Hamshi Singh
Academic registrar
Department of General Practice
Sydney Medical School
The University of Sydney

Melbourne: Therapeutic Guidelines Limited; 2012.

194 pages

These guidelines aim to provide the reader with information on assessment and management of acute and chronic pain. The topics are well organised, progressing from acute pain to chronic pain, even including a chapter on the transition between the two.

The first section on clinical assessment of pain does read a little like a first year medical textbook on how to take a pain history. However, there are some gems of information, particularly the section on psychosocial assessment of pain and assessing pain in people with communication difficulties.

Most medical practitioners in primary care would rarely need to be involved in preoperative and intraoperative pain management, but the small sections included on this are appropriate for completeness and to run into the more substantial section on postoperative pain. There is quite detailed information on treating patients in hospital and when they are discharged into the community.

There is particular emphasis and specific examples of non-pharmacological therapies for both acute and chronic pain, which is a reminder that even in patients with persistent pain not responding to analgesia, revisiting these therapies may produce gains in pain control.

Prevention of pain is as important as management, and the chapter on transition from acute to chronic pain is an important new inclusion in these guidelines. Throughout the book there is repeated mention that good acute pain management will prevent the development of chronic pain.

These guidelines provide firm recommendations on the need for adequate analgesia, but this is tempered by the clear emphasis on the safe use of analgesia. There are a number of new and expanded topics which results in a book that is practical and easy to use for the busy medical practitioner.

Subsidised medicines for Aboriginal and Torres strait Islander people

The Pharmaceutical Benefits Advisory Committee evaluates and recommends the listing of medications specifically to help with the health needs of Aboriginal and Torres Strait Islander people. It lists the items that are limited for prescription to Aboriginal and Torres Strait Islander people through the Pharmaceutical Benefits Scheme (PBS). For more information see www.pbs.gov.au/info/publication/factsheets/shared/pbs-listings-for-aboriginal-and-torres-strait-islander-people

Authority PBs listings as at 1 August 2013

Nasal colonisation with S. aureus
1. Mupirocin nasal ointment (2%)

Treatment of a fungal or a yeast infection
2. Ketoconazole cream (2%) and shampoo (1%, 2%)
3. Miconazole nitrate (2%) as cream, powder, lotion and tincture
4. Nystatin cream (100 000 units per g)
5. Terbinafine cream (1%)

Prophylaxis of thiamine deficiency
6. Thiamine tablet (100 mg)

Treatment of whipworm infestation, hookworm infestation, strongyloidiasis
7. Albendazole tablet (200 mg)

Treatment of chronic suppurative otitis media
8. Ciprofloxacin ear drops (0.3%)

Treatment of a dermatophyte infection where topical treatment has failed
9. Terbinafine tablet (250 mg)

Nicotine replacement therapy
10. Nicotine transdermal patch (releasing approximately 15 mg over 16 hours, 21 mg over 24 hours)

Hypomagnesaemia, chronic renal disease
11. Magnesium tablet (37.4 mg)

Hamshi Singh

Academic registrar, Department of General Practice, Sydney Medical School, Westmead, The University of Sydney