E160 - Ongoing challenges of off-label prescribing

Jo Cheah speaks to clinical pharmacologist Paul Chin about safe use of direct oral anticoagulants and warfarin for adults with atrial fibrillation or venous thromboembolism. They talk about dosing in renal impairment and extremes of body weight, drug interactions, anticoagulant assays, when to use anticoagulant antidotes and when to consult an anticoagulant service. Read the full article in Australian Prescriber.

Justin Coleman chats with paediatrician Daryl Efron about his paper on the pharmacological management of attention deficit hyperactivity disorder (ADHD) in children and adolescents. They discuss the role of stimulants and non-stimulants, starting and stopping treatment, and monitoring for adverse effects. Read the full paper in Australian Prescriber.

Laura Beaton talks to endocrinologist Chris Nolan about the new Australasian consensus recommendations on the screening and diagnosis of gestational diabetes. The conversation covers changes to diagnostic thresholds, indications for early testing, and pharmacological therapies. Read the full article in Australian Prescriber.

David Liew speaks with endocrinologists Faran Khalili and Morton Burt about their article on practical guidance for stopping glucocorticoids. The discussion includes common glucocorticoids used in Australia, when to stop abruptly versus when to taper, recognising adrenal insufficiency and sick day management. Read the full article in Australian Prescriber.

Justin Coleman chats to Lee Fong, member of the Oral and Dental Expert Group, about some of the updates in the latest version of Therapeutic Guidelines: Oral and Dental. With a focus on GP management of dental issues, the conversation includes discussion of preventative steps, oral risks during pregnancy, oral mucosal diseases, acute infections and much more.

Dhineli Perera talks to infectious diseases physician and clinical microbiologist Carly Hughes about the latest recommendations for aminoglycoside use in Australia. They discuss indications for parenteral aminoglycosides, drug selection, dosing and therapeutic drug monitoring. Read the full article by Carly and her co-authors in Australian Prescriber.

Laura Beaton speaks with Steph Hopkins (rheumatology registrar) and David Liew (rheumatologist and clinical pharmacologist) about choosing a nonsteroidal anti-inflammatory drug (NSAID) for pain. Steph and David discuss the importance of considering the adverse effect profile and selectivity of NSAIDs, and balancing the benefits and risks when selecting the ideal drug for a patient. Read the full article in Australian Prescriber.

Justin Coleman chats with geriatrician and clinical pharmacologist Alex Choo about potentially inappropriate medicines [PIMs] for older people. They discuss the challenges of prescribing for older people and how to use the new Australian PIMs list. The discussion covers some of the 15 drug classes on the list, including antidepressants, benzodiazepines, opioids and NSAIDs. Read the full article by Alex in Australian Prescriber.

Dhineli Perera talks to Laxmi Iyengar, dermatology research fellow and GP, and Jane Li, consultant dermatologist, about male and female pattern hair loss. Laxmi and Jane discuss presentations and available treatments, as well as important considerations for prescribing. Read the full article in Australian Prescriber.

Justin Coleman speaks with Hester Wilson, Chief Addiction Medicine Specialist for NSW, and pharmacist Jillian Kanck about the medicines used in the treatment of opioid dependence. They explain how opioid dependence is diagnosed and discuss the advantages of long-acting buprenorphine, as well as the place of sublingual buprenorphine and methadone in treatment. Read the full article by Hester and Jillian in Australian Prescriber.