Australian Prescriber April edition: Elimination of hepatitis C in Australia; treating opioid overdose; and opioids and antidepressants don’t mix

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on drugs and therapeutics for health professionals. The April edition, out now, covers a wide range of topics.

Elimination of hepatitis C in Australia by 2030

With the advent of effective ‘direct-acting antiviral’ treatments for hepatitis C, Australia is one of the 12 countries ‘on-track’ to eliminate hepatitis C by 2030. The author says prevention, screening, financial incentives and process improvement are critical strategies to reach the final goal of elimination.

Life-saving medicine for opioid overdose

While around two-thirds of opioid-related deaths are from prescription opioids, most people who are prescribed opioids don’t know about naloxone. This medicine reverses the effects of opioids and can buy precious time until an ambulance arrives. Changes have been made to increase the availability of naloxone. The authors explain that naloxone is now subsidised by the government, and available over-the-counter at pharmacies. It is now also available as a nasal spray, which many bystanders witnessing an opioid overdose may find easier to give than an injection.

Opioid pain medicines and antidepressants don’t always mix

Taking an opioid medicine at the same time as an antidepressant can sometimes result in a bad reaction such as ‘serotonin toxicity’. Symptoms include tremor and other abnormal movements, agitation, confusion, sweating, palpitations and fever. Certain antidepressants can reduce the pain-relieving effect of some opioids and potentially cause other problems. The article provides a list of what combinations should be avoided.

The way we think about dying has to change

Most people who receive palliative care die of cancer. The 80% of people over age 70 who don’t die of cancer are mostly cared for in general practice, aged-care facilities and hospital. This article focuses on the needs of a dying patient, and the importance of reducing medicines to only those that maintain current wellbeing or prevent symptoms. Managing pain, breathlessness, nausea and vomiting may have a different focus and approach in end-of-life care.

Anticoagulant blood thinners for atrial fibrillation – balancing the risk of bleeding and stroke

An irregular heart beat called atrial fibrillation can cause a potentially fatal stroke. Anticoagulants (blood thinners) can reduce this risk, but increase the risk of bleeding which can also be fatal. Around three-quarters of people with atrial fibrillation who should be taking anticoagulants are not, while a quarter of those who should not be taking them are. The risks and benefits of using anticoagulants are outlined in the article.

Who can safely stop taking medicines to prevent epileptic seizures?

People with epilepsy taking medicines to prevent seizures may not need to take them forever. Depending on the type of epilepsy, they may decide with their doctor to try weaning off the medicine if they have been seizure-free for a long time. It can be a difficult decision as seizures may return in a third to a half of these people. This has implications for employment and driving.

Read also the new drug commentaries on the COVID-19 Pfizer and Astra-Zeneca vaccines.

     

    Media contact

    Matthew Harris, NPS MedicineWise Communications & PR adviser: (02) 8217 9229, 0419 618 365 or [email protected]