NMIC Newsletters

 Update on Diabetes (Update_on__DIABETES_April_2012.pdf | 448 KB)

Contents: Pathophysiology; Diagnosis; Lifestyle interventions; pharmacological management; Management of Type 2 diabetes mellitus in practice

 April 2012, Number 4 (TToday_April_2012.pdf | 117 KB)

Contents: warfarin is still an effective option for stroke prevention in atrial fibrillation; notifying of infectious diseases in Ireland; caffeine can contribute to pain relief; and uncomplicated acute rhinosinusitis.

 March 2012, Number 3 (TToday_March__2012.pdf | 111 KB)

Contents: tackling the long-term use of benzodiazepines; community detoxification initiatives; safety advice on aliskiren; statin therapy.

 February 2012, Number 2 (TToday_Feb_2012.pdf | 109 KB)

Contents: Risk of QT interval prolongation with citalopram and escitalopram; ask about snoring in patients with resistant hypertension; HSE initiative to support rational benzodiazepine prescribing.

 January 2012, Number 1 (TToday_Jan_2012.pdf | 117 KB)

Contents: Statins are still safe and effective with long-term use; most reproductive factors have no impact on the risk of ovarian cancer; safety notice concerning the use of aliskiren.

 Update on Hypertension (hypertension_december_2011.pdf | 394 KB)

Contents: diagnosis and classification of hypertension; management of hypertension; hypertension in clinical practice; practical issues in the management of hypertension

 December 2011, Volume 12, Number 12 (T_Today_Dec_2011.pdf | 118 KB)

Contents: Study finds a possible protective effect of coffee on risk of depression in women; Chocolate may be good for your heart and your head; Overuse of antibiotics on colds and the flu

 November 2011, Volume 12, Number 11 (TToday_Nov_2011.pdf | 109 KB)

Contents: Update on oral contraceptives and venous thromboembolism; Female smokers more likely to get heart disease!; Drug-induced photosensitivity.

 October 2011, Volume 12, Number 10 (TToday_Oct2011.pdf | 111 KB)

Contents: Effect of patient payment status on antibiotic prescribing; Updated immunisation guidelines available online; Length of anticoagulant treatment and risk of recurrent venous thromboembolism; Psychoactive medications increase crash risk in older drivers.

 Update on Helicobater Pylori Infection (Final_proof_of_H_pylori.pdf | 476 KB)

Contents: Helicobacter pylori infection plays an important role in upper gastrointestinal disease. H pylori can reduce the incidence of both peptic ulcer disease and gastric cancer. Causes of treatment failure include antimicrobial resistance and non-adherence to treatment. Confirmation of H. pylori eradication should be performed at least four weeks after treatment.

 September 2011, Volume 12, Number 9 (TToday_Sept_2011.pdf | 109 KB)

Contents: What is the value of electronic drug interaction alerts in primary care? 2010 Annual Report from the National Poisons Information Centre (NPIC). Interpreting asymptomatic bacteriuria. Respiratory disease and air travel: BTS recommendations.

 The Management of Stroke (stroke_2011.pdf | 437 KB)

Contents: Stroke is a leading cause of death and major disability worldwide; Thrombolytic therapy within 3 hours of symptom onset greatly reduces mortality and morbidity in ischaemic stroke; Up to 30% of patients presenting with a TIA may be at risk of developing a stroke within 30 days; Active management of modifiable risk factors is vital in the primary and secondary prevention of stroke.

 August 2011, Volume 12, Number 8 (TToday_August_2011.pdf | 122 KB)

Contents: Management of acute infective conjunctivitis; Safety update; Treating pain may reduce behavioural disturbances in patients with dementia.

 July 2011, Volume 12, Number 7 (TToday_July_2011_MT.pdf | 137 KB)

Contents: Traveller's diarrhoea; Management of Common Infections in Primary Care; Dose rather than duration important for aspirin GI toxicity; Strategies for Safer Prescribing.

 Management of Dementia (dementia_2011.pdf | 492 KB)

Dementia may be described as a clinical syndrome associated with a loss of intellectual functions including memory, significant deterioration in the ability to carry out activities of daily living (ADL) and changes in social behaviour.

