Anaphylaxis: following an EMA review, patients at risk of anaphylaxis are now recommended to carry two auto-injectors at all times and use one at the first sign of a severe allergic reaction. This may be swelling in the throat that may affect swallowing, breathing and speaking, wheezing, and symptoms of hypotension such as dizziness, feeling faint and tiredness. If the first injection does not produce an improvement in the patient’s state, the second should be used after five to 15 minutes. 

Brimonidine gel can exacerbate rosacea symptoms in the initial stages of it being used, the MHRA warned. To minimise the risk, patients should use a small amount for a week or more, then increase the dose gradually based on tolerability and response. It also emerged this year that the product can cause cardiovascular effects, including bradycardia, hypotension and dizziness, particularly if applied to irritated or damaged skin, or after laser therapy.

Reflective exercise

After reading this module try to identify patients who would benefit from any of the new advice that has been issued this year.