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Pharmacist’s Letter: April 2017; Vol: 33, No. 4


Hello there! The Pharmacist’s Letter is a nifty resource for succinct and informative updates on new drugs, disease states management, complementary medications etc. It is also recognized by Singapore Pharmacy Council as an online CPE point provider. Wait no longer, use it as a resource to refresh your pharmacy knowledge regularly!
 

Topic of the month: Fall Prevention in the Elderly
 

One in 4 elderly of age 65 and older will fall every year, leading to 7 million injuries and over 27,000 deaths. As many drugs may predispose the elderly to higher fall risks, it is important for pharmacists to optimize drug therapies to minimize fall risks for these patients. Do check out the chart on Potentially Harmful Drugs in the Elderly: Beers List for the list of medications that can increase fall risk and potential alternative drugs that you can switch to. You can also refer to Fall Prevention in the Elderly for some practical tips to prevent falls!

Clinical updates:

  1. Stepping Down Asthma Medications in Adults

    When and how do we taper down inhaled corticosteroids dose for patients with asthma? What are some strategies to improve asthma care? For more information on asthma management and other therapies available, listen to PL VOICES and read Improving Asthma Care.

     
  2. How to treat hiccups?

    Short-term bouts of hiccups are annoying, but not harmful. Persistent hiccups are rare and last for more than 2 days. There are many reasons for persistent hiccups, which include abnormalities in central nervous system, gastrointestinal issues (e.g. gastroesophageal reflux disease, peptic ulcer), thoracic diseases (e.g. pneumonia), psychogenic causes (e.g. stress, fear) etc. There are medications for persistent hiccups, however they have limited efficacy. See Drug Therapy of Hiccups for more information.
     

 Frequently asked questions at the community pharmacy:

  1. How do I manage constipation?

    For constipation in normal, healthy adults, we can first suggest adequate fluids, fibre and physical activity. Identification of constipation-causing medications such as opioids, anticholinergics, iron and calcium will be helpful in management too. Can stool softeners be used to prevent or treat chronic constipation? Read Treatment of Constipation in Adults to better understand management of constipation.

     
  2. Are all topical dosage forms the same?

    Certain topical dosage forms can impact drug absorption. Are there differences in topical dosage forms for dry skin and oily skin? It will be useful to tailor the choice based on skin type, the affected area, patient preference, and cost. Read A guide to selecting topical dosage form for more information.