 June 2011, Volume 12, Number 6 (TToday_June_2011.pdf | 100 KB)

Contents: How to manage nocturnal enuresis in children and young people; Does longterm benzodiazepine usage affect cognition in younger adults? Newer-generation antiepileptic drugs and pregnancy.

 May 2011, Volume 12, Number 5 (TToday_May__2011.pdf | 113 KB)

Contents: Update on Amyotrophic Lateral Sclerosis; Statin therapy protects the heart in patients with diabetes; Risk of atypical fractures with use of biophosphonates.

 April 2011, Volume 12, Number 4 (TToday_April_2011.pdf | 132 KB)

Contents: Prevention of migraine; Update on contraception and drug interactions; Waste not Want not!; HSE response to Japanese Nuclear Event.

 Frequently Asked Questions on Use of Antidepressants in Adults (FAQ_depression_ADults_Vol_17_No_1_2011.pdf | 116 KB)

Contents: Use of antidepressants in pregnant and breastfeeding women; Choice of antidepressant in patients with specific concomitant medical conditions; Frequently asked questions on adverse effects/potential drug interactions with antidepressants; Management of patients not responding to initial antidepressant therapy.

 Pharmacotherapy of Depression in Adults (Depression_2010_Vol16_No6.pdf | 130 KB)

Volume 16, Number 6

 March 2011, Volume 12, Number 3 (TToday_March__2011.pdf | 100 KB)

Contents: The management of breast infection; Improve risk factor control and prolong life; HPSC launches new look website.

 February 2011, Volume 12, Number 2 (TToday_Feb__2011.pdf | 122 KB)

Contents: Breast cancer and hormone replacement therapy (HRT); possible risk of severe liver injury with dronedarone; preventing exacerbations in chronic obstructive pulmonary disease (COPD); hormonal contraception bulletin correction.

 January 2011, Volume 12, Number 1 (TToday_Jan_2011.pdf | 132 KB)

Contents: Cardiovascular effects of cocaine; Is all exercise equal in type 2 diabetes? Why do patients stop taking statins?

 December 2010, Volume 11, Number 12 (T_Today_Dec_2010.pdf | 170 KB)

Contents: Omega-3 fatty acid supplements are no help in established Alzheimer's disease...But low dose aspirin may reduce incidence/mortality from colorectal cancer. Are PPIs safe during the first trimester of pregnancy? And Finally.........Preventing Winter Falls!

 Frequently Asked Questions on Hormonal Contraception (NMIC_Newsletter_FAQ_hormonal_contraception_Vol16_No5.pdf | 119 KB)

The potential for drug interactions with hormonal contraceptives should always be considered; Combined hormonal contraceptives are contraindicated in patients experiencing migraine with aura; All forms of hormonal contraception are contraindicated in patients with breast cancer; Women > 40 years who are sexually active should be offered an effective contraceptive method

 Hormonal Contraception (Hormonal_Contraception_NMIC_v16No2_web_PRINT.pdf | 152 KB)

Contents: Combined hormonal contraceptives are suitable for women with no risk factors up to 50 years of age; UK Medical Eligibility Criteria are a useful resource for assessing the suitability of a contraceptive method for an individual patient.

 November 2010, Volume 11, Number 11 (TToday__Nov_2010.pdf | 105 KB)

Contents: Get to grips with frailty; Prevent your patients getting snookered by warfarin tablets!; How to achieve a "happy medium" with medications in the elderly.

 October 2010, Volume 11, Number 10 (TToday__October_2010.pdf | 103 KB)

Contents: Are calcium supplements bad for the heart?; Suspension of Rosiglitazone in EU; Atrial Fibrillation: new guidelines on its management.

 September 2010, Volume 11, Number 9 (TToday__Sept__2010.pdf | 100 KB)

Contents: Are all spoons equal?; Beware of different brands of Warfarin; Use an OAK to test your patient's knowledge about Warfarin; Update on neuropathic pain.

