Kieran Reynolds talks to Naz Kanani Alviri about liver cirrhosis. Discussion includes what cirrhosis is, and how it is diagnosed, the difference between compensated and decompensated cirrhosis, complications of decompensated cirrhosis and initiatives being undertaken to improve the earlier diagnosis of liver disease. (19m 16s) 

Naz Kanani Alviri - Principal Pharmacist -Hepatology & Liver transplantation, Royal Free Hospital, London  
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful Links
Calculating and using the Child-Pugh score
https://www.sps.nhs.uk/articles/calculating-and-using-the-child-pugh-score/
Prescribing weight-adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
NHS mobile testing scheme finds thousands of new cases of liver damage
https://www.england.nhs.uk/2023/10/nhs-mobile-testing-scheme-finds-thousands-of-new-cases-of-liver-damage/

Cirrhosis

Kieran Reynolds talks to Aimee Francisco about drugs in liver impairment. Discussion includes key issues to consider when prescribing in liver disease, medicines to avoid (or use with caution) in liver disease, drug induced liver injury and herbal medicines. (13m 29s) 

Aimee Francisco - Advanced Specialist Gastroenterology Pharmacist at Gloucestershire Hospitals NHS FT and primary care lead at the British Hepatology Pharmacy Group (BHPG) 
Kieran Reynolds - Advanced Specialist Pharmacist (Medicines Governance), SPS 

Useful Links
SPS medicines monitoring tool
https://www.sps.nhs.uk/home/tools/drug-monitoring/
Questions to ask when giving medicines advice in liver impairment
https://www.sps.nhs.uk/articles/questions-to-ask-when-giving-medicines-advice-in-liver-impairment/
Information resources for managing medicines in liver impairment
https://www.sps.nhs.uk/articles/information-resources-for-managing-medicines-in-liver-impairment/
Symptom control in adults with advanced liver disease
https://www.basl.org.uk/index.cfm/content/page/cid/33 (available under Resources)
Prescribing weight adjusted oral paracetamol in adults BASL position statement
https://www.basl.org.uk/index.cfm/content/page/cid/20 (available under Resources)
LiverTox
https://www.ncbi.nlm.nih.gov/books/NBK547852/
Memorial Sloan Kettering Cancer Center's About Herbs database 
https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search

Drugs in liver impairment

Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the shingles service under Pharmacy First. Discussion includes the link between chickenpox and shingles, typical presentation of shingles, dermatomal distribution of shingles and how to respond to requests for video consultations. (20m 23s)

Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member  
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS 
Liz Kramer – Community Pharmacist  

Useful links:  
Post exposure prophylaxis for chickenpox and shingles - GOV.UK (www.gov.uk) 

Images of shingles:  
NHS shingles resources 
https://www.nhs.uk/conditions/shingles/ 

DermNet shingles resources  
https://dermnetnz.org/topics/herpes-zoster

Primary Care Dermatology Society shingles resources  
https://www.pcds.org.uk/clinical-guidance/herpes-zoster

Black & Brown skin resources (including images on diverse skin tones) 
https://www.blackandbrownskin.co.uk/campaigns

DermNet dermatomes 
https://dermnetnz.org/topics/dermatomes

Shingles immunisation programme: information for healthcare practitioners 
https://www.gov.uk/government/publications/shingles-vaccination-guidance-for-healthcare-professionals/shingles-immunisation-programme-information-for-healthcare-practitioners

Pharmacy First: Shingles

Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the impetigo service under Pharmacy First. Discussion includes how patients with impetigo usually present, differential diagnoses, advice to prevent the spread of impetigo and information about how what to when first line treatments are out of stock, including information about the SPS Medicines Supply Tool. (11m)

Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member  

Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS 

Liz Kramer – Community Pharmacist  

Useful links:  

Information on how to stop impetigo spreading available via: Impetigo - NHS (www.nhs.uk) 

Patient information leaflet from the British Association of Dermatologists 
https://www.nhs.uk/conditions/impetigo/
 
SPS Medicines Supply Tool 
https://www.sps.nhs.uk/wp-login.php?redirect_to=https%3A%2F%2Fwww.sps.nhs.uk%2Fhome%2Ftools%2Fmedicines-supply-tool%2F&reauth=1

Pharmacy First: Impetigo

Kieran Reynolds talks to Dr Stephanie Gallard and Liz Kramer about some of the clinical issues you may encounter when providing the infected insect bites/stings service under Pharmacy First. Discussion includes how to differentiate between infected and non-infected insect bites, advice to give patients to prevent insect bites from becoming infected and how patients with insect borne diseases may present. (13m 53)

Dr Stephanie Gallard – GP with special interest in dermatology, PCDS Executive committee member  
Kieran Reynolds – Advanced Specialist Pharmacist (Medicines Governance), SPS 
Liz Kramer – Community Pharmacist  

Useful links: 

NHS Lyme disease 
https://www.nhs.uk/conditions/lyme-disease/

PCDS Lyme disease   
https://www.pcds.org.uk/clinical-guidance/lyme-disease

Tick Borne Encephalitis  
https://www.nhs.uk/conditions/tick-borne-encephalitis/

Malaria
https://www.nhs.uk/conditions/malaria/

Pharmacy First: Infected Insect Bites

Rakhi talks to Antonio about newer therapies for lipid management, incliseran and bemepdoic acid.  They discuss their place in therapy and how they may be initiated in primary care. 

