Practice tips: Bupropion colchicine & first void urine
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New Health target
“Better help for smokers to quit” is one of the six health targets announced by the Minister of Health.
The target is that 80% of hospitalised smokers will be provided with help and advice to quit by July 2010; 90% by July
2011, and 95% by July 2012. A similar target for primary care will be introduced by July 2010 through the PHO Performance
Programme.
Best Practice tip:
If you are arranging for a patient who smokes to be admitted to hospital it may
be a good time to discuss quitting or at least temporary abstinence and prescribing of NRT.
Recent change to the Pharmaceutical Schedule
Bupropion
Bupropion hydrochloride is a dopamine-noradrenaline reuptake inhibitor that has demonstrated benefits when used
in the treatment of nicotine dependence. When provided concomitantly with counselling, bupropion increases the chances
of a quit attempt being successful.
Bupropion became available fully subsidised on the Pharmaceutical Schedule on July 1 2009 under the brand name Zyban.
| Chemical |
Presentation |
Brand |
Pack size |
| Bupropion hydrochloride |
Tab modified-release 150 mg |
Zyban |
30 |
Safe use of colchicine
Once again the Safe and Quality Use of Medicines group (SQM) reminds prescribers about the high risks associated with
the use of colchicine. They have also identified a problem with outdated dosage recommendations on electronic discharge
summaries from secondary care.
Colchicine should only be used for acute gout when there are no other alternative treatment options. Prescribe a minimal
number of tablets only and ensure that the instructions for use are clearly understood by the patient and whānau.
- Recommended dose: 2 x 0.5 mg initially, followed by 1 x 0.5 mg every six hours, up to a maximum of five tablets (2.5
mg) in the first 24 hours (or maximum of 1 mg if elderly, renal or hepatic impairment or less than 50 kg)
- Do not exceed a cumulative oral dose of 12 tablets (6 mg) over four days. Wait for three days before administering
further colchicine.
- Check dose instructions received by patients discharged from secondary care
See
www.safeuseofmedicines.co.nz and BPJ
8 (Sept 2007) “A slow death from colchicine” and “Gout – hit
the target: treatment of gout” for further information.
First void urine
Does first void urine (FVU) mean:
- First void urine of the day
- First part of the urine stream
If you answered “a” then you agree with 68% of surveyed GPs in Australia.
The correct answer is actually “b”.
FVU is an ambiguous and commonly misunderstood term. For effective chlamydia testing, it is important to get this right.
Reference: Lusk, J, Uddin R, Ferson M, et al. Primary health care providers surveyed commonly misinterpret ‘first
void urine’ for chlamydia screening. Sex Health 2009;6(1):91-3.
Do you have a brilliant idea that you would like to share with your colleagues? Can you tell us about a mistake that
you have learnt from so others don’t fall into the same trap? What’s new in primary care that people would
want to know?
Share your practice tips with us.
Email: editor@bpac.org.nz