s NPS Media Releases for February 2011 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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NPS Media Releases for February 2011

NPS Spokesperson

articles by this author...

Regular information provided by NPS – Better choices, better health - NPS enables people to be medicinewise.

NPS is a valued independent resource for accurate, evidence-based prescribing information and education.
Given the marketing pressures applied by global drug companies, NPS plays a vital and unique role across the healthcare sector.
For more information please contact Katie Butt, NPS Media Adviser, 02 8217 8667 or kbutt@nps.org.au

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3 February 2011
ONE-IN-THREE FORGET TO TAKE THEIR MEDICINE: NPS SURVEY

New findings from a survey conducted by NPS have shed some light on exactly how Australians are using – and misusing – medicines.

Of 1500 Aussies surveyed 29% said they sometimes forget to take their medicine and while most never intentionally miss a dose (67%), take less than instructed (71%) or more than instructed (87%), NPS clinical adviser, Dr Danielle Stowasser says taking a casual approach is never a good idea.

“Every medicine you take should come with clear instructions, including things such as the maximum dose and the frequency which you can take it.  Ignoring these instructions can put your health at risk. Taking more can result in an overdose, while taking less might stop the medicine from doing its job.  That’s why it’s important people ensure they always follow the instructions carefully and if they are unsure, seek further information from their health professional. ”

While most respondents said they would seek information about their medicines from health professionals, when asked if they did ask questions of their doctor or pharmacist the last time they received or purchased a medicine, most said no (60%).

“Asking the right questions about your medicines is crucial to being medicinewise and will give you the information you need to make better choices about your health,” Dr Stowasser said.

Equally important is discussing what other medicines you’re taking with your health professional before starting a new medicine. The survey found 48% of respondents did not tell their doctor or pharmacist about other medicines they were taking the last time they received or purchased a medicine.

“All medicines, including prescription, over-the-counter and alternative and herbal, have the potential to interact with other medicines so it’s important you let your doctor or pharmacist know about all the medicines you are taking before starting any new medicine,” Dr Stowasser said.

The findings have been released as part of national Be Medicinewise Week, which is the launch of a broader campaign urging consumers to pay more attention to medicines.

“We want all Australians to be actively involved in their medicines decisions, so they get the most out of them and reduce their risk of adverse events. The quality of medicine information from sources other than your health professional can be difficult to judge, and making decisions based on incorrect or misleading information can be dangerous,” Dr Stowasser said.

To help people learn more about finding credible sources of information and what to consider before starting a new medicine, NPS has developed a series of free online learning modules called Medicinewise Choices.

A key component of Medicinewise Choices is how to find and assess reliable information sources, particularly online where advice may be driven by commercial interests, out-dated or not supported by evidence.

The NPS Medicines Line is a free telephone service providing consumers with information on prescription, over-the-counter and complementary/herbal medicines.

For more information visit www.nps.org.au/medicinewisechoices  or call 1300 MEDICINE (1300 633 424).

 

2 February 2011
CV risk assessment use must increase to combat rise in cardiovascular disease

Cardiovascular disease is the single largest cause of death in Australia. It affects 1 in 6 people – a figure expected to increase to 1 in 4 by 2050. More than half of Australians aged over 25 have cholesterol levels considered to be high.

The next NPS education program, ‘CVD risk: guiding lipid management’, encourages early assessment of people’s cardiovascular risk to identify those who may need to commence preventative therapies. Overall CV risk assessment allows treatment to be directed to those at highest risk and who are likely to receive the greatest benefit from therapy.

“There are many Australians whose CV risk has been underestimated or not assessed at all. Using a CV risk assessment tool has been shown to be more accurate at predicting absolute risk than clinical judgment alone,” NPS clinical adviser, Danielle Stowasser said.

Cardiovascular disease costs to the health system are expected to reach $11.5 billion this year. Lowering cholesterol is known to reduce total mortality and recurrent cardiovascular events in both men and women. Statins are the drug of choice for lowering blood LDL cholesterol, however before offering statin therapy for primary prevention, all other modifiable risk factors including lifestyle, should be addressed.

The CVD risk: guiding lipid management program promotes:

* Early assessment of absolute cardiovascular risk

* Discussion of the benefits of lifestyle changes on cardiovascular risk

* Determining if  a lipid lowering agent e.g. a statin  is necessary for the patient

* Encouraging long term adherence to lifestyle changes and/or lipid lowering agents to reduce cardiovascular risk

Australian guidelines recommend assessing anyone aged over 45, and Aboriginal and Torres Strait Islanders aged over 35. Repeat assessments should be conducted every 2 years for people at low risk (to coincide with their blood pressure check); every 6-12 months for people at moderate risk; and judiciously for people at high risk.

NPS provides the following resources and activities for health professionals:

* NPS News (71): Managing lipids, reducing cardiovascular risk
* Prescribing Practice Review (53): Absolute CVD risk assessment: guiding lipid management
* GP and GP Registrar clinical e-audit
* Pharmacy Practice Review (audit)
* National case study
* One-on-one educational visits by NPS facilitators
*Small group discussions led by NPS facilitators (including case scenarios for GPs, pharmacists and nurses)

A consumer campaign encouraging people to discuss CV risk assessment with their doctor or pharmacist commences in April 2011.

