Are you over 18 and want to see adult content?
More Annotations
A complete backup of central-london-apartments.com
Are you over 18 and want to see adult content?
A complete backup of herrmannsdorfer.de
Are you over 18 and want to see adult content?
A complete backup of elyricsworld.com
Are you over 18 and want to see adult content?
A complete backup of cdcgamingreports.com
Are you over 18 and want to see adult content?
A complete backup of randos-montblanc.com
Are you over 18 and want to see adult content?
Favourite Annotations
A complete backup of tvn24.pl/polska/gazeta-wyborcza-o-zeznaniach-swiadka-koronnego-w-sprawie-zony-zbigniewa-ziobry-patrycja-kot
Are you over 18 and want to see adult content?
A complete backup of www.gva.be/cnt/dmf20200227_04868327/daar-is-frank-zillion-verstraeten-weer-ex-eigenaar-legendarische-antwer
Are you over 18 and want to see adult content?
A complete backup of www.lifo.gr/now/greece/271546/eody-ola-osa-prepei-na-gnorizete-gia-ton-neo-koronaio-pos-metadidetai-poia-ei
Are you over 18 and want to see adult content?
A complete backup of www.digi24.ro/stiri/actualitate/politica/liviu-dragnea-s-a-accidentat-in-timp-ce-lucra-in-atelierul-auto-al
Are you over 18 and want to see adult content?
Text
unclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. RECOGNISING AND MANAGING EARLY DEMENTIA Recognising and managing early dementia. Dementia (mate wareware - see below) is a growing healthcare challenge. There are an estimated 70,000 people with dementia in New Zealand; this number is predicted to increase to over 170,000 by 2050, due to factors such as population growth and increased longevity. ANTIBIOTICS GUIDE, CHOICES FOR COMMON INFECTIONS Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices. HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the MANAGEMENT OF ACUTE EXACERBATIONS OF COPD IN PRIMARY CARE Bacterial infections (predominantly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis) have a primary or secondary role in about 50% of acute exacerbations of COPD. Sputum culture is not routinely required, but may be helpful if there is no improvement with treatment. The benefits of antibiotic use areunclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like NEW DIABETES MEDICINES FUNDED: EMPAGLIFLOZIN AND New diabetes medicines funded: empagliflozin and dulaglutide. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have been recommended for the treatment of type 2 diabetes for some time, but until now have notbeen funded in
ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
RECOGNISING AND MANAGING EARLY DEMENTIA Recognising and managing early dementia. Dementia (mate wareware - see below) is a growing healthcare challenge. There are an estimated 70,000 people with dementia in New Zealand; this number is predicted to increase to over 170,000 by 2050, due to factors such as population growth and increased longevity. MENOPAUSAL HORMONE THERAPY: WHERE ARE WE NOW? Menopausal hormone therapy (MHT) is an effective treatment for symptoms associated with menopause, such as hot flushes, night sweats, mood changes, sleep disturbances and changes in sexual function. While the evidence around MHT has changed over the years, there is now international consensus that the benefits of MHT are likely tooutweigh the
WITHDRAWING PATIENTS FROM LONG-TERM USE OF BENZODIAZEPINES Withdrawing patients from long-term use of benzodiazepines or zopiclone. Stopping benzodiazepine or zopiclone treatment in people who have been taking these medicines long-term can be challenging. Strategies to encourage patients to stop a benzodiazepine or zopiclone should involve education to realign their perceptions of risks andbenefits
CARDIOVASCULAR DISEASE RISK ASSESSMENT IN PRIMARY CARE Cardiovascular disease risk assessment in primary care: managing lipids. The Cardiovascular Disease Risk Assessment and Management for Primary Care consensus statement was released earlier in 2018. This is the third in a series of articles about the statement and provides guidance on the assessment and management of lipids. A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like PREVENTING AND MANAGING DRY SKIN IN OLDER PEOPLE Identify dry skin early. Dry skin (xerosis) is a common dermatological feature in older people. 3 This is caused by water loss from the stratum corneum, and as a consequence the skin is more likely to crack, which can result in itching, bleeding and asteatotic dermatitis. 4 Troublesome dry skin is often under-reported and patients may wait many years before asking a health professional for MONITORING DIURETICS IN PRIMARY CARE Thereafter, every 6-12 months for low risk patients. High risk patients (older people, renal or cardiac dysfunction), every 4-8 weeks. Potassium > 6 mmol/L or a significantly rising trend. Stop diuretic and seek specialist advice. Table 2: Recommended monitoring for diuretics in heart failure 2,5. Thiazide or loop diuretics inheart failure.
BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
POLYMYALGIA RHEUMATICA: LOOK BEFORE YOU LEAP Polymyalgia rheumatica: Look before you leap. Polymyalgia rheumatica is an inflammatory condition that causes a particular pattern of joint pain and stiffness, most commonly in older people. It is a rheumatic disorder closely associated, and often co-existing, with giant cell arteritis. Diagnosis is based on the patient’s clinical features HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the MANAGEMENT OF ACUTE EXACERBATIONS OF COPD IN PRIMARY CARE Bacterial infections (predominantly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis) have a primary or secondary role in about 50% of acute exacerbations of COPD. Sputum culture is not routinely required, but may be helpful if there is no improvement with treatment. The benefits of antibiotic use areunclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS Topical corticosteroids are used for many skin conditions ( Table 1 ). They suppress the inflammatory reaction and relieve symptoms however they are not curative and when they are discontinued symptoms can recur. 1. Topical corticosteroids should not be used for rosacea or acne vulgaris. They may worsen ulcerated or secondarily infectedlesions. 1.
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
POLYMYALGIA RHEUMATICA: LOOK BEFORE YOU LEAP Polymyalgia rheumatica: Look before you leap. Polymyalgia rheumatica is an inflammatory condition that causes a particular pattern of joint pain and stiffness, most commonly in older people. It is a rheumatic disorder closely associated, and often co-existing, with giant cell arteritis. Diagnosis is based on the patient’s clinical features HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the MANAGEMENT OF ACUTE EXACERBATIONS OF COPD IN PRIMARY CARE Bacterial infections (predominantly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis) have a primary or secondary role in about 50% of acute exacerbations of COPD. Sputum culture is not routinely required, but may be helpful if there is no improvement with treatment. The benefits of antibiotic use areunclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS Topical corticosteroids are used for many skin conditions ( Table 1 ). They suppress the inflammatory reaction and relieve symptoms however they are not curative and when they are discontinued symptoms can recur. 1. Topical corticosteroids should not be used for rosacea or acne vulgaris. They may worsen ulcerated or secondarily infectedlesions. 1.
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
NEW DIABETES MEDICINES FUNDED: EMPAGLIFLOZIN AND New diabetes medicines funded: empagliflozin and dulaglutide. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have been recommended for the treatment of type 2 diabetes for some time, but until now have notbeen funded in
ORAL CONTRACEPTIVES: SELECTING A PILL Cautions and contraindications: when to avoid COCs Venous thromboembolism (VTE) risk. COC use is associated with a three to 3.5-fold increase in the relative risk of VTE. 1 However, if there are no additional risk factors, the absolute risk of VTE associated with COC use is very small, particularly when compared to the risk during pregnancy and post-partum (). 1 The risk of VTE is highest in ANTIBIOTICS GUIDE, CHOICES FOR COMMON INFECTIONS Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices. MENOPAUSAL HORMONE THERAPY: WHERE ARE WE NOW? Menopausal hormone therapy (MHT) is an effective treatment for symptoms associated with menopause, such as hot flushes, night sweats, mood changes, sleep disturbances and changes in sexual function. While the evidence around MHT has changed over the years, there is now international consensus that the benefits of MHT are likely tooutweigh the
WITHDRAWING PATIENTS FROM LONG-TERM USE OF BENZODIAZEPINES Withdrawing patients from long-term use of benzodiazepines or zopiclone. Stopping benzodiazepine or zopiclone treatment in people who have been taking these medicines long-term can be challenging. Strategies to encourage patients to stop a benzodiazepine or zopiclone should involve education to realign their perceptions of risks andbenefits
MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like PRESCRIBING ACE INHIBITORS: TIME TO RECONSIDER OLD HABITS Prescribing ACE inhibitors: time to reconsider old habits. Prescribers in New Zealand are highly reliant on cilazapril as their “go-to” ACE inhibitor, but this prescribing is out of step with many other countries where cilazapril is infrequently used, such as Australia andthe United Kingdom.