 Prescribing in the Elderly (prescribing_in_elderly_2010__2_.pdf | 113 KB)

Contents: The elderly receive the majority of prescribed medicines in practice; Ageing affects the body's ability to handle medicines, increasing the risk of adverse events; Prescribing tools and checklists are available to enhance optimal prescribing in the elderly; Regular medication review is essential for ensuring rational and effective use of medicines in the elderly; Non-pharmacological therapies should be used whenever possible.

 August 2010, Volume 11, Number 8 (TToday_Aug_2010.pdf | 129 KB)

Contents: Vitamin B-12 Deficiency; Glucosamine no better than placebo for chronic low back pain. Triptan therapy in migraine; Update on rosiglitazone

 July 2010, Volume 11, Number 7 (TToday_20July_202010.pdf | 162 KB)

Contents: What is Antiphospholipid Syndrome (APS)? New guidance on non-prescription codeine medicines; Glucosamine (DONA®) not a "cost-effective therapy" for OA in Ireland.

 Management of Menopause (Menopause_2010.pdf | 129 KB)

Contents: Menopause is a normal event in a woman's life; symptomatic management is needed in some cases; Lifestyle modification should be considered as an integral part of menopausal management; Hormone replacement therapy (HRT) is the most effective treatment for vasomotor symptoms; The benefit/risk ratio for HRT use is favourable close to the time of menopause.

 June 2010, Volume 11, Number 6 (TToday_June_2010.pdf | 163 KB)

Contents: Identifying "at-risk" NSAID users; Does a spoonful of sugar really help the medicine go down?; Incidence of imported malaria in Ireland; Time to treatment vs. outcome in ischaemic stroke

 May 2010, Volume 11, Number 5 (TToday_May_2010.pdf | 136 KB)

Contents: Keep up to date with the safety of marketed medicines; Evaluating the risk of VTE with oral contraceptives; Fluoxetine: risk of cardiovascular birth defects; New Rules on Epilepsy and Driving; How to avoid prescribing errors.

 April 2010, Volume 11, Number 4 (TToday_April2010.pdf | 153 KB)

Contents: Anyone for Aspirin? Never too old for a statin! Safety Update for Clopidogrel and PPIs. Pharmacoeconomic Evaluation in Ireland.

 March 2010, Volume 11, Number 3 (TToday_March_2010.pdf | 133 KB)

Contents: Medication overuse headache; Clostridium difficile in Ireland; Antiepileptic drugs and contraception; Community acquired MRSA.

 WHAT IS THE SUMMARY OF PRODUCT CHARACTERISTICS? (SPC_final_web_version_NMIC_v16No1_web.pdf | 167 KB)

Contents: The Summary of Product Characteristics (SmPC) forms the basis of prescribing information for healthcare professionals; The promotion of a medicine must be done within the terms of the current SmPC; The SmPC is an intrinsic part of the approval (licensing) process of a medicine; The SmPC content is continuously updated to reflect up-to-date knowledge of the medicine.

 February 2010, Volume 11, Issue 2 (TToday_Feb_2010.pdf | 120 KB)

Contents: Withdrawal of Reductil® from the market; FIT for life!; Rout the Gout!

 Frequently Asked Questions on the Use of Medicines in Children (FAQ_on_medicines_in_children_Vol_15_No_3.pdf | 121 KB)

Contents: Many medicines used in children, have not undergone extensive evaluation in children. It is recommended that a recognised source of information is used for prescribing unauthorised/unlicensed medicines in children such as the British National Formulary for Children. The National Medicines Information Centre, through its enquiry answering service, can provide specific information on the use of medicines in children.

 January 2010, Volume 11, Issue 1 (TToday_Jan_2010.pdf | 161 KB)

Contents: Why do patients discontinue medicines?; Safety update on Sibutramine; Ginkgo biloba does not prevent cognitive decline; Do antioxidants prevent cancer?

 December 2009, Volume 10, Issue 12 (TToday_Dec_2009.pdf | 161 KB)

Contents: Go easy on the salt; Clopidogrel and PPIs; Public smoking bans are good for the heart!; Google Scholar and PubMed go head to head...

