Topics
Pharmacology
Intranasal Adrenaline Use for the Management of Insect Venom-Induced Anaphylaxis
Intranasal adrenaline has recently become available in Australia as a needle-free alternative to adrenaline autoinjectors for anaphylaxis management. Intranasal adrenaline may be particularly suitable for patients with barriers to adrenaline autoinjector usage, such as needle aversion or poor compliance with autoinjector carriage. However, although the data supporting real-world efficacy of intranasal adrenaline for anaphylaxis are growing, there is no published evidence confirming its efficacy in insect venom anaphylaxis. We report three cases of intranasal adrenaline (neffy, CSL Seqirus, Victoria, Australia) used to treat insect venom-induced anaphylaxis. Clinicians should be aware of the availability and current level of evidence for intranasal adrenaline for anaphylaxis management.
Thomas J. Young, Wilhelmina R. F. Johnson, Braydon L. Pennington, Troy Wanandy, Wun Y. Lau, Thanh-Thao A. Le
Gabapentinoid Poisoning Presentations to Victorian Emergency Departments: A 15-Year Trend Analysis
This study identified and characterised 1207 emergency department presentations related to gabapentinoid overdose in Victoria from 2009–2010 to 2023–2024. Presentation rates increased substantially since 2009–2010, and about half (49.5%; 597/1207) of all presentations were classified as intentional. Co-ingestants were common, although 36.2% (437/1207) of presentations were reported to involve gabapentinoids alone.
Bishaal Tej Gurung, Amy McNeilage, Angus Skeen, Tina Lam, Joanna F. Dipnall, Jane Hayman, Suzanne Nielsen, Ting Xia
Still Treating Yesterday's Risk? Reconsidering Antiviral Use for Mild-to-Moderate COVID-19 Cases in a Broadly Immune Population
Antivirals for mild-to-moderate coronavirus disease 2019 (COVID-19) were adopted for use based on trials in unvaccinated adults during the pre-Omicron period. In today's broadly immune populations, where the risk of hospitalisation and death has decreased substantially, there is a lack of high-quality contemporary evidence to support routine antiviral use for mild-to-moderate disease. Comparing the Australian and New Zealand experiences in the evolving COVID-19 landscape highlights differences in policy and prescribing practice. Treatment guidelines should be informed by systematic evaluation of emerging data, given uncertainty regarding antiviral effectiveness in a context of widespread immunity and milder disease, which have altered the balance of risks and benefits.
Hadar Mudrik-Zohar, Tim Cutfield, Susan Morpeth, Thomas Hills, Eamon Duffy, Laura J. Edwards, Allen C. Cheng, Steven Y. C. Tong
Birth prevalence, clinical sequelae, and management of congenital cytomegalovirus infections in Australia, 1999–2023: a national prospective study
Universal newborn screening could improve timely detection and avert neurological and other adverse consequences of CMV infections
Ece Egilmezer · Suzy M Teutsch · Carlos Nunez · Stuart T Hamilton · Adam W Bartlett · Pamela Palasanthiran · Elizabeth J Elliott · William D Rawlinson
Medication delivery and dispensing interval preferences of people who use antihypertensive medications in Australia: a survey study
Most people prefer in-person pickup at pharmacies to postal delivery, and longer dispensing intervals, if it saves costs
Carissa Bonner · Michael A Fajardo · Rachael M Keast · Emily Atkins · Niamh Chapman · Kristie R Weir · Anthony Rodgers · Aletta E Schutte
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021
Aaron E Boyce · Tony Caccetta · Jo‐Ann See · Rosemary L Nixon AM
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021
Michelle KY Chen · Adrian Lim · Deshan F Sebaratnam
Incidence of GLP‐1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study
Further evidence and guidelines are needed for safe, effective use of GLP-1 receptor agonists by women of reproductive age
Kailash Thapaliya · Arianne Sweeting · Kirsten I Black · Amanda Poprzeczny · Danielle Mazza · Luke E Grzeskowiak
Estimated carbon emissions for PBS‐subsidised prescription respiratory inhalers, Australia, 2019–2023: a descriptive analysis
Reducing the use of high emissions inhalers is a high priority for decarbonising health care in Australia
Luise Kazda · Alexandra L Barratt · Sean Docking · Kristen Pickles · Darlene Cox · Ross S Bailie · Kate Wylie · Katy JL Bell
Severe hypoglycaemia secondary to chronic opioid‐induced hypothalamic–pituitary–adrenal axis suppression: an under‐recognised phenomenon