PREVENTING AND MANAGING DRY SKIN IN OLDER PEOPLE Identify dry skin early. Dry skin (xerosis) is a common dermatological feature in older people. 3 This is caused by water loss from the stratum corneum, and as a consequence the skin is more likely to crack, which can result in itching, bleeding and asteatotic dermatitis. 4 Troublesome dry skin is often under-reported and patients may wait many years before asking a health professional for BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
POLYMYALGIA RHEUMATICA: LOOK BEFORE YOU LEAP Polymyalgia rheumatica: Look before you leap. Polymyalgia rheumatica is an inflammatory condition that causes a particular pattern of joint pain and stiffness, most commonly in older people. It is a rheumatic disorder closely associated, and often co-existing, with giant cell arteritis. Diagnosis is based on the patient’s clinical features HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the MANAGEMENT OF ACUTE EXACERBATIONS OF COPD IN PRIMARY CARE Bacterial infections (predominantly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis) have a primary or secondary role in about 50% of acute exacerbations of COPD. Sputum culture is not routinely required, but may be helpful if there is no improvement with treatment. The benefits of antibiotic use areunclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS Topical corticosteroids are used for many skin conditions ( Table 1 ). They suppress the inflammatory reaction and relieve symptoms however they are not curative and when they are discontinued symptoms can recur. 1. Topical corticosteroids should not be used for rosacea or acne vulgaris. They may worsen ulcerated or secondarily infectedlesions. 1.
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
POLYMYALGIA RHEUMATICA: LOOK BEFORE YOU LEAP Polymyalgia rheumatica: Look before you leap. Polymyalgia rheumatica is an inflammatory condition that causes a particular pattern of joint pain and stiffness, most commonly in older people. It is a rheumatic disorder closely associated, and often co-existing, with giant cell arteritis. Diagnosis is based on the patient’s clinical features HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the MANAGEMENT OF ACUTE EXACERBATIONS OF COPD IN PRIMARY CARE Bacterial infections (predominantly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis) have a primary or secondary role in about 50% of acute exacerbations of COPD. Sputum culture is not routinely required, but may be helpful if there is no improvement with treatment. The benefits of antibiotic use areunclear.
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLE 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS Topical corticosteroids are used for many skin conditions ( Table 1 ). They suppress the inflammatory reaction and relieve symptoms however they are not curative and when they are discontinued symptoms can recur. 1. Topical corticosteroids should not be used for rosacea or acne vulgaris. They may worsen ulcerated or secondarily infectedlesions. 1.
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
NEW DIABETES MEDICINES FUNDED: EMPAGLIFLOZIN AND New diabetes medicines funded: empagliflozin and dulaglutide. Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have been recommended for the treatment of type 2 diabetes for some time, but until now have notbeen funded in
ORAL CONTRACEPTIVES: SELECTING A PILL Cautions and contraindications: when to avoid COCs Venous thromboembolism (VTE) risk. COC use is associated with a three to 3.5-fold increase in the relative risk of VTE. 1 However, if there are no additional risk factors, the absolute risk of VTE associated with COC use is very small, particularly when compared to the risk during pregnancy and post-partum (). 1 The risk of VTE is highest in ANTIBIOTICS GUIDE, CHOICES FOR COMMON INFECTIONS Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices. MENOPAUSAL HORMONE THERAPY: WHERE ARE WE NOW? Menopausal hormone therapy (MHT) is an effective treatment for symptoms associated with menopause, such as hot flushes, night sweats, mood changes, sleep disturbances and changes in sexual function. While the evidence around MHT has changed over the years, there is now international consensus that the benefits of MHT are likely tooutweigh the
WITHDRAWING PATIENTS FROM LONG-TERM USE OF BENZODIAZEPINES Withdrawing patients from long-term use of benzodiazepines or zopiclone. Stopping benzodiazepine or zopiclone treatment in people who have been taking these medicines long-term can be challenging. Strategies to encourage patients to stop a benzodiazepine or zopiclone should involve education to realign their perceptions of risks andbenefits
MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
A PRIMARY CARE APPROACH TO SODIUM AND POTASSIUM IMBALANCE A primary care approach to sodium and potassium imbalance. Interpreting and managing a laboratory result of abnormal sodium or potassium levels is a common scenario in general practice. Electrolyte imbalances are more common in older people and in people with co-morbidities. The immediate cause of the imbalance is usually clinically apparent, e THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like PRESCRIBING ACE INHIBITORS: TIME TO RECONSIDER OLD HABITS Prescribing ACE inhibitors: time to reconsider old habits. Prescribers in New Zealand are highly reliant on cilazapril as their “go-to” ACE inhibitor, but this prescribing is out of step with many other countries where cilazapril is infrequently used, such as Australia andthe United Kingdom.