 Use of Medicines in Children (meds_in_Children_Bulletin_1.pdf | 131 KB)

Contents: Many medicines used in children, have not undergone extensive evaluation in children; The developmental stage of a child influences their response to a medicine; The age of the child may determine the formulation required; Recent EU initiatives aim to improve the safety, efficacy and availability of medicines for children.

 November 2009, Volume 10, Issue 11 (T_Today_Nov_2009.pdf | 122 KB)

Contents: The impact of "tailored care" on patient outcome in cardiovascular disease; Why have excipients in medicines?; Soluble fibre works better than insoluble fibre in IBS; Is there a link with migraine and cardiovascular disease? Vaccination programme for the Pandemic (H1N1) 2009.

 October 2009, Volume 10, Issue 10 (TToday_Oct_09.pdf | 160 KB)

Contents: Update on oral contraceptives and venous thromboembolism; Proton Pump Inhibitor (PPI) Prescribing Initiative; What is a cytokine?; "Bisphosphy Jaw".

 September 2009, Volume 10, Issue 9 (TToday_Sept_09.pdf | 138 KB)

Contents: The ABC of H1N1!; Where to look for information on Pandemic (H1N1) 2009; Thiazolidinediones and risk of fractures; Drug Safety Update: coloured medication and the colour blind.

 Generic Prescribing (Generic_bulletin_NMIC_v15No1_web_with_refs.pdf | 179 KB)

Contents: A generic medicine contains the same qualitative and quantitative composition of active substance as the proprietary ("reference") version of that drug. Use of the generic name when prescribing reduces the potential for confusion and error.

 August 2009, Volume 10, Issue 8 (T_Today_Aug_09.pdf | 133 KB)

Contents: Short vs long-term androgen suppression therapy in prostate cancer; What is the best treatment for Bell's Palsy?; British guideline on asthma updated (revised June 2009); Management of Hepatitis C (Hep C).

 July 2009, Volume 10, Issue 7 (T_Today_July_09.pdf | 126 KB)

Contents: Professor John Feely; Tools to aid prescribing in the elderly; Individualise statin therapy in elderly patients with CHD; What role does aldosterone play in resistant hypertension and the metabolic syndrome?

 June 2009, Volume 10, Issue 6 (TT_June_09.pdf | 143 KB)

Contents: Update on Potential Interaction between Clopidogrel and PPIs; Intensive glucose control of diabetic patients; Why look at an SPC?; Updated WHO guidelines on Hand Hygiene in Healthcare now available.

 Update on Osteoporosis (osteoporosis_2008.pdf | 130 KB)

Osteoporosis is a significant cause of morbidity and mortality especially in the elderly population. Evaluation of clinical risk factors is important in the identification of osteoporosis. Patients at risk of osteoporosis should have adequate intakes of calcium and vitamin D. Bisphosphonates are usually the first line treatment of osteoporosis.

 May 2009, Volume 10, Issue 5 (TToday_May_09.pdf | 123 KB)

Contents: How to manage hirsutism; Update on mumps outbreak in Ireland; Potential Interaction between Clopidogrel and PPIs; Psychiatric symptoms and chronic physical disease.

 April 2009, Volume 10, Issue 4 (TT-04-09.pdf | 179 KB)

Contents: We are still better at curing than preventing cardiovascular disease!; Obesity reduces life expectancy; Where to find information on HPV Vaccines?; Managing chronic constipation in adults.

 March 2009, Volume 10, Issue 3 (TToday_March___2009.pdf | 135 KB)

Contents: Update on Alzheimer's Disease; Do multivitamins prevent cancer and cardiovascular disease?; Should you administer medication through an enteral feeding tube?; Fertility drugs and risk of ovarian cancer.

 February 2009, Volume 10, Issue 2 (TT-02_09.pdf | 128 KB)

Contents: Management of Stroke Prevention in Atrial Fibrillation; Update on tibolone and breast cancer risk; Should minocycline be used in the management of acne?

