National Prescribing Service (NPS) - Community Information

  

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NPS Direct May 2013	9 years since Vioxx - NSAIDs still a concern NSAIDs are essential medicines for many people experiencing all levels of pain. However, they may increase the risk of developing  cardiovascular disease. Are you up to date with the latest research? Will new dietary guidelines improve health? The 2013 NHMRC Australian Dietary Guidelines are out. Not much has changed from the previous 2003 guidelines but the evidence has strengthened. Despite a decade of guidelines, rates of obesity and type 2 diabetes continue to rise. What can be done? Incretins and pancreatitis - is there a problem? People with diabetes have an increased risk of developing pancreatitis but the risk may be higher in people taking incretin-based medicines. How can you manage this risk while offering the latest treatments to your diabetes patients? Click HERE to see overview of NPS Direct March 2013
NPS Direct  April 2013	Fatal arrhythmias drugs and the QT A variety of medicines have known QT interval effects. Prescribing these medicines may lead to the development of fatal arrhythmias. Are you aware which medicines prolong the QT interval and how to prescribe them for your patients? New antivirals to manage hep C The direct-acting antivirals boceprevir and telaprevir will soon be reimbursed for treatment of hepatitis C virus infection. The landscape of treatment may be changing but GP's still hold the key to expanding access to treatment. Find out what you can do in primary care. Youth suicide: are you doing enough? Suicide is the leading cause of death among young people. Many people seek GP help in the months preceding a suicide attempt, providing an opportunity for you to introduce interventions that may positively impact suicide prevention. What are the current treatment strategies you can use? Click HERE to see overview of NPS Direct April 2013
NPS Direct March 2013	Aspirin and AMD -a link missing A study of age-related macular degeneration (AMD) in aspirin users prompted media claims of a risk of blindness in long term users. Aspirin is an important preventive medicine for people at risk of cardiovascular disease. Will it increase their risk of AMD? Is it safe to use SSRIs during pregnancy? Depression can influence pregnancy outcomes and should be managed appropriately. There are inconsistent findings about whether SSRIs increase adverse outcomes in pregnancy, so what should you consider when treating pregnant women? Fracture risk with high dose thyroxine The TGA has published a safety update, and the Product Information has been updated, warning about the risk of osteoporotic fracture in patients taking excessive thyroxine doses. Read more for practical advice on managing patients taking thyroxine. Click HERE to see overview of NPS Direct March 2013
NPS Direct Feb 2013	Genetic testing and personalised medicine Advances in personalised medicine and direct-to-consumer marketing of tests have moved genetic testing into the medical mainstream. GPs are increasingly called upon to manage issues in what was once the domain of clinical geneticists and other specialists. Are you ready? Safety update on allopurinol hypersensitivity Allopurinol hypersensitivity (AH) may present differently among patients; thus identifying a causative mechanism is difficult. There has been a sustained effort to find markers which may predict susceptibility to AH with the aim to prevent serious and occasionally fatal reactions Zolpidem may cause next-morning alertness impairment The FDA is calling for a 50% reduction in bedtime doses of the insomnia drug zolpidem in women, and asking prescribers to consider lower doses for men. New data show that next-morning blood levels of zolpidem may remain high enough to impair alertness Click HERE to see overview of NPS Direct February 2013
NPS Direct Jan 2013	Varenicline (Champix) — clearing the air on cardiovascular safety A recent meta-analysis demonstrated a small, statistically non-significant, increase in cardiovascular events in people taking varenicline. Health professionals are advised to weigh up the small risk of cardiovascular adverse events against the cardiovascular benefits of quitting smoking when considering varenicline. MRI in primary care — reducing radiation exposure Concerns about exposure to ionising radiation inducing cancer | Imaging is justified if the potential benefits outweigh the risks | The risk of radiation-induced cancer depends on patient age and imaging protocol | CT is associated with higher effective radiation doses than X-ray | Increased opportunities for GP-referred MRI | Discuss options and findings in partnership with radiologists Delay in PBS listing of dabigatran An announcement by the Australian Minister for Health indicated that the decision recommending PBS listing of dabigatran should be reviewed. It recommended that more work is needed before new oral anticoagulants could be listed for stroke prevention in atrial fibrillation. EARN CPD points with NPS MedicineWise online activities GPs – register for the Clinical e-Audits and earn 40 RACGP QI&CPD (Category 1) points or 30 ACRRM PRPD points. Latest topic: Type 2 Diabetes - Priorities and Targets Pharmacists – register for Pharmacy Practice Reviews and earn 8 hours of Group 2 CPD (or 16 CPD credits). Latest topic: Type 2 Diabetes - Enhancing patient care Click HERE to see overview of NPS Direct January 2013
