Australian Prescriber最新文献_第3页

Quality use of medicines: who owns it now? 药品使用质量：现在谁说了算？

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.018

Jonathan Dartnell, Darlene Cox, Paresh Dawda, Catherine Hill

引用次数: 0

New and emerging drug therapies for Alzheimer disease. 治疗阿尔茨海默病的新兴药物疗法。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.021

Louise M Waite

{"title":"New and emerging drug therapies for Alzheimer disease.","authors":"Louise M Waite","doi":"10.18773/austprescr.2024.021","DOIUrl":"10.18773/austprescr.2024.021","url":null,"abstract":"Established drug therapies for Alzheimer disease (cholinesterase inhibitors and memantine) do not modify the disease course and provide only modest clinical benefit. Biomarker measures of amyloid, tau and neurodegeneration have been integral to Alzheimer disease clinical trials for biologic drugs, for patient selection and efficacy monitoring. At the time of writing, two monoclonal antibodies targeting the amyloid-beta protein (aducanumab and lecanemab) have been approved in the USA, and two agents (lecanemab and donanemab) are under evaluation by the Therapeutic Goods Administration in Australia. Clinical trials have demonstrated that monoclonal antibodies are effective at removing amyloid from the brain in people with early Alzheimer disease. Cognitive benefits are statistically significant, but do not achieve the minimal clinically important difference. Amyloid-related imaging abnormalities of vasogenic oedema and microhaemorrhages occur more frequently on treatment; although these are usually asymptomatic or transient, in some people they are serious or fatal. Targeting amyloid as a unimodal strategy is unlikely to be sufficient and future therapies may need to be multimodal, targeting multiple pathogenic pathways. The burden of dementia is greatest in the older population where mixed dementia pathology dominates; the relationship between biomarkers, clinical phenotype and pathology attenuates; and frailty and comorbidity impact cognition. This creates challenges in identifying effective therapies for the group where dementia is most prevalent.","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 3","pages":"75-79"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500163","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}

引用次数: 0

Controversies in the management of community-acquired pneumonia in adults. 成人社区获得性肺炎治疗中的争议。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.024

Emily Tucker, Maeve O'Sullivan, Lisa Waddell

{"title":"Controversies in the management of community-acquired pneumonia in adults.","authors":"Emily Tucker, Maeve O'Sullivan, Lisa Waddell","doi":"10.18773/austprescr.2024.024","DOIUrl":"10.18773/austprescr.2024.024","url":null,"abstract":"Community-acquired pneumonia (CAP) is a common infectious syndrome in Australia and a leading global cause of morbidity and mortality. It drives a significant amount of antimicrobial prescribing in Australia. Accurate assessment and stratification of CAP severity is important. However, adequate evaluation is challenging and controversy remains about the optimal method. Streptococcus pneumoniae is the most commonly identified bacterial pathogen causing CAP. As such, oral amoxicillin monotherapy is the mainstay of empirical therapy for low-severity CAP. The need to start empirical therapy for pathogens such as Mycoplasma pneumoniae and Legionella species in low-severity CAP remains controversial; evaluating the causative pathogen on clinical grounds alone is difficult. Oral antibiotics recommended for CAP (e.g. amoxicillin, doxycycline) have excellent bioavailability and may be used instead of intravenous therapy in some hospitalised patients. A duration of 5 days of antibiotic therapy is recommended in clinical practice guidelines for patients with uncomplicated CAP who meet stability criteria at follow-up.","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 3","pages":"80-84"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499732","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}

引用次数: 0

Lipid-lowering therapy in patients with a 'normal' LDL-C. 低密度脂蛋白胆固醇 "正常 "患者的降脂治疗。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.019

引用次数: 0

Nirsevimab for prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants. 用于预防新生儿和婴儿呼吸道合胞病毒（RSV）下呼吸道疾病的 Nirsevimab。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.027

引用次数: 0

Deprescribing antihypertensive drugs in frail older adults. 对年老体弱者停用降压药。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.023

Emily Reeve, Danijela Gnjidic, Aili V Langford, Sarah N Hilmer

{"title":"Deprescribing antihypertensive drugs in frail older adults.","authors":"Emily Reeve, Danijela Gnjidic, Aili V Langford, Sarah N Hilmer","doi":"10.18773/austprescr.2024.023","DOIUrl":"10.18773/austprescr.2024.023","url":null,"abstract":"Antihypertensive drugs are commonly used by older adults because of the high prevalence of cardiovascular disease and its risk factors, and the increased absolute benefit of blood pressure reduction with increasing age. Clinical trials of blood pressure reduction in older adults have generally excluded older adults with multimorbidity, frailty and limited life expectancy. In this population, the benefit-harm ratio of aggressive blood pressure lowering may become unfavourable; a more relaxed blood pressure target may be appropriate; and deprescribing (cessation or dose reduction) of one or more antihypertensive drugs can be considered. Before deprescribing an antihypertensive drug, it is important to consider other indications for which it may have been prescribed (e.g. heart failure with reduced ejection fraction, diabetic nephropathy, atrial fibrillation). Evidence from randomised controlled deprescribing trials indicates that it is possible to deprescribe antihypertensives in frail older people. However, some patients may experience an increase in blood pressure that warrants restarting the drug. There are limited data on long-term outcomes (follow-up in deprescribing trials ranged from 4 to 56 weeks). The risk of adverse outcomes associated with deprescribing, such as withdrawal effects, can be minimised through appropriate planning, patient engagement, dose tapering and monitoring.","PeriodicalId":55588,"journal":{"name":"Australian Prescriber","volume":"47 3","pages":"85-90"},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499733","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}

引用次数: 0

Recombinant respiratory syncytial virus (RSV) vaccines for older adults, and pregnant women to prevent disease in their infant. 为老年人和孕妇提供重组呼吸道合胞病毒 (RSV) 疫苗，以预防婴儿患病。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.028

引用次数: 0

Inclisiran for hypercholesterolaemia. 治疗高胆固醇血症的 Inclisiran。

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.026

引用次数: 0

Thiopurines and risk of lymphoproliferative disorders. 硫嘌呤与淋巴组织增生性疾病的风险

IF 3.4

Australian Prescriber Pub Date : 2024-06-01 DOI: 10.18773/austprescr.2024.020