Latest edition of Australian Prescriber out now

1 February 2012

The February 2012 edition of Australian Prescriber is out now and looks at the following topical issues:

Two viewpoints on deferring PBAC recommendations

In 2011 the government deferred the listing of seven medicines and one vaccine on the Pharmaceutical Benefits Scheme (PBS). Professor Rob Moulds, Medical advisor to Therapeutic Guidelines, argues that good use of older and cheaper drugs can achieve excellent clinical results, whereas Brendan Shaw, Chief executive of Medicines Australia, says the decision generated enormous uncertainty for Australian pharmaceutical companies.

Time to restock the doctor’s bag

The Pharmaceutical Benefits Scheme (PBS) provides doctors with a range of drugs for use in an emergency, however some of the drugs currently available do not represent best practice and should be replaced. Some drugs are potentially more dangerous than beneficial when used outside of hospital. Dr John Holmes, senior staff specialist in emergency medicine at Caloundra Hospital, writes that it is time to review the contents of the doctor’s bag to reflect modern practice.

Assessing fever in the returned traveller

Dr Tony Gherardin and Dr Jennifer Sisson from The Travel Doctor-TMVC group discuss the many causes of fever occurring after travel, and priorities for managing patients. While some patients may have tropical diseases such as malaria, many will have more common conditions such as respiratory illness and diarrhoea. The authors provide a checklist for taking a history in returned travellers to assist in the diagnosis.

Safe prescribing of opioids

Increasing use of opioids for non-cancer pain, and emerging evidence of a corresponding increase in related deaths, highlight the importance of prescribing opioids safely, says Dr Michael McDonough, Director of Addiction Medicine and Toxicology at Western Hospital in Melbourne. He outlines key factors in considering opioid treatment, choosing an appropriate opioid, and evaluating the efficacy of ongoing therapy. For many patients, long-term opioid use may not be safe and effective, according to the author, and having a treatment plan that includes the possibility of stopping opioids is essential.

Dangerous drugs online

The risks associated with self-medication have been amplified by the ability to buy prescription, non-prescription and complementary medicines as well as 'recreational' drugs online, according to Dr Ben Davies of the Institute of Medical and Veterinary Science, Adelaide. Some medicines ordered over the internet may be counterfeits or contain undeclared ingredients, and without effective methods for detecting emerging drugs, and with limited knowledge of their effects on users, online ordering poses a new challenge to public health. In the same issue, the Therapeutic Goods Administration warns of the inherent dangers of purchasing unregistered products online.

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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