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.

Calcipotriol (Daivonex) is now a Pharmacist Only Medicine

Calcipotriol (Daivonex) is a prescription medicine, except in medicines containing not more than 50mcg/g or ml and when sold in a pack of not more than 30 gram or ml by a pharmacist to an adult with mild to moderate psoriasis previously diagnosed by a doctor.  This is not the same as a pharmacist-only classification, but the effect is similar – it can be sold by a pharmacist.

Online Training for Methadone Dispensing

Free online training for pharmacists is now available for Opioid Substitution Treatment = methadone services for opioid dependence.

This is a course written by pharmacists at Community Alcohol and Drug Services in Auckland, with the aim of enabling pharmacists to dispense and administer methadone and buprenorphine for opioid substitution treatment safely, within national guidelines and regulatory requirements.  It is available for pharmacists throughout New Zealand to use, but be aware that there may be some minor regional variations in practice.

Why it is essential to take Fosamax on an empty stomach and remain upright for 30 mins

Fosamax Patient counselling

Chloramphenicol consumer leaflet

To assist pharmacists convey to patients appropriate information in the use of chloramphenicol, the Pharmaceutical Society provided to each pharmacy a pad of 50 Self Care-style eye care and conjunctivitis tear-off leaflets.  It is important that a leaflet is given to each purchaser.

Chloramphenicol ocular is now a Pharmacist-Only medicine – with important conditions

Chloramphenicol eye preparations can now be sold by pharmacists without prescription, subject to some important conditions.  This reclassification is unique in that no pharmaceutical company initiated or actively supported the classification change.  Nor is there any promotion of the product planned now that it can be sold by pharmacists.  The Pharmaceutical Society stepped in and has, with the assistance of pharmacists on MCC, worked hard over the past three years to achieve the re-classification.

Advertising of Medicines of Potential Misuse. New guidelines

New Medicine Advertising Rules

Cardiovascular Guidelines Handbook launched

To help reduce the risk of coronary heart disease and stroke, the New Zealand Guidelines Group has published an updated Cardiovascular Guidelines Handbook.

Dose conversions of erythromycin salts

Martindale says that each 1 g of erythromycin is equivalent to about the following amounts of each salt or ester:

erythromycin estolate 1.44 g

erythromycin ethyl succinate 1.17 g

erythromycin gluceptate 1.31 g

erythromycin lactobionate 1.49 g

erythromycin propionate 1.08 g

erythromycin stearate 1.39 g

Reading this could be taken to mean that 1.39g of stearate is therefore equivalent to 1.17g of ethylsuccinate.  So if 250mg of stearate was prescribed and you didn’t have it, you might say “I’ll give 210mg of ethylsuccinate instead (ie. if you could), because it provides the same ‘dose’ of base erythromycin”.

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Advertising & Promotion of Infant Milk Formulas

Pharmacy Practice Handbook

Handbook Contents > Part 4 Pharmacy Practice

4.3.4  Advertising and Promotion of Infant Milk Formulas Breastfeeding is key to providing the best start for New Zealand infants, and important for both infant and maternal health.  The World Health Organisation International Code of Marketing of Breast-milk Substitutes helps