{"title":"Bariatric surgery and medicines: from first principles to practice.","authors":"Teresa Girolamo, Rosemary Allin","doi":"10.18773/austprescr.2022.053","DOIUrl":"https://doi.org/10.18773/austprescr.2022.053","url":null,"abstract":"<p><p>Obesity is a major public health issue with significant health and financial costs. Almost one in three Australian adults are living with obesity Bariatric surgery can have a role in the management of obesity. There is evidence for its effectiveness in preventing or reversing chronic health conditions The type of bariatric surgery can significantly impact the absorption, distribution, metabolism or elimination of orally administered drugs. Some changes can be predicted from pharmacokinetic and physiological effects, but management should be individualised The effect of weight loss itself after bariatric surgery may require drug doses to be altered A review of the patient's medicines and ongoing follow-up are important before and after surgery to ensure optimal outcomes.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 5","pages":"162-166"},"PeriodicalIF":2.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/76/austprescr-45-162.PMC9584784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10429472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to step down asthma preventer treatment in patients with well-controlled asthma - more is not always better.","authors":"Helen K Reddel, Gloria J Foxley, Sharon R Davis","doi":"10.18773/austprescr.2022.033","DOIUrl":"https://doi.org/10.18773/austprescr.2022.033","url":null,"abstract":"<p><p>Most of the benefit of asthma preventer inhalers is seen with low doses. However, many Australian patients are prescribed doses of inhaled corticosteroids that are higher than necessary to control their asthma. Prescribing unnecessarily high preventer doses increases the patient's risk of adverse effects. They may also increase the patient's out-of-pocket costs. Asthma guidelines recommend considering a step-down in preventer treatment after asthma has been well controlled for two to three months in adults and for six months in children. The step-down process should be individualised for each patient. Preventive therapy should not be stopped completely.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 4","pages":"125-129"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/f8/austprescr-45-125.PMC9427634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40361740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Australian PrescriberPub Date : 2022-08-01Epub Date: 2022-07-07DOI: 10.18773/austprescr.2022.041
{"title":"Risdiplam for spinal muscular atrophy.","authors":"","doi":"10.18773/austprescr.2022.041","DOIUrl":"https://doi.org/10.18773/austprescr.2022.041","url":null,"abstract":"The most common form of spinal muscular atrophy is due to mutations in a gene located on chromosome 5. This is sometimes referred to as 5q SMA. As a result of the mutation there is reduced production of survival motor neuron (SMN) protein. This leads to progressive muscle weakness. The most frequent type of spinal muscular atrophy (SMA1) presents in babies as hypotonia, poor head control and impaired swallowing. Due to neuromuscular weakness, respiratory support will be needed and life expectancy is usually under two years.","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 4","pages":"142-143"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/22/austprescr-45-142.PMC9427635.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Progesterone and progestogens.","authors":"Joanne Lipinski","doi":"10.18773/austprescr.2022.047","DOIUrl":"https://doi.org/10.18773/austprescr.2022.047","url":null,"abstract":"I am concerned by the ambiguity about progesterone/progestogen in the article ‘Hormonal contraception and mood disorders’.1 The summary correctly states ‘The link between oral contraceptive pills and depression relates to the amount and type of progestogen contained in these pills’, but the article subsequently says that progesterone can worsen mood symptoms. Plausible links are said to include progesterone augmentation of GABA-induced inhibition of glutamate transmission, and progesterone increasing the concentrations of monoamine oxidase, resulting in decreased serotonin concentrations. However, these links should be referring to progestogen rather than progesterone.","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 4","pages":"115"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/eb/austprescr-45-115.PMC9427621.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Therapeutics for rheumatic fever and rheumatic heart disease.","authors":"Anna P Ralph, Bart J Currie","doi":"10.18773/austprescr.2022.034","DOIUrl":"10.18773/austprescr.2022.034","url":null,"abstract":"<p><p>The goals of acute rheumatic fever therapy are to relieve symptoms, mitigate cardiac valve damage and eradicate streptococcal infection. Preventing future recurrences requires long-term secondary antibiotic prophylaxis and ongoing prevention of Streptococcus pyogenes (group A streptococcus) infections The recommended regimen for secondary prophylaxis comprises benzathine benzylpenicillin G intramuscular injections every four weeks. For patients with non-severe or immediate penicillin hypersensitivity, use erythromycin orally twice daily The goals of therapy for rheumatic heart disease are to prevent progression and optimise cardiac function. Secondary antibiotic prophylaxis can reduce the long-term severity of rheumatic heart disease Patients with rheumatic heart disease, including those receiving benzathine benzylpenicillin G prophylaxis, should receive amoxicillin prophylaxis before undergoing high-risk dental or surgical procedures. If they have recently been treated with a course of penicillin or amoxicillin, or have immediate penicillin hypersensitivity, clindamycin is recommended.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 4","pages":"104-112"},"PeriodicalIF":3.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/bf/austprescr-45-104.PMC9427630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Australian PrescriberPub Date : 2022-08-01Epub Date: 2022-06-07DOI: 10.18773/austprescr.2022.043
{"title":"Trastuzumab deruxtecan for breast cancer.","authors":"","doi":"10.18773/austprescr.2022.043","DOIUrl":"https://doi.org/10.18773/austprescr.2022.043","url":null,"abstract":"","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"45 4","pages":"146"},"PeriodicalIF":2.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/99/austprescr-45-146.PMC9427624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}