PREVENTING AND MANAGING DRY SKIN IN OLDER PEOPLE Identify dry skin early. Dry skin (xerosis) is a common dermatological feature in older people. 3 This is caused by water loss from the stratum corneum, and as a consequence the skin is more likely to crack, which can result in itching, bleeding and asteatotic dermatitis. 4 Troublesome dry skin is often under-reported and patients may wait many years before asking a health professional for BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC bpac nz advocates for best practice in healthcare treatments and investigations across a wide range of health service delivery areas, and we are recognised nationally and THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ANTIBIOTICS GUIDE, CHOICES FOR COMMON INFECTIONS Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. MENOPAUSAL HORMONE THERAPY: WHERE ARE WE NOW? Menopausal hormone therapy (MHT): still an effective treatment for menopausal symptoms. Menopause is associated with a range of symptoms including hot flushes and night sweats (vasomotor symptoms), vaginal dryness, itching or pain during intercourse, changes in mood or sleep patterns, and joint or musculoskeletal discomfort. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS The Best Practice Advocacy Centre delivers educational and continuing professional development programmes to medical practitioners and other health professional groups throughout New Zealand. A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLEEFFECTS OF STOPPING BETA BLOCKERHOW TO STOP TAKING BETA BLOCKERSSTOPPING BETA BLOCKERSTOPPING CALCIUM CHANNEL BLOCKER SUDDENLY Polypharmacy increases the risk of adverse effects and medicine interactions. The majority of older people have more than one medical condition, more than one prescriber and take more than one medicine. 1 Polypharmacy increases the risk of adverse effects and medicine interactions and the physiological changes that accompany ageing alter the handling and response to medicines. HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like MAKING SENSE OF SERUM PROTEIN BANDS Monoclonal gammopathies are associated with excessive production of immunoglobulins from a single clone of cells that is malignant or potentially malignant, whereas polyclonal gammopathies are characterised by a generalised increase in immunoglobulins. 1 A polyclonal gammopathy can be caused by various infections, haematologic diseases, liver disease, some malignancies andinflammatory
BPJ 49: THE NIGHT TIME HUSTLE: MANAGING RESTLESS LEGSRESTLESS LEGS SYNDROMETREATMENT FOR RESTLESS LEGS SYNDROMERESTLESS FEET SYNDROME IN WOMENRESTLESS LEGS AT NIGHTHOW TO STOP RESTLESS LEGSWHAT FOODS CAUSERESTLESS LEGS
What is restless legs syndrome? Restless legs syndrome is a neurological disorder characterised by throbbing, pulling, creeping or other unpleasant sensations in the legs and an uncontrollable, usually overwhelming, urge to move them. BEST PRACTICE ADVOCACY CENTRE NEW ZEALANDABOUT USFAQCONTACT USPERMISSIONS & REPRINTSMYBPAC Prescribing statins to reduce cardiovascular risk. Management of impetigo. Cancer care: the role of primary care in identifying and managing cachexia. Prescribing ACE inhibitors: time to reconsider old habits. Early detection of lung cancer in primary care. THE COPD PRESCRIBING TOOLS The COPD prescribing tools. These tools present pharmacological treatment options for patients with COPD based on their symptoms and exacerbation severity; the first tool is used for treatment initiation and the second tool is used for the escalation or de-escalation of treatment. Previously, bpac nz provided one tool for COPD treatment initiation and escalation or de-escalation. ANTIBIOTICS GUIDE, CHOICES FOR COMMON INFECTIONS Antibiotics: choices for common infections. The following information is a consensus guide. It is intended to aid selection of an appropriate antibiotic for typical patients with infections commonly seen in general practice. Individual patient circumstances and local resistance patterns may alter treatment choices. TOPICAL CORTICOSTEROID TREATMENT FOR SKIN CONDITIONS Topical corticosteroids are used for many skin conditions ( Table 1 ). They suppress the inflammatory reaction and relieve symptoms however they are not curative and when they are discontinued symptoms can recur. 1. Topical corticosteroids should not be used for rosacea or acne vulgaris. They may worsen ulcerated or secondarily infectedlesions. 1.
