, cellulitis, impetigo, mastitis, Recurrence Group A Streptococcal throat infection Uncomplicated gonorrhoea Azithromycin Single dose Chlamydia or male urethritis, uncomplicated gonorrhoea Erythromycin only 7 days Skin infections: boils, cellulitis, mastitis Diagnosis of rheumatic fever must be established for secondary prophylaxis. Specific education on rheumatic fever required. Refer to National Guideline: Heart Foundation of New Zealand. Group A Streptococcal Sore Throat Management Guideline Update. Auckland, Heart Foundation of New Zealand and ohttp:// Must be given with 2mls 1% lidocaine. Nurse must carry adrenaline and be educated in resuscitation management. Must be trained in injection administration. Specific education on rheumatic fever required. Refer to National Guideline: Heart Foundation of New Zealand. Group A Streptococcal Sore Throat Management Guideline Update. Auckland, Heart Foundation of New Zealand. Refer to guideline for example Skin infection, boils, cellulitis, impetigo, mastitis refer to guideline for example Specific education on recurrent Group A streptococcal throat infections and rheumatic fever required Uncomplicated gonorrhoea refer to NZ sexual health Guidelines. Must be given with 2mls 1% lidocaine. Nurse must carry adrenalin and be educated in resuscitation management. Must be trained in injection administration. Must be given with oral azithromycin as per guideline. Refer to NZ sexual health guidelines Skin infections: boils, cellulitis, mastitis refer to guideline for example For Pharyngitis Specific education on rheumatic fever required. 2

3 Medicine Route Duration/ Pharyngitis Metronidazole 7 days Bacterial vaginosis only Ornidazole 5 days Bacterial vaginosis only Trimethoprim only Adult women only 3 days Uncomplicated urinary tract infection only Refer to National Guideline: Heart Foundation of New Zealand. Group A Streptococcal Sore Throat Management Guideline Update. Auckland, Heart Foundation of New Zealand. Refer to guideline for example Refer to NZ sexual health guidelines Refer to guideline for example Refer to guideline for example updated Oct, 2015 Antivirals Valaciclovir 5-7 days Genital herpes simplex virus Development of diagnostic skills during supervision and ongoing practice or prescribing following established diagnosis. Refer to NZ sexual health guidelines Sympathomimetics Adrenaline IM injection Emergency treatment of Anaphylaxis Contraceptives Ethinyloestradiol with levonorgestrel Ethinyloestradiol with desogestrel Only in combination for contraception Must be trained in resuscitation Must complete Family Planning Certificate in and Sexual Health or equivalent course Refer to UK Medical Eligibility Criteria for Contraceptive Use (2009). Published by the Faculty of Sexual and Reproductive Healthcare (FSRH) (UKMEC 2009) 3

4 Medicine Route Duration/ Ethinyloestradiol with norethisterone Ethinyloestradiol with drospirenone Levonorgestrel, subdermal Additional training required for implant insertion Desogestrol Contraceptive use only Includes long-term and emergency contraception Norethisterone Etonogestrel Subdermal Additional training required for implant insertion Medroxyprogesterone acetate Ear preparations IM Injection Contraceptive use only Long - term contraception Flumetasone pivalate (with clioquinol) Ear drops Aural only 7 days Otitis externa Diagnostic skills to be developed during supervised practice/ongoing practice experience. Contraindicated where there is perforation of the ear-drum (suspected or verified). Also contraindicated in children under 2 years old. 4

5 Medicine Route Duration/ Dexamethasone with framycetin and gramicidin Ear drops Aural only 7 days Eczematous inflammation with secondary infection in otitis externa Diagnostic skills to be developed during supervised practice/ongoing practice experience. Refer to guidance on otitis externa Triamcinolone + neomycin sulfate + gramicidin + nystatin Eye preparations Ear drops Aural only 1 course only Bacterial and candida infections in otitis externa Diagnostic skills to be developed during supervised practice/ongoing practice experience. Contraindicated where there is perforation of the ear-drum (suspected or verified). Chloramphenicol Eye drop, Eye ointment Ocular only 1 course only Conjunctivitis Refer to guideline for example Non-prescription medicines for subsidy on prescription Medicines group Medicine Restrictions Dematologicals Antipruritic preparations Antipruritic preparations Calamine Crotamiton Cetomacrogol Cetomacrogol with glycerol Zinc and castor oil Aqueous cream 5

6 Medicines group Medicine Restrictions Emulsifying ointment Oil in water emulsion Urea Wool fat with mineral oil Corticosteroids topical Hydrocortisone 1% Corticosteroids topical Disinfecting and cleansing agents Disinfecting and cleansing agents Minor skin infections Parasiticidal preparations Parasiticidal preparations Psoriasis and eczema preparations Psoriasis and eczema preparations Topical antibacterials Topical antibacterials Topical antifungals Topical antifungals Topical antifungals Topical antifungals Hydrocortisone 1%+ miconazole Chlorhexidine gluconate Triclosan Povidone iodine Malathion with permethrin and piperonyl butoxide Permethrin Salicylic acid Tar with triethanolamine lauryl sulphate and fluorescein Hydrogen peroxide Silver sulphadiazine Amorolfine Ciclopirox olamine Clotrimazole Econazole nitrate 6

7 Medicines group Medicine Restrictions Shampoo Scalp preparations Ketoconazole Gynaecological and urinary Other urinary agents Urinary Tract Infections Pain management Topical products for joint and muscular pain Non-opioid analgesics Opioid analgesics Treatments for Substance Dependence Treatments for substance dependence Ears Ear preparations Gastrointestinal Vitamins Sodium citro-tartrate Hexamine hippurate Acetic acid with hydroxyquinoline and ricinoleic acid Clotrimazole Miconazole nitrate Nystatin Fluconazole Capsaicin Paracetamol Paracetamol with codeine Nicotine Acetic acid with 1, 2- propanediol diacetate and benzethoium Folic acid Vaginal jelly, 150mg single dose only Cream, suppositories 7

8 Medicines group Medicine Restrictions Minerals agents Agents used in mouth ulceration Oropharyngeal anti-infectives; Oropharyngeal anti-infectives; Anthelmintics Laxatives, bulk-forming agents Laxatives, faecal softeners Laxatives, faecal softeners Laxatives, faecal softeners Laxatives, osmotic laxatives Laxatives, osmotic laxatives Potassium iodate Thymol glycerin Triamcinolone acetonide Miconazole Nystatin Mebendazole Ispaghula (psyllium) husk Docusate sodium Docusate sodium with sennosides Poloxamer Glycerol Lactulose paste Medical devices for subsidy on prescription Medical device Brands Funding barrier Pregnancy tests- HCG urine Easy Check Fully subsidised Intra-uterine devices Choice TT380 Short, Choice TT380 Standard, Choice Load 375 Fully subsidised Condoms Multiple brands available Fully subsidised/ partial subsidy 8

9 Medical device Brands Funding barrier Diaphragm Ortho All-flex Fully subsidised Contraceptive caps Dumas, Prentif Not funded 9

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