EDITORIAL for Monday 24 October 2016

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine dated Monday 24 October 2016.
You may have noticed a gap in our publishing schedule and it was due to this editor having a heavy landing in a hospital bed battling a stroke attack.
That it was unexpected goes without question, but I will share the circumstances because they may be of interest to clinical pharmacists.

I am a Type 2 diabetic and two weeks prior to the above event I had a review of my diabetic medications with my GP, because my glucose levels were heading north and existing medications were not doing the job.
I was persuaded that a relatively new drug, Forxiga, might be the answer, so I agreed to add it to my treatment.

Neither the GP, or I, undertook a drug interaction screen and this turned out to be an uncharacteristically bad move on my part, because a stroke occurred through an interaction with the diuretic component of Atacand Plus, which was part of my existing treatment.
Forxiga itself has a diuretic action (Forxiga Preoduct Infofrmation) and patient hydration has to be optimum during treatment with the drug.
There is a strong possibility I was dehydrated (noted in product information as having a potential for adverse reaction) with further depletion occurring during exercises (without prior hydration) directed by a physiotherapist during rehabilitation.
Fortunately, I was still functioning at a high level and belatedly undertook my own review and(see clinical report – Are They Related_ Sglt-2 Inhibitors and Stroke_ _ Case Series)
The side effects described for these case studies were identical to mine and disappeared after discontinuing Forxiga.
Given that this class of drug is relatively new to the Australian market clinical pharmacists may need to be alert to the potential for stroke given that senior patients are often inadequately hydrated, and if diabetic, may already have been prescribed a diuretic as a treatment for hypertension, often associated with insulin resistance.
I am now recovering progressively with some dexterity deficits and minimal intellectual deficits and hopefully will eventually get back to baseline.
A lesson learned the hard way.

Our lead article this week describes a home-grown effort to establish an Australian ethical medical marijuana industry.
From a tragic event an opportunity is emerging to make a genuine impact on the health of all Australians economically and with a strong evidence base.
Read: United in Compassion – Medical Marijuana and Dan’s Story
Some countries are developing a less ethical marijuana industry involving pharmacies in the recreational marketing of this substance.

Read: Medical Maijuana – will Australian Community Pharmacies consider the legislation of Uruguay?

Consumerism as an important component of health cost management, particularly in such programs like patient-centred homes. It appears they may not deliver promised benfits.
Read: Consumerism, health care costs and patient-centred “homes”

Pharmacy marketing and direction has a new imperative. It is no longer about being everything to everyone but being more selective and professionally focused .
It requires the systematic acquisition of knowledge – the real currency of marketing and practice development.
Read: Methods for gaining knowledge – mentors, advisers and choosing a discomfort zone

Mouhamad Zoghbi is back with an intriguing perspective of embracing care as a competitive advantage.
Think about it.
Read: Caring as a Competitive Advantage

Harvey Mackay has contributed an article for this edition and it concerns the concept of branding – that elusive and sometimes intangible that is central to successful marketing programs.
Read: Branding should be fascinating

And we finish up our offering for this edition with a range of media releases from pharmacy leadership organisations.

PSA – http://i2p.com.au/psa-media-releases-multi-releases-for-october-2016/

ASMI – http://i2p.com.au/asmi-media-release-tga-announces-nsaids-review/

NPS – http://i2p.com.au/nps-media-releases-for-october-2016/


We hope you enjoy the content offered in this edition and don’t forget to use the comments panel at the foot of each article if you have something to contribute.


Neil Johnston

Editor i2P E-Magazine,
Monday 24 October 2016

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