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Choosing Wisely Australia

The Society of Hospital Pharmacists of Australia

Products containing low dose (<12mg) codeine per tablet combined with another analgesic medicine are available without a prescription and are commonly recommended for the treatment of mild to moderate pain. Codeine is converted to morphine in the body to work. The extent of this metabolism depends on each individual’s pharmacogenetics, which are not readily known and highly variable between individuals. There is evidence that doses of codeine less than 30 mg every 6 hours, are no more ...

Choosing Wisely Australia

The Society of Hospital Pharmacists of Australia

Non-steroidal anti-inflammatory medicines (NSAIDs) are frequently used in the short term to treat moderate acute pain. They are not usually required after the cause of the acute pain has been addressed. Treatment should be re-assessed if the acute pain is ongoing and not resolved within 2 weeks. Oral NSAIDs have considerable cardiovascular, gastrointestinal and kidney function risks. They should not be recommended without consideration of the patient’s additional diseases or conditions; in ...

Choosing Wisely Australia

The Society of Hospital Pharmacists of Australia

Behavioural and psychological symptoms of dementia (BPSD) are often temporary. The mainstay treatment of BPSD is non-pharmacological. Antipsychotic medicines should only be considered when non-pharmacological interventions have failed and the patient has symptoms that are distressing for them, their family or co-residents. Patients or their carer, or designated guardian, should be involved in the decision to begin treatment with an antipsychotic medicine. Consideration needs to be given to the ...

Choosing Wisely Australia

The Society of Hospital Pharmacists of Australia

Antibiotics may be prophylactic, empirical or targeted against a known organism. Prolonged duration of antibiotics is associated with: an increased risk of adverse reactions, Clostridium difficile infection, candidiasis, selection of antibiotic resistant organisms as well as unnecessary cost. Therefore the shortest possible duration of therapy should be used. For the majority of infections treatment should not exceed 7 days. The most appropriate duration of therapy may be difficult to identify ...

Choosing Wisely Australia

The Society of Hospital Pharmacists of Australia

Frail, elderly patients are more susceptible to the adverse effects of medicines. There is limited evidence to support the use of many medicines in elderly patients as they are typically excluded from clinical trials. One study has estimated the cost to the PBS of potentially inappropriate medication in older patients is between $240 and $450 million each year. The use of medicines used to prevent a condition, or disease, or those with a long ‘time to benefit’ profile may not be consistent ...