Prescribing issues associated with anticonvulsant medications for epilepsy
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| The goal of successful pharmacological treatment in epilepsy is the complete control of seizures, however for some people this may not be achievable without intolerable adverse effects. All anticonvulsant medications are associated with adverse effects which in rare circumstances can be potentially life-threatening. Special issues apply for women of child bearing potential taking anticonvulsant medications. |
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| Seasonal allergic rhinitis |
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| Seasonal allergic rhinitis, more commonly known as hay fever, can have a significant impact on quality of life. Asthma often co-exists with allergic rhinitis. Mild symptoms may be treated first-line with an intranasal or oral antihistamine, whereas for more severe symptoms, intranasal corticosteroids are the most effective medication. Other treatments may be added as required. The key to management is to aim for symptom control with the lowest dose and number of medications. |
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| TNF inhibitors – an update |
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| Tumour necrosis factor (TNF) inhibitors are used in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, severe psoriasis, Crohn’s disease and juvenile idiopathic arthritis, when conventional treatments have failed. TNF inhibitors are associated with some serious adverse effects and use should be closely monitored. |
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Low molecular weight heparin use in primary care
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Enoxaparin (Clexane) is a low molecular weight heparin used in the treatment of acute coronary syndromes and in the treatment and prevention of thromboembolic disorders. Access to enoxaparin has recently been widened and GPs may become increasingly involved in its use.
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| Breast screening – achieving equity |
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| Breast cancer is the leading cause of cancer death in New Zealand women. The national target for breast screening is for 70% of all eligible women to have been screened within a two year screening interval. To date, this target has not been met for any ethnic group, and there are significant differences in screening rates between Māori and Pacific women, and other women. The key role of general practice is to ensure that all eligible women, especially Māori and Pacific women, are encouraged to enrol in the breast screening programme. |
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| Essentials |
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