 January 2009, Volume 10, Issue 1 (TToday_Jan_2009.pdf | 213 KB)

Contents: Update on MS; Don't blame the sugar, blame the parents!; Drugs and liver failure; Antioxidants do not prevent cancer - further evidence; Reminder on Influenza.

 December 2008, Volume 9, Issue 12 (TT-12-2008.pdf | 170 KB)

Contents: Time to forget Gingko?; Go easy on the (cranberry) sauce!; Statin-induced myopathy.

 November 2008, Volume 9, Issue 11 (TT-11-_08.pdf | 117 KB)

Contents: Treatment of Helicobacter pylori (H pylori) infection; Update on Influenza; Steroids shorten the recovery time in Bell's Palsy (BsP); Childhood Immunisation in Ireland.

 October 2008, Volume 9, Issue 10 (TT-10-08.pdf | 112 KB)

Contents: Update on Guillain-Barré syndrome; Can we prevent drug-related hospital admissions?; Paracetamol and ibuprofen for fever in children; Low-dose aspirin and cognitive function.

 Management of Parkinson's Disease (Management_of_Parkinson_s_Disease.pdf | 74 KB)

The prevalence of Parkinson's Disease (PD) is increasing due to increasing life expectancy. Levodopa remains the single most effective symptomatic treatment but is associated with motor complications in up to 70% of patients. Other treatment options have less motor complications, but are also less effective. Due to difficulties in diagnosis and deciding when to initiate therapy, specialist advice is recommended.

 September 2008, Volume 9, Issue 9 (TT-09-08.pdf | 135 KB)

Contents: Tibolone: the good and the bad!; Benzodiazepine use and risk of fracture in the elderly; How to manage hypothyroidism; Safety Update! Interactions with statin therapy.

 August 2008, Volume 9, Issue 8 (TT-08-08.pdf | 108 KB)

Contents: How to manage fibromyalgia; Updated immunisation guidelines; New prescribing recommendations for fluoroquinolones; Drugs and QT-prolongation.

 July 2008, Volume 9, Issue 7 (TT-07-08.pdf | 108 KB)

Contents: Drugs in Sports; C. difficile infection in Ireland; Polymyalgia Rheumatica; Fatal Adverse Drug Reactions.

 June 2008, Volume 9, Issue 6 (TT-06-08.pdf | 126 KB)

Contents: How to manage peanut allergy; The NMIC needs you; Update on Crohn's Disease; New guideline on Asthma; Treating high blood pressure beneficial in patients 80 and over.

 May 2008, Volume 9, Issue 5 (TT-05-08.pdf | 134 KB)

Contents: Does ezetimibe enhance survival?; Statins can reduce your blood pressure!; Treating high blood pressure is beneficial in patients aged 80 years and older; Commercial versus home-made spacers for bronchodilator therapy in children; Reminder: The NMIC needs you.

 April 2008, Volume 9, Issue 4 (TT-04-08.pdf | 104 KB)

Contents: Oral contraceptives confer long-term protection against ovarian cancer; Hear ye, hear ye, the NMIC needs you!; People assume expensive drugs work better; Contemporary management of haemorrhoids; Oh my aching head!

 March 2008, Volume 9, Issue 3 (TT-03-08.pdf | 148 KB)

Contents: Functional dyspepsia; Soccer may be bad for you!; New guidance on management of Osteoarthritis (OA); High dose allopurinol toxic to skin

 February 2008, Volume 9, Issue 2 (TT-02-08.pdf | 119 KB)

Contents: How do you treat fungal nail infections?; Safety update on rosiglitazone; Statins are good for diabetic patients; Study finds no link between MMR vaccine and autism.

 January 2008, Volume 9, Issue 1 (TT-01-08.pdf | 135 KB)

Contents: Safety Update for Champix®; Continued use of anti-ulcer therapy may be inappropriate after hospital discharge; Medicines for Children; Acute bronchiolitis; Is a cuppa good for your bones?