A 49-year-old woman with type 2 diabetes mellitus was hospitalised with critical hypoglycaemia
Michael Do · Annabelle G Hayes · Malgorzata M Brzozowska
Antidepressant prescribing in Australian primary care: time to reevaluate
Given limited benefit in mild to moderate mental illness, limited evidence demonstrating benefit and safety with long term antidepressant therapy, and the difficulties that people can experience stopping antidepressants, better decision support and informed consent for starting antidepressants are needed
Katharine A Wallis · Anna King · Joanna Moncrieff
Strong medication overdose data, but we need to consider both toxicity and therapeutic need when prescribing
Physicians should know which medications should be prescribed in limited quantities and only after safer alternatives have been tried
Angela L Chiew · Geoffrey K Isbister
The relative toxicity of medicines detected after poisoning suicide deaths in Australia, 2013–19: a data linkage case series study
More toxic medicines should be supplied in limited quantities and their dispensing to individuals monitored
Jessy Lim · Nicholas A Buckley · Kate Chitty · Andrea L Schaffer · Jennifer Schumann · Zein Ali · Rose Cairns
Pills, profits, and pollution: accountability for pharmaceuticals‐related greenhouse gas emissions
We must consider why action to reduce pharmaceuticals-related emissions is still so limited
Angie Bone · Nick Watts
Shortages of benzathine benzylpenicillin G in Australia highlight the need for new sovereign manufacturing capability
A proactive national response to ongoing benzathine benzylpenicillin G shortages is required, and this includes exploring sovereign manufacturing capacity
Rosemary Wyber · Glenn Pearson · Laurens Manning
The role of GLP‐1 receptor agonists in the management of obesity: risks and opportunities for the Australian health care system
The use of glucagon-like peptide-1 receptor agonists in the treatment of obesity has the potential to impact one-third of Australians. This warrants due consideration and planning for future funding models, systems and models of care to ensure equitable access
Christopher Kanellis · Kyle Williams · Darcy Q Holt · Jennifer Wong · Rachel David · Ravi Carothers · Suong Le
Cannabis poisonings in Australia following the legalisation of medicinal cannabis, 2014–24: analysis of NSW Poisons Information Centre data
Edible cannabis forms may be less harmful than smoking cannabis, but the acute poisoning risk they pose must be considered
Rose Cairns · Sara Allaf · Nicholas A Buckley
Updated recommendations for warfarin reversal in the setting of four‐factor prothrombin complex concentrate
The upcoming introduction of 4FPCC to Australia and New Zealand for warfarin reversal will allow for comprehensive replacement of vitamin K-dependent clotting factors and improved and safter rapid INR correction
Danielle Robinson · James McFadyen · Eileen Merriman · Chee Wee Tan · Ross Baker · Huyen Tran
The cost of treating hypertension in Australia, 2012–22: an economic analysis
During 2012–22, about 40% of the cost of managing hypertension in Australia was borne directly by patients (about $494 million per year)
Emily R Atkins · Long Huy Nguyen · Mary Lou Chatterton · Markus Schlaich · Aletta E Schutte · Anthony Rodgers
Cerebral palsy in Australia: optimism and challenges
Targeted education, mindful of cultural sensitivities, is required to identify and manage children at greatest risk of cerebral palsy
Rod W Hunt
Aligning legislation with clinical practice: off‐label prescribing under the microscope
A legal analysis of off-label prescribing in Australia. Can we harmonise legislation with clinical practice?
Narcyz Ghinea
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021: a retrospective cohort study
Awareness of the importance of hormonal contraception and its uptake by women prescribed category X medications should be increased
Luke E Grzeskowiak · Vivienne Moore · Kelly Hall · Jenni Ilomäki · Danielle Schoenaker · Elizabeth Lovegrove · Danielle Mazza · Kirsten I Black · Debra S Kennedy · Michael J Davies · Alice Rumbold
Cost barriers to medication access in Australia: an analysis of the Patient Experience Survey in context
Medicines are less affordable for women, the ill, the young, and the socio-economically disadvantaged
Narcyz Ghinea
Pharmaceuticals in pregnancy: a multifaceted challenge in Australia
Pregnant women face barriers to pharmaceutical trial participation, and a conservative drug safety categorisation system
Stefan C Kane · Renuka Shanmugalingam · Amanda Henry
