Christchurch Medicines Information Service

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...

Morphine is considered internationally to be the opioid analgesic of choice for the relief of moderate to severe pain. It is used in many areas of medicine including musculoskeletal injury, pre- and post-surgery and in malignant disease. Oxycodone is an opioid analgesic which has similar indicati...

Metronidazole is often indicated in infections affecting breastfeeding mothers, such as trichomoniasis, pelvic inflammatory disease and bacterial vaginosis. This bulletin reviews the safety of metronidazole in breastfeeding women. Transfer into breast milk Nearly all drugs transfer into...

Prescribing for older patients is complex. Many older patients are frail (25-50% of people older than 84 years) - characterised by physiological decline in multiple systems, resulting in patient vulnerability to medicines. Older people are at greater risk of harm, including iatrogenic harm. This ...

Clinical guidelines recommend that patients prescribed opioids should be co- prescribed laxatives. However, opioid induced constipation remains a common local and international problem associated with morbidity and mortality occurring in up to 90% of those taking opioids. Within CDHB hospitals fr...

The use of opioids has been of interest both nationally and locally. Codeine is the most commonly used opioid from step 2 of the WHO analgesic ladder within CDHB hospitals. The use of codeine and another step 2 analgesic, tramadol, are increasing in the CDHB. Solid oral dose forms of codeine (...

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...

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...

Use of IV paracetamol has increased from 1,160 of the 1 g infusions (cost of $4,928) in the financial year 2006/2007 to 20,600 (cost of $81,852) in the financial year 2012/2013. A dose of 1 g of paracetamol costs $2.25 IV and $0.02 oral. PHARMAC Hospital Medicines List (HML) restricts the use ...

Herbal products are commonly used by many patients alongside conventional medicines. The aim of this bulletin is to describe potential interactions with five popular products; St John’s wort, ginkgo, garlic, echinacea and fish oil. Pharmacokinetic interactions (see table below): Enzym...