Hypnotics and anxiolytics – a wake-up call

A recently released coroner’s report serves as a reminder to all healthcare professionals that the use of benzodiazepines and other hypnotics needs careful consideration when used for the treatment of insomnia.

Importantly, the duration of use and dose of hypnotics and benzodiazepines should be limited to a short course of treatment with regular review.

Quinine is not indicated for nocturnal leg cramps

Prescribers are reminded that quinine is no longer indicated for the treatment of leg cramps in New Zealand.¹

CARM continues to receive reports of adverse events associated with the use of quinine for leg cramps, indicating that a signi.cant number of patients are still being prescribed quinine for this off-label indication.

Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors

Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) have varying degrees of anti­inflammatory, analgesic and antipyretic effects. These effects are related to the inhibition of the cyclo-oxygenase isoenzymes COX-1 or COX-2 that are involved in the production of prostaglandins and thromboxanes.¹

Iodine tablets for healthy pregnant and breastfeeding women

The Ministry of Health has recently issued advice to healthy pregnant and breastfeeding women to supplement their dietary intake of iodine.

The Ministry recommends that healthy pregnant and breastfeeding women take a daily 150 mcg iodine-only tablet from confirmation of pregnancy until the discontinuation of breastfeeding. This tablet should be taken in addition to eating well and choosing iodine-containing foods such as low-fat milk products, eggs, seafood, and commercially prepared bread.^1,2

SSRI & Serotonin syndrome/toxicity

Serotonin syndrome, more correctly termed serotonin toxicity, is a set of predictable type A dose dependent adverse reactions caused by increased intra-synaptic/extracellular serotonin.¹

Drug-induced QT prolongation and Torsades de Pointes – the facts

Prescribers are advised to consider the possibility of drug-induced QT prolongation or Torsades de Pointes (TdP) in patients presenting with new onset syncope, palpitations, seizures or resuscitated cardiac arrest.

QT prolongation, a surrogate marker for the risk of developing TdP, is an established side effect of Class I and Class III anti-arrhythmic medicines. It is also a rare side effect of a wide range of non-cardiac medicines including some antibiotics, antihistamines, opioid analgesics and complementary medicines.

Codeine & Breastfeeding

Healthcare professionals are reminded that codeine use by breastfeeding mothers has been associated with fatal cases of infant morphine toxicity. Healthcare professionals should carefully consider the risks and benefits of codeine before recommending its use to breastfeeding mothers.