Bulletins - Adverse drug reactions
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Drug-Induced QTc Interval Prolongation - February 13, 2020
The risk of developing a life threatening arrhythmia at any given QTc interval (the QT interval corrected for heart rate) varies widely between patients. In patients with a high baseline risk of QTc prolongation, QTc prolonging drugs should be either avoided or the QTc interval should be monitore...



Oral Anticoagulants – Rivaroxaban and Dabigatran - October 1, 2019
Rivaroxaban (Factor Xa inhibitor), dabigatran etexilate (direct thrombin inhibitor), or warfarin (vitamin K epoxide reductase inhibitor) can be used as oral anticoagulants for most indications. Warfarin remains first line for patients with mechanical heart valves or severe chronic kidney disease....



‘Sulfur allergy’ - July 17, 2019
The term ‘sulfur allergy’ is misleading. It can lead to patients believing that they are allergic to all sulfur-containing medications or preservatives, and even to sulfur, an important building block of life. It can also cause potentially useful medicines to be unnecessarily avoided. The ter...



Vildagliptin for diabetes – funded in NZ - March 29, 2019
There are over 240,000 people in NZ currently diagnosed with diabetes mellitus (mostly type 2), and possibly another 100,000 undiagnosed. In October 2018, vildagliptin became the first dipeptidyl peptidase-4 (DPP-4) inhibitor funded in NZ. It is one of a number of DPP-4 inhibitors used internatio...



Pregabalin - January 14, 2019
Pregabalin is now fully funded without restrictions both in hospitals (Hospital Medicines List) and in the community (PHARMAC Schedule). As the use of newly available medicines, particularly new medicines within a class, presents some challenges to clinicians the aim of the below is to familiaris...



Sacubitril + valsartan for heart failure - November 5, 2018
Sacubitril + valsartan is now available in New Zealand and fully subsidised under Special Authority criteria. Eligible patients must have NYHA/WHO functional class II, III or IV heart failure; a left ventricular ejection fraction of <35%; and be receiving standard heart failure therapy. It can...



Medication induced hyponatraemia - December 1, 2014
Hyponatraemia (plasma sodium <135mmol/L) is common in hospitalised patients, the incidence is 12% in medical wards and up to 30% in intensive care. Hyponatraemia is associated with an increased length of stay in hospital and increased mortality. Mild hyponatraemia is often asymptomatic with sy...