MENOPAUSAL HORMONE THERAPY: WHERE ARE WE NOW? Menopausal hormone therapy (MHT) is an effective treatment for symptoms associated with menopause, such as hot flushes, night sweats, mood changes, sleep disturbances and changes in sexual function. While the evidence around MHT has changed over the years, there is now international consensus that the benefits of MHT are likely tooutweigh the
A PRACTICAL GUIDE TO STOPPING MEDICINES IN OLDER PEOPLEEFFECTS OF STOPPING BETA BLOCKERHOW TO STOP TAKING BETA BLOCKERSSTOPPING BETA BLOCKERSTOPPING CALCIUM CHANNEL BLOCKER SUDDENLY 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 and medicine interactions. Individual review of the need for each medicine can simplify treatment regimens and reduce the potential for harm. THE CHANGING FACE OF HELICOBACTER PYLORI TESTING- BEST There is ongoing debate in the literature about which is the best test to request for the detection of infection with Helicobacter pylori.The most appropriate test is influenced by several factors, such as the pre-test probability of H.pylori infection (reflected by prevalence), the patient’s specific clinical circumstances and the cost and availability of the test. 1 In New Zealand, like MAKING SENSE OF SERUM PROTEIN BANDS Making sense of serum protein bands. Serum protein bands (monoclonal gammopathy) will sometimes be found following serum protein electrophoresis in patients presenting with classic signs or symptoms of multiple myeloma, e.g. bone pain. In other cases, patients may have non-specific symptoms, meaning the discovery of a protein band in theserum
HYPERTENSION IN ADULTS: THE SILENT KILLER Hypertension is a risk factor for many conditions including stroke, myocardial infarction, heart failure, atrial fibrillation, kidney disease and cognitive decline. 1 It is described as a silent killer because it is insidious, chronic and progressive. 2 In New Zealand, the mean systolic blood pressure of many people is increasing due to the rise in obesity, sedentary lifestyles and the BPJ 49: THE NIGHT TIME HUSTLE: MANAGING RESTLESS LEGSRESTLESS LEGS SYNDROMETREATMENT FOR RESTLESS LEGS SYNDROMERESTLESS FEET SYNDROME IN WOMENRESTLESS LEGS AT NIGHTHOW TO STOP RESTLESS LEGSWHAT FOODS CAUSERESTLESS LEGS
Restless legs syndrome is a neurological disorder characterised by throbbing, pulling, creeping or other unpleasant sensations in the legs and an uncontrollable, usually overwhelming, urge to move them. Symptoms occur primarily in the evening when a person is relaxing, and can increase in severity throughout the night. BEST TESTS - BEST PRACTICE NEW ZEALAND - BPAC The Best Practice Advocacy Centre delivers educational and continuing professional development programmes to medical practitioners and other STAY INDEPENDENT FALLS PREVENTION TOOLKIT The Stay Independent Falls Prevention Toolkit is an aid for Primary Care Teams for the assessment of an individual's risk of falling, including practical strategies to reduce this risk. ORAL CONTRACEPTIVES: SELECTING A PILL 24 November 2020 Mercilon funding status updated. 13 October 2020 COC supply status updated. 2 September 2020 COC funding and supply status updated. 4 August 2020 New COC options added to Table 1; COC and POP funding and supply status updated.. 1 November 2019 Content updated: levonorgestrel IUDs are fully funded without restriction from 1November, 2019.
