1 February 2011

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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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 www.australianprescriber.com