MEDUSA is an injectable medicines guide comprising of around 400 monographs for medicines given by the parenteral route. With the exception of cytotoxics, monographs describe how medicines should be prepared and administered and are written by pharmacists from trusts around the UK. Additional input comes from the drug manufacturers and the NPSA. The guide is co-ordinated by a team at Imperial College in
London.
Direct access to the site without the requirement to login is through this link
What information do the monographs contain?
Information on reconstitution and dilution and how and at what rate the medicine should be administered is included. Technical information (e.g. pH, osmolarity, sodium and latex content), compatibility data, storage instructions and expiry times are also covered. Each monograph has links to relevant BNF and BNFC entries and to the SPCs and PILs.
Does the website include help with drug infusion rate calculations?
Yes. Example calculations are given for medicines administered by continuous IV infusion and an electronic calculator is also added to the monograph if appropriate. Example calculations are often supported by ‘linked’ tables in which rates of administration have been calculated for a selection of doses and concentrations of solution.
Are the NPSA Product risk assessments covered in the Guide?
Yes. Example product risk assessments for commonly-used products are given. Separate risk assessments for adult and paediatric practice are included for medicines given by the IV route. Be aware that these are examples only and may not always be relevant because of differences in practice.
How can my Trust gain access to the Injectable Medicines Guide?
To access the Guide, NHS hospital trusts can either contribute to the Guide by writing monographs or
subscribe. The number of monographs required and the cost of the subscription is determined by
the size of the Trust.
To find out more about contributing or subscribing, contact gillbullock@nhs.net
Can the Guide website be accessed without a user name and password?
Yes. Once the website is installed on a local Trust network it can be made available without the need
to log in.
Can Trusts select which monograph headings are available to website users?
Yes. A ‘condensed’ version of a monograph can be created that includes only those sections that are
essential for safe administration of the medicine but with access to the full monograph.
Monographs can be printed if access to computers is limited in clinical area. Monograph sections included in any printed versions can be adapted to local requirements.
Is it possible to ‘link’ local guidelines to the Guide website?
Yes. Organisations can link locally-produced medicine-related guidelines to individual monographs to create a version of the website more suitable for local needs.
For organisations with their own local injectable medicines guide it is possible to add the local guide
to the website so that it can be viewed with a link to the relevant website monograph.
Is there external funding for the Injectable Medicines Guide?
No sustainable source of continuous funding is currently available. This is why the database is password protected and only available to Trusts that write monographs for the Guide or those that subscribe. Free access for everyone would remove the incentive to contribute.
Other than Trusts, who else can access the Guide?
UK community practitioners and private hospitals can subscribe to the guide. Manufacturers can have access to monographs for medicines that they make/supply, free of charge. Manufacturers are asked to comment on draft monographs before they are published on the website and to provide the Guide group with access to an electronic version of relevant SPCs and PILs.
As an author, is there any support to help me write monographs?
Yes. There is a comprehensive Process Manual and Writing Guideline and the Injectable Medicines Guide team is always available on the phone. All monographs are checked by a medicines information and a paediatric pharmacist external to the Trust before publication.
Is there a training package for using the Guide?
Yes, on the ‘Documents and links’ page. It is only accessible using a ‘write access’ (authors) password.
What groups are involved in the development of the Injectable Medicines Guide?
A multidisciplinary advisory board, chaired by the president of the Intensive Care Society, has recently been set up to oversee development of the Guide. Board members include medics, nurses and pharmacists representing several areas of practice and specialties.
The Neonatal and Paediatric Pharmacist group (NPPG) has funded paediatric pharmacist time to develop paediatric IV monographs.
Mental health pharmacists have written monographs for mental health medicines given by IM injection.
The UK Ophthalmic Pharmacy Group has written monographs for intraocular injections and for IV medicines specifically used in ophthalmic practice.
The Specialist Pharmacy Service, specifically the UK Medicines Information group (UKMi), check all new and updated monographs for accuracy and clarity.
The Commercial Medicines Unit (CMU) provides information on all injectable products on contract in England and gives authors access to the CMU database.
Is the Injectable Medicines Guide group involved in any other projects?
Yes. Work is in progress to standardise concentrations of drug infusions used in critical care areas. The Intensive Care Society has issued a statement supporting the adoption of standard concentrations for sixteen medications commonly used in critical care. Monographs on the website relating to the medicines listed in the statement are being updated to reflect the recommended standard concentrations.
What is it?
The Injectable Medicines Guide comprises around 400 monographs for medicines given by the parenteral route. Monographs describe how medicines should be prepared and administered and are written by pharmacists from Trusts around the UK. The Guide contains additional useful documents and resources (eg Guidance from the Royal College of Nurses).
The Guide is co-ordinated by a team based at Imperial College in London.
Which medicines are included?
The Guide covers medicines given by the intravenous (IV) route with the exception of cytotoxics. There are separate IV monographs for adult and paediatric practice.
Monographs for medicines given by the intramuscular (IM) route are also included. Most are for medicines used in mental health practice; monographs are being written for other medicines commonly given by IM injection, such as antibiotics.
There are a small number of monographs for medicines given by intraocular injection.
Where is the Injectable Medicines Guide hosted?
The Guide is available electronically.
Monographs are formatted so that they can be printed if required.
Main website: http://medusa.wales.nhs.uk
Can I see a demonstration of the guide, before I subscribe or contribute? Yes.
Username: ivgdemo
Password: bolus7
More information on the Injectable Medicines Guide?
Contact:
gillbullock@nhs.net
or for website queries
robin.burfield@wales.nhs.uk