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Medicines management

The safe and effective use of dabigatran and warfarin in primary care

Patients taking oral anticoagulants require appropriate management in order to receive the maximum benefit from treatment with... View Article

August 2017

Amiodarone brand-change and a reminder on patient monitoring

Two brands of amiodarone are currently subsidised in New Zealand; Aratac (a generic brand) and Cordarone-X (the innovator brand). View Article

October 2016

Oxycodone prescribing: New Zealand solutions to a global problem

Inappropriate prescribing of opioids for non-cancer pain is an international problem. In this article we examine an initiative... View Article

October 2016

Polypharmacy Update

This report provides prescribers with details about patients in their practice who are taking ten or more medicines over a 12... View Article

July 2016

Alcohol misuse: how to help patients in primary care

Approximately one in five New Zealanders over the age of 15 years drinks in a way that is hazardous to their health. Counselling... View Article

May 2016

Use the New Zealand Formulary to access patient information leaflets

Patient information leaflets (PILs) are now available from the New Zealand Formulary (NZF). View Article

May 2016

Oxycodone Update

This report provides an update on the use of oxycodone over the 12 month period from October, 2014 – September, 2015. View Article

March 2016

Travel consultation essentials: for departures and arrivals

Travel consultations involve assessing the risks that may occur during a journey and helping the traveller minimise them. This... View Article

December 2015

An update on the use of nitrofurantoin in patients with renal impairment

The Medicines and Healthcare products Regulatory Agency (MHRA) in the United Kingdom (UK) have updated their guidance to allow... View Article

October 2015

Improving the safety of community-based chemotherapy

Chemotherapy is predominantly managed in secondary care, but many prescriptions for oral medicines are dispensed and taken in... View Article

October 2015

Piles of pills: Prescribing appropriate quantities of medicines

Medicine wastage is a significant problem in New Zealand, with large quantities of subsidised medicines dispensed, but never used.... View Article

August 2015

Overuse of benzodiazepines: still an issue?

Benzodiazepines may be considered as a short-term treatment for insomnia and anxiety; zopiclone, a benzodiazepine-like medicine,... View Article

March 2015

The optimal management of patients with COPD - Part 2: Stepwise escalation of treatment

The progression of COPD can be slowed by providing support for patients to stop smoking, and encouraging regular exercise and... View Article

February 2015

Polypharmacy

Polypharmacy is a marker of potential problematic prescribing. In clinical practice, defining polypharmacy purely by a specific... View Article

November 2014

Polypharmacy in primary care: Managing a clinical conundrum

Polypharmacy can be appropriate and beneficial for patients. However, polypharmacy also increases the risk of problematic prescribing... View Article

October 2014

Safer prescribing of high-risk medicines - Methotrexate: potentially fatal in overdose

Low-dose methotrexate is commonly used in the treatment of patients with rheumatoid arthritis and other rheumatologic diseases,... View Article

October 2014

Identifying and managing addiction to opioids

The increased use of opioid analgesics in recent years, particularly oxycodone, has resulted in misuse and addiction issues associated... View Article

October 2014

Safer prescribing of high-risk medicines: Colchicine – extremely toxic in overdose

Colchicine is a plant-based alkaloid, extracted from Colchicum autumnale (autumn crocus, meadow saffron) and Gloriosa superba... View Article

September 2014

News Updates

Does aspirin protect against cancer? More high-quality research is needed View Article

September 2014

Encouraging children to swallow tablets or capsules

Many health professionals will encounter children who are reluctant or unable to swallow tablets and capsules. This can present... View Article

September 2014

Investigating myalgia in patients taking statins

Muscle pain (myalgia) and weakness is experienced by up to 10% of patients taking statins. However, myalgia is commonly experienced... View Article

August 2014

Oxycodone Update

Since 2011, bpacnz has produced a series of reports and articles on appropriate use of opioids and has urged prescribers to review... View Article

August 2014

Oxycodone: how did we get here and how do we fix it?

Following on from the interview with Dr Jeremy McMinn in the last edition of Best Practice Journal, we examine in more detail... View Article

July 2014

Safer prescribing of high-risk medicines: Clozapine

Pharmacological treatment is an integral part of the practice of medicine, and is one of the most significant factors in improving... View Article

July 2014

Proton pump inhibitors: When is enough, enough?

