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BPJ 48 November 2012

Best Practice Journal

Obstructive sleep apnoea in adults

Obstructive sleep apnoea affects many adults in New Zealand, and is especially common among Māori and Pacific peoples. Moderate to severe obstructive sleep apnoea is associated with a significant risk of cardiovascular morbidity and mortality, along with an increased risk of motor vehicle accidents, due to daytime sleepiness and fatigue. In most cases, an overnight sleep study is required to confirm the diagnosis. Continuous positive airway pressure (CPAP) devices are the mainstay of treatment. View Article

Sleep disturbances: managing parasomnias in general practice

The term "parasomnia" describes a group of sleep disorders associated with unnatural movements, behaviours, emotions, perceptions and dreams that occur while falling asleep, during sleep, between sleep stages or upon waking. Most people experience a parasomnia during their lifetime. In the majority of cases, parasomnias are benign and, although frightening, no cause for concern. Reassurance, advice on methods to maximise sleep (sleep hygiene) and making the sleep environment safe are the key factors in managing people with parasomnias. View Article

When and how to use a syringe driver in palliative care

Syringe drivers are often required to provide medicines for symptom management in patients who are terminally ill. They provide continuous subcutaneous administration of medicines to enable effective symptom control when medicines given by other routes are inappropriate or no longer effective. With guidance and support from the local hospice or district nursing services, General Practitioners can arrange a syringe driver infusion for a patient in their home or in a residential care facility, prescribe and monitor the appropriate mix of medicines and manage breakthrough symptoms. View Article

Initiating interventions in people with intermediate hyperglycaemia ("pre-diabetes")

Intermediate hyperglycaemia is a biochemical state in which a person has glucose levels above the normal range, but does not yet meet the criteria for a diagnosis of diabetes. The primary aim of management of intermediate hyperglycaemia is to prevent progression to diabetes. Intervention involves structured lifestyle changes, and for people with a high risk of progression to diabetes who do not achieve normoglycaemia, treatment with metformin. View Article

Upfront: Lung cancer in New Zealand

Lung cancer in New Zealand: overcoming barriers View Article

News and updates: Update on azithromycin

Update on azithromycin: new prescriber information and availability View Article

Using the New Zealand Formulary

Are you getting the most from the NZF? Resources for getting started View Article