start_alert
START criteria
Cardiovascular
| condition | Drug |
|---|---|
| AF | anticoagulant |
| Vascular disease & in sinus rhythm | Aspirin or clopidogrel |
| sBP >160 mmHg (consistently) | Antihypertensive |
| Vascular disease + independent for activities of daily + life expectancy >5 years | Statin |
| Chronic heart failure | Angiotensin Converting Enzyme inhibitor |
| Acute myocardial infarction | Angiotensin Converting Enzyme inhibitor |
| Chronic stable angina | Beta-blocker |
Chest
| Mild to moderate asthma or COPD | Regular inhaled beta 2 agonist or anticholinergic |
|---|---|
| Moderate-severe asthma or COPD & FEV1 <50%. | Regular inhaled corticosteroid |
| Chronic type 1 respiratory failure (pO2 <8.0kPa, pCO2 <6.5kPa) | Continuous oxygen |
| Chronic type 2 respiratory failure (pO2 <8.0kPa, pCO2 > 6.5kPa) | Continuous oxygen |
Neurology
| Parkinson’s Disease with definite functional impairment & resultant disability | Levo-dopa |
|---|---|
| Depression, moderate-severe <3 months | Antidepressant |
Gastroenterology
| Severe GORD | Proton Pump Inhibitor |
|---|---|
| Peptic stricture requiring dilatation | Proton Pump Inhibitor |
| Diverticular disease with constipation | Fibre supplement |
MSeletal
| Active moderate-severe rheumatoid disease > 12weeks | Disease-modifying anti-rheumatic drug |
|---|---|
| Maintenance corticosteroid therapy | Bisphosphonates |
| Osteoporosis (previous fragility fracture, acquired dorsal kyphosis | Calcium & Vitamin D |
Endocrine
| Type 2 diabetes +/- metabolic syndrome | Metformin |
|---|---|
| Diabetes + proteinuria or microalbuminuria + GFR <50ml/min | ACE inhibitor or Angiotensin Receptor Blocker |
| Diabetes mellitus + major cardiovascular risk factors | Statin |
Author: Dr Dylan Jenkins, Oct 2023
ref: NHS England
ref: NHS England