Proton pump inhibitors (PPIs) are one of the most widely used medicines in New Zealand; in 2013 omeprazole was the third most... View Article

June 2014

Changes to the National Immunisation Schedule: rotavirus vaccine now added

Changes to the National Immunisation Schedule will soon take effect, with the introduction of rotavirus vaccine, free of charge,... View Article

June 2014

Upfront: “A disaster in the making”: it’s time to take action against misuse of oxycodone

Dr Jeremy McMinn is a consultant psychiatrist and addiction specialist at Capital & Coast DHB. He is also the Co-Chair of the... View Article

June 2014

Upfront: Azithromycin: use it wisely

Growing use of azithromycin in New Zealand means that we are in danger of increasing bacterial resistance to macrolide antibiotics,... View Article

April 2014

Update on the Adverse Drug Reaction reporting tool

Reporting suspected adverse drug reactions enables the collection of information on the safety and quality of medicines and vaccines... View Article

April 2014

The year that was: Key messages from Best Practice Journal 2013

2013 began with publication of the 50th issue of Best Practice Journal. In this edition we focused on the topic at the heart of... View Article

February 2014

News Updates

Captopril tablets discontinued: ACE inhibitor alternatives | Removal of Special Authority for combination inhaler Seretide |... View Article

February 2014

The New Zealand Formulary for children

In November 2013, the New Zealand Formulary for Children (NZFC) was released. This is a New Zealand adaptation of the British... View Article

December 2013

News updates

Comparing results between different blood glucose meters | Beating the Blues: online cognitive behavioural therapy for mild to... View Article

June 2013

Laboratory testing for isotretinoin

Oral isotretinoin is a highly effective treatment for severe acne, however it is associated with a number of adverse effects,... View Article

June 2013

Using the New Zealand Formulary

Guide for switching antidepressants View Article

December 2012

Using the New Zealand Formulary

Are you getting the most from the NZF? Resources for getting started View Article

November 2012

When and how to use a syringe driver in palliative care

Syringe drivers are often required to provide medicines for symptom management in patients who are terminally ill. They provide... View Article

November 2012

Polypharmacy in people aged over 75 years

This report focuses on continuous polypharmacy, which is the chronic use of multiple medicines over a long period of time. View Article

October 2012

Managing medicines in older people

It is increasingly recognised that health care for older people is improved when one prescriber takes responsibility for all of... View Article

October 2012

Using the New Zealand Formulary

Locating product and funding information View Article

October 2012

New Zealand Formulary launches

New Zealand healthcare professionals now have their own medicines formulary View Article

August 2012

New Zealand Formulary – coming soon

About the NZF Governance The clinical editorial team View Article

April 2012

Prescribing citalopram safely: an update

Evidence of adverse cardiac effects associated with citalopram has prompted a reduction in the recommended maximum daily dose... View Article

February 2012

Diagnosing and managing asthma in children

New Zealand has one of the highest rates of childhood asthma in the developed world. It is the leading cause of sleep disturbance,... View Article

February 2012

Updated data sheet for dabigatran etexilate

The dabigatran data sheet was updated in early November 2011 to highlight the importance of an assessment of renal function in... View Article

December 2011

The use of dabigatran in general practice

Dabigatran (Pradaxa) is now available in New Zealand, fully funded, without Special Authority, as an alternative oral anticoagulant... View Article

September 2011

News in brief: Varenicline: amendments to Special Authority funding

Brief details on Varenicline use and changes to the special authority funding criteria. View Article

August 2011

Use of INR for monitoring warfarin treatment

Regular measurement of INR levels is an essential component in the management of patients receiving warfarin treatment. Many factors... View Article

November 2010

The warfarin dilemma

Evidence suggests that warfarin is under utilised in older people. The dilemma is that in older people with atrial fibrillation,... View Article

October 2010

INR for Warfarin Monitoring

Sample of data report on the frequency of INR testing for patients on warfarin, national data only. View Article

September 2010

An update on statins

The decision to initiate a statin should be based upon an individual’s risk of cardiovascular disease (CVD), the likely... View Article

August 2010

Avoiding medication errors in children

Medication errors may never be completely eliminated, but strategies can be implemented to reduce the likelihood of error occurring.... View Article

July 2010

A practical guide to stopping medicines in older people

The majority of older people who require drug therapy take multiple medicines. Polypharmacy increases the risk of adverse effects... View Article

April 2010

Upfront: When is enough enough? Stopping medicines in older people

In New Zealand, it is estimated that 30% of people aged over 75 years are taking five or more medicines and around 10% are taking... View Article

April 2010

Prescribing issues associated with anticonvulsant medications for epilepsy

The goal of successful pharmacological treatment in epilepsy is the complete control of seizures, however for some people this... View Article

November 2009

Practical considerations for therapeutic drug monitoring

Advice on therapeutic drug monitoring (TDM), the measurement of the concentration of specific drugs at intervals in order to adjust... View Article

July 2009

Counseling patients through a brand change

Health care professionals have an important role in helping patients understand that generic medicines are as safe and effective... View Article

July 2009

Medicine Brand Changes

A short article on the perceptions of generics and brand changes. View Article

July 2009

Pharmacological Management of Depression in Adults

All antidepressant drugs are approximately equal in effectiveness, although individual patient response may vary markedly.10 View Article

July 2009

Self Management Plans for asthma - obsolete or needing a fresh start?