Case study 75 report - Type 2 diabetes	Case study 75 report — Type 2 diabetes The report for Case study 75: Type 2 diabetes — Intensifying glycaemic control is now available online. Evidence-based practice points include: • Manage lipids and blood pressure as a priority in people with type 2 diabetes. • Individualise glycaemic targets based on patient factors such as: – duration of the disease – intensity of glucose-lowering medicines used – presence of cardiovascular disease and comorbidities – hypoglycaemic risk • Consider insulin as the preferred drug in people with poor glycaemic control despite taking maximally tolerated doses of metformin and a sulfonylurea. • Monitor all aspects of the patient's health using the 'Annual Cycle of Care'  Click here for the full publication online This is the final NPS case study and case study report. For other NPS professional development activities, see the Professional development section on the new NPS website. Information from NPS — at no cost to you! Order NPS has many free resources for use by health professionals. To view and order from our extensive range of medicines information resources, go to NPS online catalogue.
NPS Direct Dec 2012	NPS Direct is a new monthly e-newsletter for Australian health professionals, designed to meet your information needs and keep you up to date with the latest evidence on medicines, medical devices and current health topics Increasing use of MRI in primary care Immunisation - call for vigilance not complacency  Can statins reduce cancer-related mortality? Click here for the full publication online
Medicines Talk issue41	NPS - Medicines Talk issue 41 This issue of Medicines Talk contains articles on tackling anxiety, medicines and machinery, antibiotics use, talking about medicines in hospital. Written by consumers for consumers, Medicines Talk is a free quarterly newsletter that gives you reliable, accurate information and useful hints on managing your medicines. Visit http://www.nps.org.au/bemedicinewise for further information.
Common Cold	Common cold Anyone can get a cold at any time and they are very common: children can get about 5-10 colds per year adults can get 2-4 colds per year children get more colds than adults because they are not immune to as many cold viruses as adults are. Colds are caused by a virus. There are about 200 different viruses that can cause a cold and each one is slightly different. That is why you can get one cold after another. Once your immune system has fought off an infection with one particular cold virus, you will be immune to that virus. The cold is also called acute viral rhinosinusitis. The common cold is not the same as flu (influenza). Flu is caused by a completely different virus (influenza virus A or B), and has much more severe symptoms. However the cold virus can still make you feel unwell and is usually more than just a runny nose. For more information about the common colds and the problem of resistance, please visit NPS at http://www.nps.org.au/conditions/common_cold
Cold/Coughs/Flu Medicines	Cough and cold medicines in young children: New TGA advice   The Therapeutic Goods Administration (TGA) has released new advice restricting the use of cough and cold medicines in young children. This advice comes amidst concerns they have limited efficacy and may even be harmful.   A review conducted by the TGA found that there was little credible research showing the effectiveness of cough and cold medicines, particularly in children, and these medicines should not be given to children younger than 6 years old. The advice also recommends that parents should also ask a doctor, pharmacist or nurse practitioner for advice before giving cough and cold medicines to children aged 6 to 11 years.   Clinical trials have shown that some of the active ingredients in cough and cold medicines may cause serious side effects in children, for example seizures.   To reflect the new advice, labels on these medicines are being changed to indicate that they should not be given to children under 6, and that consumers should ask their doctor, pharmacist or nurse practitioner before giving the medicine to children aged 6 to 11.   In light of this advice, health professionals are reminded of some other simple remedies that can be used to manage a child’s cough or cold symptoms, including: •      Plenty of rest and water •      Avoiding cigarette smoke •      Steam from a hot shower or bath (supervised) •      Hot honey and lemon drink •      Ice cube or sore throat lozenge to soothe a sore throat (for older children) •      Paracetamol to ease the discomfort of fever   To read updated information about cough and cold medicines on the NPS MedicineWise website go to http://www.nps.org.au/conditions/common_cold/medicines_and_treatments_for_colds/cough_cold_flu_medicines/   More information can also be found on the TGA website.
Register now	NPS clinical audits First online NPS Clinical e-Audit for GPs now available - Management of specific respiratory tract infections   GPs can register for and complete the audit via http://www.nps.org.au/clinical_audits   This activity is part of the Antibiotic resistance and respiratory tract infections program and allows GPs to review their management in comparison with best practice clinical indicators and their peers.
Order Now	Healthy Communities program updates Why do some people need antibiotics?   NPS has developed a bilingual brochure on acute respiratory infections for seniors and those with chronic conditions. The brochure explains why some people are more likely to be prescribed antibiotics than others and offers tips on preventing the spread of infection.   Available in Arabic, Chinese (simplified and traditional), Croatian, Greek, Italian, Korean, Macedonian and Vietnamese, this resource can be ordered or downloaded at: http://www.nps.org.au/ordernow

 Updated 23 May 2013