1 DECEMBER 2014
Latest edition of Australian Prescriber out now
The December 2014 edition of Australian Prescriber is out now.
Paediatric urinary incontinence
Gail Nankivell and Dr Patrina Caldwell from The Children’s Hospital Westmead analyse the often distressing condition of paediatric urinary incontinence. It is common in school-aged children and the article examines daytime and night-time incontinence. The authors explain how it can have a significant negative impact on a child’s well-being and quality of life. The article covers the physiology of bladder function, clinical assessment and treatment options.
Dr Donald Perry-Keene from the Royal Brisbane and Women’s Hospital provides a summary of male hypogonadism, a clinical syndrome of symptoms and signs confirmed by the presence of low testosterone. Hypogonadism in men refers to decreased function of the testes, in either testosterone or sperm production. A deficiency of testosterone may be due to primary gonadal failure, or be secondary to hypothalamo-pituitary disease. Dr Perry-Keene explains that treatment should not be based on serum testosterone alone. Reversible conditions and the adverse effects of other therapies should be excluded before prescribing testosterone.
Palliative care and pharmocovigilance
Debra Rowett, Director, Drug and Therapeutics Information Service at the Repatriation General Hospital, and Professor David Currow from Flinders University, discuss how patients receiving palliative care are at high risk of adverse effects from drugs. As these effects can be difficult to distinguish from the symptoms of terminal illness, harm from medicines is often not recognised. Prescribing medicines to relieve suffering and distress is a cornerstone of palliative care, however there is limited evidence about the efficacy and safety of many drugs in palliative care. The authors say there is a need to be aware of symptom cascades in palliative care and a need to encourage the reporting of adverse drug events.
The lists published annually in Australian Prescriber show the top 10 drugs by prescription count, by cost to government, and by defined daily dose per 1000 people. A statin tops each list, and pain relievers, proton pump inhibitors, ACE inhibitors, asthma, diabetes and blood pressure medicines also appear.
Other articles in this edition of Australian Prescriber include:
* New antiplatelet drugs for acute coronary syndrome
* Population pharmacokinetics: an overview
* Preoperative assessment: a cardiologist’s perspective
To read the full articles and more visit www.australianprescriber.com
1 DECEMBER 2014
TOP 10 SUBSIDISED DRUGS IN AUSTRALIA
The annual publication of the top10 subsidised drugs appears in the December edition of Australian Prescriber. Statins (cholesterol-lowering medicines) top the lists again.
More than 19 million prescriptions for the statins atorvastatin, rosuvastatin and simvastatin were filled under the Pharmaceutical Benefits Scheme between July 2013 and June 2014.
Rosuvastatin replaced atorvastatin at the top of the list for the most costly prescribed medicine, costing the government over $284 million for over 7.6 million prescriptions. The most prescribed medicine was atorvastatin, which topped the list at over 8.6 million prescriptions.
Adalimumab (an immune-system-modifying medicine prescribed for rheumatoid arthritis and Crohn’s disease) was the second most expensive drug, costing the government $270 million for around 152,500 prescriptions. Etanercept, a medicine for severe arthritis, cost the government $153 million for around 87,000 prescriptions.
In addition to statins, proton pump inhibitors (for reducing stomach acid production), pain relievers, ACE inhibitors (for high blood pressure and heart failure), and medicines for asthma, diabetes and blood pressure also appeared on the lists.
Other articles in this issue are:
* Medicines in palliative care.
To view the full lists of Top 10 drugs and other articles from the December issue of Australian Prescriber, visit