The asthma & respiratory foundation of New Zealand has developed a revised version of its self-management plan for asthma. View Article

June 2009

The use of insulin in type 2 diabetes

There is evidence that early use of insulin in people with type 2 diabetes is beneficial. At present insulin is under used in... View Article

April 2009

Drug monitoring - Monitoring diuretics in primary care

Monitoring a person on diuretics is necessary to assess response to treatment and to prevent adverse events, particularly electrolyte... View Article

March 2009

WHO Analgesic Ladder: Methadone - safe and effective use for chronic pain

Methadone is a strong opioid that may be suitable for people whose pain is uncontrolled with, or who are unable to tolerate, morphine.... View Article

December 2008

Monitoring Response to Drug Treatment

Clinicians are frequently asked to monitor the effects of drug treatment with the objective of ensuring safe and effective therapy.... View Article

November 2008

Medication-overuse headache: when the cure becomes the cause

Medication-overuse headache is a complex disorder best described as an interaction between a therapeutic agent used excessively... View Article

September 2008

Eltroxin (levothyroxine) formulation change

From July 2007, Glaxo Smith Kline has distributed a new formulation of Eltroxin 50 microgram and 100 microgram. Since then, there... View Article

August 2008

Self monitoring of blood glucose: An update

New evidence concludes that self monitoring of blood glucose for people with non-insulin treated type 2 diabetes is not beneficial.... View Article

June 2008

Ten minute tutorial

Adding a pop-up alert for patients on clozapine. View Article

June 2008

Why you should prescribe generically

Generic prescribing is cost effective, associated with less potential for error and is considered “best practice” in most situations.... View Article

June 2008

Dilemmas: Principles of prescribing for elderly people

Several key principles should be considered when prescribing for elderly people. Quality of life is the most relevant outcome.... View Article

February 2008

Dilemmas: Why is it difficult

Prescribing for elderly people is difficult because the risks of polypharmacy, adverse drug effects and drug interactions are... View Article

February 2008

Brand change update: Ritalin SR now available by special access

In response to concerns raised by Medsafe and the Centre for Adverse Reactions Monitoring, PHARMAC has agreed to allow patients,... View Article

December 2007

Upfront: Changing to a Generic Drug

Visits the main points around changing to a generic drug from varoius viewpoints. View Article

June 2007

10 minute audit: omeprazole

This audit is designed to identify people in your practice on omeprazole View Article

April 2007

Changing to a Generic Drug

An explanation of the issues around the switching of patients to generic medication including international research in the area. View Article

March 2007

Lithium monitoring

Biochemical monitoring of lithium therapy. An overview of of laboratory tests usually recommended for the routine monitoring... View Article

March 2007

Ten minute audit

Identifies patients on Lithium using MedTech View Article

February 2007

ADHD: The Primary Care role

The role of primary care clinicians in improving outcomes for people with ADHD. View Article

February 2007

10 minute audit

This audit is designed to identify people in your practice on LABAs in order to discuss their Asthma Management Plans and ICS... View Article

December 2006

Improving the care of children with asthma

Studies suggest that the majority of children with asthma do not have good control. This appears to be associated with low asthma... View Article

December 2006

Kōwhai tackles overdue INRs

INR testing plus:
• Kōwhai tackles overdue INRs
• Oral route first choice for vitamin K in excessive anticoagulation
• Re-emergence...
View Article

November 2006

Excessive anticoagulation

INR testing plus:
• Kōwhai tackles overdue INRs
• Oral route first choice for vitamin K in excessive anticoagulation
• Re-emergence...
View Article

November 2006

INR testing

INR testing plus:
• Kōwhai tackles overdue INRs
• Oral route first choice for vitamin K in excessive anticoagulation
• Re-emergence...
View Article

November 2006

INR Testing

Warfarin is the most widely used anticoagulant in New Zealand. It has a valuable role in the prevention of thrombosis but the... View Article

October 2006

Guide for using INR to manage warfarin

Appendices from "INR Testing" including:
• Guide for using INR to manage warfarin
• Treatment Guide for managing warfarin
• Drugs...
View Article

October 2006

Ten minute audit

Identifies people under the age of 18 years on paroxetine to enable checks for suicidal and aggressive behaviour View Article

October 2006

Polypharmacy at the Primary-Secondary interface

Polypharmacy due to multiple physician involvement in patient care increases the risk of serious adverse drug event. View Article

October 2006

Polypharmacy

We have defined polypharmacy as the addition of one or more drugs to an existing regimen which provides no additional therapeutic... View Article

May 2006

Introduction: BPJ Generics special edition

Generic drugs are reproductions of the original innovator medicine which are made widely available when a drug’s patent expires.... View Article

July 2009