PRESCRIBING STATINS TO REDUCE CARDIOVASCULAR RISK There have been a number of new or updated international guidelines on dyslipidaemia and CVD risk reduction over the last few years. 3, 11–17 Changes were made due to evidence indicating that better outcomes could be achieved, especially in primary prevention, by the management of absolute CVD risk rather than management of single risk factors. 3,18,19 There has been some criticism of this WHAT’S NEW IN CARDIOVASCULAR DISEASE RISK ASSESSMENT AND New aspects of CVD risk assessment and management Changes to the definition of established CVD or a CVD risk equivalent . In patients with pre-existing CVD or a CVD risk equivalent (), assertive risk management and lifestyle modification is strongly recommended as these patients are at high risk (>15%) of having a cardiovascular event.Using risk equations for these patients is NOT BEST PRACTICE ADVOCACY CENTRE NEW ZEALAND Blood pressure management continues to be based on five-year cardiovascular risk. A risk-based approach to blood pressure management is recommended in the Cardiovascular Disease Risk Assessment and Management for Primary Care consensus statement (2018). DIAGNOSING AND MANAGING HEADACHE IN ADULTS IN PRIMARY CARE Diagnosing and managing headache in adults in primary care. A systematic approach is recommended when assessing patients with headache to rule out serious underlying conditions and to ensure anaccurate diagnosis.
BPJ 49: THE NIGHT TIME HUSTLE: MANAGING RESTLESS LEGS What is restless legs syndrome? Restless legs syndrome is a neurological disorder characterised by throbbing, pulling, creeping or other unpleasant sensations in the legs and an uncontrollable, usually overwhelming, urge to move them. PRESCRIBING ACE INHIBITORS: TIME TO RECONSIDER OLD HABITS Prescribing ACE inhibitors: time to reconsider old habits. Prescribers in New Zealand are highly reliant on cilazapril as their “go-to” ACE inhibitor, but this prescribing is out of step with many other countries where cilazapril is infrequently used, such as Australia andthe United Kingdom.
GENERALISED ANXIETY DISORDER IN ADULTS Anxiety disorders are common. Anxiety is a normal human emotion. It becomes a disorder when it is of greater intensity or duration than would be normally expected and if it leads to impairment ordisability.
NEW ! The primary care update series is a new subscription based service from bpacnz Find out more* Search
* Mybpac - Login
LATEST ARTICLES
View Articles
ANTIBIOTICS GUIDE UPDATEDView Guide
PERSONALISED PRESCRIBING REPORTSView reports
PEER GROUP DISCUSSIONS View all discussionsAUDITS
View all audits
CME QUIZZES
Do Quizzes
FEATURE LETTERS
* About us
* FAQ
* Contact us
* Permissions & reprintsHELLO THERE!