This is the final part of our three-part series. 
 
Antonio Ochoa-Ferraro: Consultant Pharmacist, Inherited Metabolic Disorders; University Hospitals of Birmingham 
Rakhi Aggarwal: Primary Care Lead, Medicines Use and Safety; NHS SPS 

Useful links 

Cholesterol and Cholesterol levels 
https://www.heartuk.org.uk/cholesterol/overview  

NICE guidance 
Inclisiran: https://www.nice.org.uk/guidance/TA733  
Bempedopic acid with ezetimibe: https://www.nice.org.uk/guidance/ta694  

NHS England summary of national guidance for lipid management 
https://www.england.nhs.uk/aac/publication/summary-of-national-guidance-for-lipid-management/ 

NHS Birmingham and Solihull ICB procurement & prescribing of inclisiran  
https://www.birminghamandsurroundsformulary.nhs.uk/docs/files/Procurement%20and%20Prescribing%20of%20Inclisiran.pdf?UNLID=93161104220252141045  

Novartis inclisiran resources 
https://www.pro.novartis.com/uk-en/medicines/cardio-metabolic/leqvio/resources 

Open Access Articles 

Harnessing RNA Interference for Cholesterol Lowering: The Bench-to-Bedside Story of Inclisiran 
https://pubmed.ncbi.nlm.nih.gov/38456415/  

Inclisiran administration potently and durably lowers LDL-C over an extended-term follow-up: the ORION-8 trial 
https://pubmed.ncbi.nlm.nih.gov/38753448/ 

Bempedoic Acid for Prevention of Cardiovascular Events in People With Obesity: A CLEAR Outcomes Subset Analysis 
https://pubmed.ncbi.nlm.nih.gov/39921511/ 

Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society 
https://pubmed.ncbi.nlm.nih.gov/23956253/

Lipid management and newer therapies

Claire Davies chats to Neera Shah about the challenges and considerations with insulin safety in health and justice and secure settings.  

Claire Davies – Advanced Specialist Pharmacist, SPS – Project Lead, Insulin Safety  
Neera Shah -  Area pharmacist, Offender Health 


MSATS: Insulin safety considerations in Health and Justice and secure settings

Claire Davies chats with Toby, a person living with diabetes, as to why it is essential that the voice of those with lived experience is heard and is central to any system-wide discussions about insulin safety and what is important to him to ensure his insulin therapy is safe alongside visual impairment. 

MSATS: Voice of people living with diabetes - insulin safety and visual impairment

In this episode of Pharmacy Podcast that provides regular interviews with Pharmacy leaders, entrepreneurs, and members of The Independent Pharmacies of Australia (IPA), host Melody Mugari, a Pharmacist and Programs and Corporate Partnerships Manager at Independent Pharmacies Australia (IPA)  sits down with Nader Mitri, General Manager of PharmaPrograms, to explore how innovation, strategic thinking, and patient-first models are reshaping the Pharmacy landscape. With over two decades of experience, including owning three community pharmacies and holding a Master’s in Health Economics, Nader brings deep industry insight into how Pharmacists can expand their impact beyond the dispensary. Together, Melody and Nader unpack the challenges, opportunities, and future pathways for Pharmacists looking to create meaningful, lasting change in healthcare delivery.


Pharmacy Podcast  - Ep 11 - How to Increase your Pharmacy’s Revenue while Achieving Better Patient Outcomes

Audio from our webinar held on the 4 March 2025 which featured a facilitated case-based discussion about the complexities of polypharmacy and deprescribing. This was a follow on from our first webinar, which lays the foundations of some of the deprescribing tools available. (57m02s)

Speakers: 
Lelly Oboh: Older people lead, NHS SPS
Jasvir Singh Dhillon: Clinical pharmacist, Shropshire, Telford & Wrekin ICB, & GP practices
Rakhi Aggarwal: Primary care lead, NHS SPS

Primary care discussions: personalised evidence-based medicine to minimise polypharmacy

NHS Specialist Pharmacy Service serves healthcare professionals across the NHS who are involved in all aspects of buying, making and using medicines.  Our motto is 'do once and share'.

Welcome to Pharmacy View – Technology in Pharmacy Business Podcast Series where we provide regular interviews with Pharmacists and key industry people within the Australian Pharmacy and associated industry. In each podcast we look to discuss aspects of Pharmacy operation and how technology is improving or interacting with each guest’s current role or Pharmacy related business.

New tracks tagged #communitypharmacy