June 2021 edition of Australian Prescriber out now

Drugs in secondary stroke prevention

Each year almost 20,000 Australians have a stroke, the majority of which are ischaemic. Treatment recommendations for secondary stroke prevention change regularly, and in the June edition of Australian Prescriber, Dr Chris Tremonti – advanced trainee in clinical pharmacology at the Royal Prince Alfred Hospital in Sydney and a co-author summarise the latest recommendations. Antiplatlets or anticoagulants, as well as blood pressure management and high-dose statins for all patients, regardless of their cholesterol, are the mainstay of medicines for secondary stroke prevention.

Managing hoarding and squalor

Hoarding and squalor are complex conditions that can pose safety risks to the individual, household occupants, pets and neighbours. Dr Andrew Gleason from the Department of Consultation Liaison Psychiatry at the Concord Repatriation General Hospital in Sydney examines the diagnosis and treatment of hoarding and squalor. A multiservice, multidisciplinary approach is often required which may include cognitive behavioural therapy for hoarding disorder and potentially some medicines.

Updated anaphylaxis guidelines: management in infants and children

Rates of hospital admission for anaphylaxis in Australia are increasing, particularly for food-related anaphylaxis in older children and adolescents. Dr Katie Frith, Anaphylaxis Committee Chair at the Australasian Society of Clinical Immunology and Allergy reviews updated anaphylaxis guidelines. There are no contraindications to intramuscular adrenaline in the treatment of anaphylaxis. Correct positioning of the patient is vital as death can occur within minutes if a patient stands, walks or sits up suddenly after administration of adrenaline.

Managing medicines in alcohol-associated liver disease

Alcohol-associated liver disease is one of the major causes of chronic liver disease in Australia. Optimising medicines to manage complications of liver disease can be difficult due to a complex mixture of behavioural and pharmacological factors. Dr Kelly Hayward, clinical research fellow and liver disease pharmacist at the Centre for Liver Disease Research at The University of Queensland, and a co-author give an overview of medicine management for people with alcohol-associated liver disease.

Also in this issue:

• Editorial: Risky business? Pharmaceutical industry sponsorship of health consumer groups
• Medicinal Mishap: Death from diltizem–ibrutinib interaction
• New drugs: Romosozumab for osteoporosis and trientine dihydrochloride for Wilson’s disease.