Links to CVD risk tools online can be accessed at www.nps.org.au/cvdrisktools

For more information visit www.nps.org.au/health_professionals

1 February 2011
Timely, independent information about new drugs

This NPS RADAR online update covers some February 2011 additions to the PBS, including new listings for nicotine patches and dutasteride, and a change to the listing of varenicline.

REVIEWS 

Nicotine patches (Nicabate P, Nicorette, Nicotinelle Step 1) for smoking cessation
PBS subsidised with support and counselling
Nicotine transdermal patches are now available on the PBS to all smokers who participate in a support and counselling program. This listing covers one 12-week course of treatment per patient per year, but not in combination with varenicline or bupropion. More

 IN BRIEF 

Dutasteride (Avodart) for lower urinary tract symptoms due to benign prostatic hyperplasia

Varenicline (Champix) — new PBS listing for an extra 12 weeks of therapy


NEXT ISSUE

The next issue of NPS RADAR will be published in April 2011. The latest reviews are also available in the December software updates of Genie and Medical Director.

FEEDBACK?

We welcome your feedback. Tell us what you think of NPS RADAR and what information you would like to receive.

INFORMATION FROM NPS

Order

To order from our extensive range of free medicines information resources for health professionals, visit the NPS online catalogue.

Subscribe

To keep up-to-date with information about medicines, subscribe to an NPS RSS feed or e-alert.

To update your details or unsubscribe click here.

To view our privacy policy click here.

 

1 February 2011
BE PREPARED FOR THE UNEXPECTED: DON’T LET YOUR HEALTH BE AN ADDITIONAL WORRY

During the recent Queensland floods, many people were caught without their medicines. This put some people at risk of serious health complications and caused untold additional stress.

Ahead of possible cyclones and further severe weather patterns, NPS has some tips for how people can protect their health during emergencies.

Keep a medicines list

A medicines list is a handy way to keep track of your medicines. It allows you to record important details about all your medicines, such as its name, what it’s for, what strength you take, and when you take it. This includes prescription, over-the-counter and natural or alternative medicines.

If you find yourself without your medicines you can take your medicines list to a GP and ensure you get replacement scripts for the right medicines, or to a pharmacist to discuss how they can help you. To download a printable medicines list visit www.nps.org.au

Keep a prescription wallet

Keep all your prescriptions in a prescriptions wallet and keep this in a safe and easy-to-access place so if you are evacuated you can find it quickly.

Take your regular medicines when you leave home

During emergencies, medicines are often the last thing on your mind. If you have time to pack, remember to take your regular medicines with you, or keep the prescription wallet in your bag so you don’t forget them in a hurry.

Remember to take your medicines as directed

During stressful situations when you’re not in your normal routine it’s easy to forget to take your medicines. When possible, set reminders for yourself on your phone or use your medicines list to check off each dose you take so you don’t get out of kilter.

If you forget to take a dose, ask a doctor or pharmacist what you should do or call the NPS Medicines Line on 1300 MEDICINES (1300 633 424).

Ensure you have adequate supplies

If you have time to prepare ahead of a possible emergency, ask your local pharmacist to help you ensure you have adequate supplies of your regular medicines. Make sure you store them in a safe, cool and dry place so they aren’t damaged. Think about any medicines that need to be refrigerated if it’s likely you will lose power. If your medicines have become wet or too hot, ask a pharmacist or call Medicines Line before taking them as it might affect how the medicines work in your body.

 

1 February 2011
Latest edition of Australian Prescriber out now

The first edition of Australian Prescriber for 2011 is out now and looks at the following topical issues:

Editorial – standards for electronic prescribing systems

Despite the widespread use of e-prescribing systems, there are no clear standards or guidelines for their development. Dr James Reeve and Ms Michelle Sweidan from NPS’s pharmaceutical decision support team discuss how this has led to systems with markedly different capabilities and what an ideal system should have to support safety and quality.

Non-surgical treatments for skin cancer

Dermatologist Dr Stephen Shumack of Sydney’s Royal North Shore Hospital weighs non-surgical treatments for skin cancer against excision, and argues that while they may sometimes have a superior cosmetic result and lower treatment-associated morbidity, they should not be used when the diagnosis is unclear or if follow-up is not assured.

Pain relief in pregnancy and breast-feeding

Women need not suffer pain unnecessarily during pregnancy and lactation as untreated pain can have adverse effects on the mother and baby. Dr Debra Kennedy, Director of MotherSafe, Royal Hospital for Women writes that appropriate therapeutic doses of commonly used paracetamol, aspirin and opioids have not been associated with an increased incidence of birth defects, although non-steroidal anti-inflammatory drugs should not be used in the third trimester.

Managing delirium in older patients

Delirium has many causes, however the diagnosis is often missed. It is best treated by addressing risk factors, treating underlying causes and minimising harm, writes Associate Professor Gideon Caplan, Director of Geriatric Medicine at Prince of Wales Hospital in Sydney. Pharmacological management may be needed by ceasing drugs that may cause the delirium and managing hyperactive symptoms with cautious use of antipsychotics. 

Medicines Safety Update

* Clozapine and serious adverse bowel reactions
* Drug interaction between tamoxifen and antidepressants

* Methysergide and retroperitoneal fibrosis 

To read the full articles and more visit www.australianprescriber.com

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