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interaction

Interaction

While alternative oral anticoagulant drugs such as dabigatran have recently been developed, warfarin is currently still the most commonly used and only PBS-listed oral anticoagulant in Australia for the prevention and treatment of thromboembolism in patients with mechanical heart valves, atrial fibrillation and deep vein thrombosis or pulmonary embolus. Warfarin exerts its therapeutic action as a vitamin K antagonist, lowering the amount of vitamin K available for the production of important clotting factors.

Download the bulletin:

Download (PDF, 18.48KB)

A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.

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Interaction
Urinary alkalinisers are used to relieve the discomfort associated with urinary tract infections, help treat certain types of renal stones, or may be used in the specialist setting to treat some metabolic and renal disorders.

The E-Bulletin contains a table of some of the drugs that may interact (some quite dramatically) with urinary alkalinisers.

Download the RGH E-Bulletin: Drug Interactions with Urinary Alkalinisers (767)

The 2009 RGH E-Bulletins are archived here.

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Image source: OpenClipArt.org, public domain.

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This was written for me some time ago by Melissa, a Remote Area Nurse I worked with in 2008.

Working in a remote area as a health professional is a very challenging role. Unlike working in an urban or rural hospital situation, where there are a multitude of doctors, nurses, allied health professionals and pharmacists available 24 hours a day, remote health clinics rarely have a variety of health professionals, let alone the ones which are essential. Having a pharmacist located within the region is not only rare, but is highly valuable and appreciated.

There are many times when having a pharmacist nearby is a definite advantage. Questions over medication interactions, brand names, etc can easily be sorted by pharmacist who is only a phone call away and is well familiar with the medications commonly utilised in the area. Pharmacists are a fount of knowledge about medications, drug interactions, and side effects. This is not only helpful for doctors, so that they do not prescribe medications which interact, but also for nurses who may need help with understanding certain medications, interactions and side effects.

Having a pharmacist as a part of the remote health team helped immensely in streamlining patients medications when they have been discharged from hospital. Commonly, patients are discharged from hospital without any consultation with Medical and/or Nursing staff, with patients discharged on new or altered medications, which may not be readily available in the remote clinic. Having a pharmacist who is actively involved in helping with patient discharges means that any new or altered dose medications a patient may require can be ordered and, hopefully, arrive prior to the patient returning to the community. The pharmacist can also help to organise new remote scripts when patients’ medications have been changed by a hospital or specialist.

Transportation of medical supplies and medications in remote areas is not merely a matter of placing an order and it arriving in a day or two. It takes time to get medications and medical supplies transported out, mostly by airplane, and having a remote health pharmacist has certainly helped with this. Whilst it is impossible to know exactly how much medication a clinic will use in a given month, the pharmacist can be instrumental in helping to calculate average usage and to assess what minimum level of medication stock should be kept in a clinic.

When a medication inadvertently does run out before the next order is due/arrives, having a pharmacist nearby is handy. By calling the pharmacist who has a general idea of what clinics have what medications and the levels of medication in each clinic, the pharmacist can organise to have emergency supplies transferred from another clinic to the clinic in need. This can also be useful for medications whose expiration date is coming up. Because the pharmacist has knowledge about which clinics and patients use certain medications, close to expiration date medications and vaccines can be transferred to where they are most likely to be used in order to help prevent wastage.

A remote health pharmacist can also spend time with individual patients and explain their individual medications, changes to their medications, and how to use medication devices such as dosette boxes and insulin pens. Whilst nursing and medical staff aim to explain the medication prescribed to the individual, often they do not have the time or the expertise of knowledge which a pharmacist has. Having a pharmacist travel from remote clinic to remote clinic means that patients who require extra explanations can have a visit booked with the pharmacist for that express purpose.

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