please login to access my bpacUsername
Password
Remember me
------------------------- Dont have an account? Sign up here Forgot your login? Reset password×
search
*
* Featured
* Latest
* By Category
* BPJ
*
Adverse drug reactions and interactions Allergies and immunology Antibiotic resistance and stewardshipBiochemistry
Cardiovascular systemChild health
Complementary and alternative medicinesCorrespondence
Debates
Dermatology
Diabetes
Ear, nose and throat Endocrinology (excl diabetes)Feature letters
Gastroenterology
Genetics
Genitourinary system (male)Guidelines
Gynaecology and urinary tract disorders (female) HaematologyHealth informatics
Hepatology
Immunisation
Infections
Integrated Performance and Incentive Framework Maori health Medicine indicationsMedicine subsidy
Medicines managementMedico-legal issues
Mental health
Musculoskeletal
Nephrology
Neurology
News
Nutrition
Occupational medicine Older person’s healthOncology
Ophthalmology
Oral health
Pacific peoples healthPain management
Palliative care
Peer group discussionsPharmacology
PHO Performance Programme Pregnancy and reproductive health Professional practice and developmentPublic health
Reports
Research updates
Respiratory conditionsRheumatology
Sexual health
Smoking, alcohol, and drug misuse Trauma and surgical proceduresVirology
Your browser does not support HTML5 video. BPACNZ PRIMARY CARE UPDATE SERIES NEW ! The primary care update series is a new subscription based service developed by bpacnz. It’s a multimedia package that keeps you up to date on the management of conditions commonly encountered in primary care.Find out more
PRESCRIBING REPORT: A PHARMACOLOGICAL PROFILE OF PATIENTS WITH TYPE 2DIABETES
This report provides an overview of the clinical characteristics of patients with type 2 diabetes including sex, age, ethnicity and the long-term use of other medicines.View report
August 2019
ANTIARRHYTHMIC MEDICINE BRAND CHANGES: FLECAINIDE AND AMIODARONE Patients taking oral flecainide or amiodarone need to know that the suppliers of these medicines have...July 2019
KNOWING YOUR PATIENT WITH TYPE 1 DIABETES: THE TRANSITION TOSELF-MANAGEMENT
Living with type 1 diabetes is challenging, particularly as a youngadult who...
July 2019
UNDERSTANDING THE ROLE OF INSULIN IN THE MANAGEMENT OF TYPE 1 DIABETES Insulin treatment is an essential component of type 1 diabetesmanagement.
June 2019
SLOWING PROGRESSION OF RENAL DYSFUNCTION IN PATIENTS WITH DIABETES Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease in New Zealand.June 2019
DIALLING BACK TREATMENT INTENSITY FOR OLDER PEOPLE WITH TYPE 2DIABETES
Type 2 diabetes management in older people can be complex due to the wide variations in co-morbidities, physical and cognitive impairment, and life expectancy.May 2019
WEIGHT LOSS: THE OPTIONS AND THE EVIDENCE The benefits of intentional weight loss in people who are overweight are obvious and undeniable.May 2019
CLAIMING CME POINTS
Information about the ways you can claim CME points on bpac.org.nzView information
PERSONALISED PRESCRIBING REPORTS Access your personalised prescribing reportsView reports
AUDITS
Audits are endorsed by the RNZCGP as a CQI activity for allocation of MOPS credits for General PractitionersView all audits
CME QUIZZES
Quizzes are endorsed by RNZCGP for allocation of MOPS creditsDo Quizzes
PEER GROUP DISCUSSIONS Discussion points for peer groups or self-reflection of practice View all discussions BPACNZ RESEARCH PUBLICATIONS Collection of research publications by bpacnz including Pharmacoepidemiology, Health Informatics & other publicationsView publications
ANTIBIOTICS GUIDE UPDATED Antibiotics Guide 2017 editionView Guide
THE COPD PRESCRIBING TOOL UPDATED Pharmacological treatment options for patients with COPDView Tool
COMING UP...
Our current theme is “Diabetes”, including articles on pharmacological management of HbA1c, managing weight loss, diabetes in elderly people, diabetic kidney disease and Type 1 diabetes.COMING SOON...
Our next theme will be “Over-diagnosis and over-treatment” LATEST ARTICLES FOR YOU bpacnz advocates for best practice in healthcare treatments and investigations across a wide range of health service delivery areas, and we are recognised nationally and internationally for our expertiseand innovation.
POST
P.O. Box 6032
DUNEDIN 9059
PHONE
03 477 5418
* Articles
* Mybpac
* About
* FAQ
* Contact
* Permissions & reprints ------------------------- Follow us on facebook Follow us on twitterPARTNER LINKS
BPACNZ GUIDELINES
INPRACTICE
BPAC CLINICAL SOLUTIONSNZ FORMULARY
SOUTH LINK
HEALTH SERVICES
LOCUM SERVICES TOOL
GENERAL PRACTICE
STAFFING SOLUTIONS
COLLECTION OF RESEARCH PUBLICATIONS BY BPACNZ Made with by the bpacnz teamDetails
Copyright © 2024 ArchiveBay.com. All rights reserved. Terms of Use | Privacy Policy | DMCA | 2021 | Feedback | Advertising | RSS 2.0