Dexamfetamine (as Amfexa®▼)

Where to buy Amfexa online UK. (from age 6 years) [unlicensed in adults]

ESCA: For the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) as part of a comprehensive treatment programme.

AREAS OF RESPONSIBILITY FOR THE SHARING OF CARE

This shared care agreement outlines suggested ways in which the responsibilities for managing the prescribing of dexamfetamine in Attention-Deficit/Hyperactivity Disorder (ADHD) as part of a comprehensive treatment programme can be shared between the specialist and general practitioner (GP). You are invited to participate however, if you do not feel confident to undertake this role, then you are under no obligation to do so. In such an event, the total clinical responsibility for the patient for the diagnosed condition remains with the specialist.

Where to buy Amfexa online UK. Sharing of care assumes communication between the specialist, GP and patient. The intention to share care will be explained to the patient by the specialist initiating treatment. It is important that patients are consulted about treatment and are in agreement with it. Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) are usually under regular specialist follow-up, which provides an opportunity to discuss drug therapy.

The doctor who prescribes the medication legally assumes clinical responsibility for the drug and the consequences of its use.

RESPONSIBILITIES and ROLES

Where to buy Amfexa online UK. Specialist responsibilities

1. Patients who are being transferred to adult services need to be reviewed by the specialist adult teams as per the trust internal governance process and to confirm that the current treatment is suitable and in line with the BSSE APC formulary.
2. Specialist assessment and confirmation of the diagnosis of attention deficit/hyperactivity disorder.
3. Discuss the potential benefits, treatment side effects, and possible drug interactions with the patient.
4. Ask the GP whether he or she is willing to participate in shared care before initiating therapy so that appropriate follow on prescribing arrangements can bemade.

6. Initiate treatment and stabilise dose of Dexamfetamine (as Amfexa®).
7. Dexamfetamine is a Schedule 2 Controlled Drug (CD), therefore should be prescribed in line with the Misuse of Drug Regulations. Prescription requirementsfor prescribing CDs should therefore be observed, maximum of 30 days per prescription.
8. Advise the patient on the importance of good adherence with the prescribed medication. Check adherence at each clinic appointment. Where to buy Amfexa online UK

10. Reassume prescribing responsibilities if a woman becomes or wishes to become pregnant.
11. A written summary to be sent promptly to the GP i.e. within 10 working days of a hospital outpatient review or inpatient stay.
12. Advise the GP what to do when defined parameters are altered, and when (if at all) an emergency referral should be made back to the specialist service.
13. Advise GP on the management of side effects and raise awareness at which point these will be reviewed and/ or managed by the specialist.
14. Advise the GP when to stop treatment and on management of discontinuation if necessary.
15. Report serious adverse events to the MHRA via Yellow Card Scheme https://yellowcard.mhra.gov.uk
16. Ensure clear backup arrangements exist for GPs, for advice and support (please complete contact details in appendix 1)General Practitioner responsibilities

1. Reply to the request for shared care as soon as practicable i.e. within 10 working days.
2. Ensure:• Patient/ family are clear who will be responsible for monitoring and what this will entail.
   • Patient/ family are aware of any significant adverse effects/ events, which should be urgently reported and who these should be reported to. (GP/specialist).
3. Prescribe dexamfetamine (as Amfexa®) at the dose recommended.
4. Dexamfetamine is a Schedule 2 Controlled Drug (CD), therefore should be prescribed in line with the Misuse of Drug Regulations. Prescription requirementsfor prescribing CDs should therefore be observed, maximum of 30 days per prescription.
5. Adjust the dose as advised by the specialist.
6. In the patient’s notes, using the appropriate Read Code listed below, denote that the patient is receiving treatment under a shared care agreementGP Prescribing System Read Code Description GP Prescribing System Read Code DescriptionEMIS and Vision 8BM5.00 Shared care prescribing SystmOne XaB58 Shared care
7. Monitor patient’s response to treatment; make dosage adjustments if agreed with specialist.
8. Report to and seek advice from the specialist or clinical nurse specialist on any aspect of patient care that is of concern to the GP, patient or carer and mayaffect treatment.
9. Refer back to specialist if condition deteriorates.
10. For women of child bearing age, refer prescribing responsibilities back to specialist immediately if patient becomes, or wishes to become, pregnant.
11. Report serious adverse events to specialist and MHRA via the Yellow Card Scheme https://yellowcard.mhra.gov.uk
12. Stop treatment on advice of specialist. Where to buy Amfexa online UK

5. Do baseline monitoring prior to initiation of this agent:

• weight, blood pressure, pulse and essential medical history, cardiovascular examination and ECG where indicated.
• full mental health and social assessment, full history and physical examination, family history of cardiac disease and an ECG if there is past medicaland/or family history of cardiac or cerebrovascular problems.
• risk assessment for substance misuse and potential for drug diversion. Where to buy Amfexa online UK

9. Review the patient’s condition and response to treatment every 6 months. Advise patients, families/ carers to report any side effects and/ or concerns. At 6 monthly reviews (unless otherwise indicated):

• Monitor efficacy of long term treatment and consider whether benefit can be gained from continued treatment.
• Monitor height, weight, appetite, heart rate and BP and any psychiatric symptoms.
• Request any further investigations that are clinically indicated such as ECG, blood investigations.
• Assess progress with regards to psychological, behavioural, educational and occupational needs.
• Assess ongoing need for medication.
• Assess any side effects.
• Consider the potential for drug diversion and potential for misuse.

Where to buy Amfexa online UK. Patient’s role

Report to the specialist, clinical nurse specialist or GP if he or she does not have a clear understanding of the treatment.
Attend regularly for required blood tests and annual health checks.
Share any concerns in relation to treatment with dexamfetamine (as Amfexa®) with the specialist, clinical nurse specialist or GP. Report any adverse effects to the specialist or GP whilst taking dexamfetamine (as Amfexa®).
Attend regular outpatient appointments with the specialist.
Female patient: Inform the specialist, clinical nurse specialist or GP if she becomes or wishes to become pregnant.