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Activation of prodrugs affected by CYP induction/inhibition - February 26, 2021
Definition
Prodrugs are inactive precursors designed to be converted to an active form after administration. This is to overcome poor physio-chemical or pharmacokinetic properties of the active drug.
Prodrugs – methods of activation
Prodrugs are activated by a variety of mechanisms including...


CDHB Training workbook for therapeutic drug monitoring of aminoglycosides and vancomycin 5th ed 2021 - January 27, 2021



NDMA, Nitrosamine Impurities in Medicines - February 26, 2020
Due to concerns about cancer risks from contamination with NDMA, ranitidine tablets and injection have been unavailable in New Zealand since September 2019, following a global recall by the manufacturers. This bulletin aims to provide information for health professionals about NDMA impurities in ...



Levomepromazine 25 mg and 100 mg tablets – important note regarding product change - February 26, 2020
Key points
The current NZ Sanofi levomepromazine (Nozinan®) 25 mg and 100 mg tablets will be replaced with Swiss Sanofi Nozinan® formulations temporarily from 1st March 2020. They are not bioequivalent.
Dose equivalency is 1 x NZ tablet ≈ 0.75 x Swiss tablet.
All prescriptions sho...



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...



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...



Repackaging dabigatran into compliance packs - October 8, 2018
Compliance packs
With an ageing population there is increasing incidence of multimorbidity and polypharmacy. This leads to complex dosing regimens.
Compliance aids, such as the Medico Paks® or unit dose medication sachets, are widely used to manage complex medication regimes, and help remind...



Transdermal patches: MRI safety concerns - June 1, 2017
Patients should be asked if they are wearing a transdermal patch prior to a magnetic resonance imaging (MRI) scan
Background
A recent case of possible fentanyl toxicity in a patient wearing a transdermal patch during an MRI highlighted the safety issues associated with medication patches in MR...



Omeprazole use in upper gastrointestinal bleeds - March 1, 2016
At the end of February this year all CDHB hospitals switched from using iv infusions of omeprazole to iv intermittent boluses in the treatment regimen for upper gastrointestinal bleeding. This decision (which involved General Surgery, Gastroenterology, Clinical Pharmacology, Pharmacy and the Emer...



Analgesics on discharge - February 1, 2015
The discharge prescribing of opioid analgesics, particularly oxycodone, has caused concern nationally and locally. Canterbury District Health Board (CDHB) encourages the prescribing of morphine in preference to oxycodone in most situations. In New Zealand the number of community prescriptions for...