October 2021 edition of Australian Prescriber out now

Polypharmacy and dental problems – six ways to reduce the risk

Anticholinergic medicines, used frequently by frail older people, reduce saliva function – the body’s own protection against oral and dental disease. The more of these medicines that are used, the greater the risk. In an article in the October edition of Australian Prescriber, dental experts Drs Alan Deutsch and Emma Jay look at the effect of medicines on oral health and suggest six ways to reduce risks associated with pneumonia, systemic comorbidities and tooth decay in older people.

Diagnosing secondary hypertension – what and how

Hypertension with an abrupt onset, or occurring in people under 40 years old, could mean that there is an underlying cause that needs to be found. In the latest edition of Australian Prescriber, chemical pathologist Dr Michael Page, endocrinologist Dr Ranita Siru and co-authors from Western Diagnostic Pathology in Perth look at the conditions that can trigger high blood pressure, when to check for them, and which tests should be done.

Fluoroquinolone antibiotics and adverse events

Fluoroquinolones are broad-spectrum antibiotics used to treat urinary tract infections and pneumonia. Advanced trainee Diva Baggio and Infectious diseases and general medicine physician Dr Michelle Ananda-Rajah examine rare but significant serious adverse effects of fluoroquinolones including tendinopathy, aortapathy, neuropathy, arrythmia, hypoglycaemia and hyperglycaemia. Prescribers should be aware of risk factors and patients should be vigilant for symptoms.

The management of hypertension in pregnancy

Hypertensive disorders during pregnancy can result in complications and even death for the mother and baby. Dr Amanda Beech, obstetric physician at the Royal Hospital for Women in Sydney and Assoc Prof George Mangos from UNSW Sydney review the management of hypertension during pregnancy which involves close maternal and fetal surveillance.

Improving the quality use of highly specialised drugs

Over the past 20 years therapeutics has changed significantly with an increasing number of highly specialised and high-cost medicines, prescribed by physician specialists. During this period quality use of medicine (QUM) activities and programs have focused on medicine use in primary care and prescribing by general practitioners. The Value in Prescribing (ViP) Biological Disease-Modifying Antirheumatic Drugs (bDMARDs) program is now implementing and evaluating a QUM program for physician specialists, along with consumers and other health professionals. In this issue of Australian Prescriber, Prof Catherine Hill, consultant rheumatologist at the Queen Elizabeth Hospital in Adelaide, describes the program.

Also in this issue:

• New drugs: Cariprazine hydrochloride for schizophrenia, elasomeran[GH1] for the prevention of COVID-19, recombinant varicella zoster virus glycoprotein E antigen vaccine for herpes zoster and postherpetic neuralgia, and trabectedin for soft tissue sarcoma.