{"title":"Pharmacological management of polycystic ovary syndrome.","authors":"Carolyn Ee, Chau Thien Tay","doi":"10.18773/austprescr.2024.030","DOIUrl":"10.18773/austprescr.2024.030","url":null,"abstract":"<p><p>Polycystic ovary syndrome is a common and frequently undiagnosed female endocrine disorder that is associated with diverse symptoms and features, and an increased risk of long-term chronic diseases such as type 2 diabetes and cardiovascular disease. Pharmacotherapy for polycystic ovary syndrome should be directed at the key concerns of the individual patient. The combined oral contraceptive pill or metformin may be prescribed for irregular periods. The combined oral contraceptive pill is preferred over antiandrogens for treatment of hirsutism and acne. Metformin is of benefit for reducing excess body weight and improving hormonal and metabolic outcomes in those with high metabolic risk (e.g. body mass index greater than 25 kg/m<sup>2</sup>). Inositol appears to have limited benefits for metabolic outcomes, although it is associated with fewer adverse effects than metformin. Modification of lifestyle factors is important as part of a holistic approach to managing polycystic ovary syndrome. Anti-obesity drugs may be considered for weight management in addition to lifestyle interventions.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 4","pages":"109-112"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127480","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":"Utility of common investigations for suspected inflammatory arthritis in adults.","authors":"Nicola Cook, Rachelle Buchbinder","doi":"10.18773/austprescr.2024.035","DOIUrl":"10.18773/austprescr.2024.035","url":null,"abstract":"<p><p>Inflammatory arthritis may be the principal feature or one component of an inflammatory rheumatological disease. It is a clinical diagnosis, principally made based on the patient's history and examination. Specific investigations, such as rheumatoid factor and human leucocyte antigen B27 gene, may support the diagnosis in the context of a suggestive clinical presentation, but a diagnosis cannot be made based on these tests alone because positive results may also be seen in healthy individuals. To reduce the likelihood of false positive results, laboratory and radiological investigations should be tailored to the suspected diagnosis based on pretest probability. While musculoskeletal symptoms are a common presentation in general practice, specific features that increase suspicion of an inflammatory arthritis include prolonged morning stiffness (more than 1 hour) that is improved by exercise or movement. A broad 'rheumatological panel' increases the likelihood of false positive results and should be avoided to prevent unnecessary further investigations and treatment, and unwarranted anxiety in both the patient and the doctor.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 4","pages":"119-124"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127484","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":"Sum of the parts: a cascade of adverse effects.","authors":"Jane Poon, Fiona Coombes, Ian Coombes","doi":"10.18773/austprescr.2024.031","DOIUrl":"10.18773/austprescr.2024.031","url":null,"abstract":"","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 4","pages":"125-128"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127483","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}
Rohan A Elliott, Manya Angley, Deirdre T Criddle, Fatemeh Emadi, Shania Liu, Jonathan Penm
{"title":"Achieving safe medication management during transitions of care from hospital: time for a stewardship approach.","authors":"Rohan A Elliott, Manya Angley, Deirdre T Criddle, Fatemeh Emadi, Shania Liu, Jonathan Penm","doi":"10.18773/austprescr.2024.034","DOIUrl":"10.18773/austprescr.2024.034","url":null,"abstract":"","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 4","pages":"106-108"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127476","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":"Management of occupational exposure to blood and body fluids in primary care.","authors":"Anna Pierce","doi":"10.18773/austprescr.2024.037","DOIUrl":"10.18773/austprescr.2024.037","url":null,"abstract":"<p><p>Primary care workplaces where occupational exposure to blood and body fluids may occur should have policies and procedures in place to manage such incidents. All healthcare workers should be immunised against hepatitis B and ideally should have documentation of their antibody response to vaccination. Knowledge of hepatitis B immune status helps streamline the response to any exposure. Most occupational exposures carry a low risk of transmission of bloodborne viruses, and management can often be undertaken in general practice. Urgent risk assessment and management is crucial. If postexposure prophylaxis for hepatitis B or HIV is required, the earlier it is given, the more likely it is to be effective. Two-drug HIV postexposure prophylaxis is now more accessible because generic formulations of the drug combination are available, and general practitioners can prescribe this on a private prescription.</p>","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 4","pages":"113-118"},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127478","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":"Additional preconception considerations for patients with diabetes.","authors":"","doi":"10.18773/austprescr.2024.022","DOIUrl":"10.18773/austprescr.2024.022","url":null,"abstract":"","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 3","pages":"95-96"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499731","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":"Medicines Repurposing Program - supporting new uses for existing medicines.","authors":"","doi":"10.18773/austprescr.2024.025","DOIUrl":"10.18773/austprescr.2024.025","url":null,"abstract":"","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 3","pages":"97"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499736","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}