Dental infections, breast cancer testing, and cardiac effects of non-cardiac drugs, in April edition of Australian Prescriber

 April 2011

The latest edition of Australia Prescriber is out now and looks at the following topical issues:

Improving Aboriginal and Torres Strait Islander people’s access to medicines

Despite having more chronic disease than other Australians, Aboriginal and Torres Strait Islander people make less use of the Pharmaceutical Benefits Scheme (PBS). Dr Noel Hayman, Clinical director of the Inala Indigenous Health Service, explainshow their access to medicines can be improved by using PBS medicines listed specifically for Aboriginal and Torres Strait Islander people. They can also register for the Indigenous Chronic Disease Package to receive their drugs at a lower price. Incentives are available to doctors to enrol patients to obtain these benefits.

Managing dental infections

Access to dental care can be difficult in some areas, and can sometimes result in inappropriate treatment. Dr Ricky Kumar, Dr Paul Sambrook and Professor Alastair Goss of the Royal Adelaide Hospital provide an example of why toothache should not be treated with antibiotics and argue that dental pain and swelling is a dental problem which should be treated by a dentist. If the patient presents to a doctor they should be referred to a dentist.

Breast cancer testing

Genetic testing for familial breast cancer is available in specialised laboratories but is only useful for a small number of breast cancers. It is expensive and presents a significant technical and interpretative challenge, write Dr Chiyan Lau and Dr Graeme Suthers of the Women's and Children's Hospital in Adelaide. Identification of a causative mutation carries lifelong health and psychosocial implications for the woman and her relatives, and influences surveillance and treatment options. Testing should therefore only be considered with professional genetic counselling by specialists in familial cancer clinics.

Cardiac effects of non-cardiac drugs

Drugs prescribed for non-cardiac conditions can have unexpected and serious cardiac effects which may occur immediately or be delayed for years. Dr Ingrid Hopper, Clinical pharmacology fellow at Alfred Health, discusses drugs with known cardiac adverse effects including clozapine, rosiglitazone, non-steroidal anti-inflammatory drugs, tumour necrosis factor blockers, cancer chemotherapy and drugs for Parkinson's disease.

Medication Safety Update

  • Drug-induced hyponatraemia
  • Rotavirus vaccination and risk of intussusception: investigation of a possible safety signal
  • New packaging to reduce potential for dispensing errors

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Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published by NPS, an independent, not-for-profit organisation for quality use of medicines funded by the Australian Government Department of Health and Ageing. Australian Prescriber is published every two months, in hard copy that is distributed to health professionals free of charge, and online in full text at