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BPJ 49 December 2012

Best Practice Journal

Strong opioids for pain management in adults in palliative care

Pain is estimated to be the most prevalent symptom preceding all deaths occurring in a palliative care setting. Strong opioids are a safe and effective treatment for moderate to severe pain in adults, if used appropriately. However, individual patient responses vary making dose titration an important aspect of pain management. Constipation, nausea and other adverse effects are common and should be managed pre-emptively. Switching between opioids should be undertaken with caution as the equivalent dose will vary between patients. View Article

The night time hustle: managing restless legs syndrome in adults

Restless legs syndrome is a common neurological disorder that can significantly affect a patient's quality of life. Lifestyle modification is the mainstay of treatment for people with mild or infrequent symptoms. Pharmacological treatments, starting with dopamine agonists, should be reserved for people with more severe symptoms. View Article

Nocturnal leg cramps: is there any relief?

Nocturnal leg cramps are common, particularly in older people and in women who are pregnant. Is there an effective treatment? Unfortunately, treatment options are limited, but lifestyle modifications and gentle stretching may have some effect. Pharmacological treatment may be considered for people with frequent, severe leg cramps. Quinine is no longer recommended for leg cramps, however, it appears to still be used. View Article

Upfront: Recommended vaccinations for primary health care staff

Recommended vaccinations for staff working in primary health care View Article

Appropriate use of sulfonamides

What are sulfonamides and how do they work? | Prescribing co-trimoxazole | Adverse effects of co-trimoxazole | Medicine interactions with co-trimoxazole View Article

Using the New Zealand Formulary

Guide for switching antidepressants View Article