 Management of Atopic Eczema (Atopic_Eczema_Dec_2007.pdf | 75 KB)

Contents: Atopic eczema is a common condition responsible for 30% of general practice dermatological consultations; Patient education is an important aspect of the management of atopic eczema and may improve compliance; Emollient use should be liberal and should exceed topical corticosteroid (TCS) use by at least 10:1; The weakest effective potency of the TCS should be used and matched to the disease severity.

 December 2007, Volume 8, Issue 12 (TT-12-07.pdf | 113 KB)

Contents: Transmitting infections via staff clothing; Safety warning issued for strontium; THANK you very very very MUCH; Hair loss in women; IMB electronic reporting system for adverse drug reactions (ADRs).

 November 2007, Volume 8, Issue 11 (TT-11-07.pdf | 119 KB)

Contents: Paracetamol and Osteoarthritis; Safety Update on Glitazones; Keep taking your statin!; A cautionary reminder for women of child-bearing potential.

 October 2007, Volume 8, Issue 10 (TT-10-07.pdf | 149 KB)

Contents: Essential Hypertension; Corticosteroids prevent relapse in asthma; High normal blood pressure carries cardiovascular risks too!; Oral contraceptives do not cause cancer; Influenza in Ireland.

 September 2007, Volume 8, Issue 9 (TT-09-07.pdf | 108 KB)

Contents: Update on Endometriosis; Milk-Alkali Syndrome; Screening for Atrial Fibrillation in General Practice; And the award goes to….WARFARIN; Remember to check the dose of digoxin.

 Management of Obesity & Metabolic Syndrome (Management_of_Obesity__Metabolic_Syndrome.pdf | 131 KB)

Contents: Obesity is a major preventable cause of morbidity and mortality worldwide; lifestyle intervention is the cornerstone of management. Drug treatment should be considered where lifestyle intervention has failed and for those with BMI >30kg/m2 or >27kg/m2 with a co-morbidity. Drug treatment may be of limited efficacy (2-5 kg loss) and may have adverse effects in individual patients. Metabolic syndrome may also require therapy to reduce cardiovascular risk.

 August 2007, Volume 8, Issue 8 (TT-08-07.pdf | 110 KB)

Contents: How to manage smoking cessation; Update on Venous Thromboembolism and Travel; Safety update on rimonabant; Antibiotic prescribing and resistance in primary care; Patient expectation for physicians’ behaviour during the greeting stage of medical visits.

 UPDATE ON TYPE 2 DIABETES MELLITUS (DM) (update_on_type_2_diabetes_mellitus.pdf | 75 KB)

Contents: Type 2 DM is triggered by age, obesity and lack of exercise in genetically predisposed persons; Hyperglycaemia should be managed by lifestyle interventions and step-by-step pharmacotherapy; Metformin remains the most effective monotherapy, especially in obese patients; DM-related vascular complications should be proactively managed from diagnosis.

 July 2007, Volume 8, Issue 7 (T_T_July_07.pdf | 126 KB)

Contents: Study on the effect of dietary sodium intake on longterm morbidity and mortality; Statins are safe in clinical practice; Update on Herpes Zoster; Use of triamcinolone depot injection (Kenalog®).

 June 2007, Volume 8, Issue 6 (T_T_June_07.pdf | 95 KB)

Contents: Aspirin Dose: low dose is best for cardioprotection; But aspirin may not protect against cognitive decline!; Rosiglitazone and Cardiovascular Risk; How to manage Age-related Macular Degeneration.

 May 2007, Volume 8, Issue 5 (TT-05-07.pdf | 118 KB)

Contents: Have COURAGE - optimal medical therapy as good as PCI in Stable CAD!; Long-term full strength aspirin may reduce cancer incidence; Runny Nose Blues!; Pre-pubertal gynaecomastia.

 April 2007, Volume 8, Issue 4 (TT-04-07.pdf | 151 KB)

Contents: Reducing the risk of ovarian cancer; Pain relief for childhood strains and sprains; Mind your head!; Update on (non alcoholic) fatty liver!

 March 2007, Volume 8, Issue 3 (TT-03-07.pdf | 133 KB)

Contents: Polycystic ovarian syndrome; Drug-related hospital admissions; Update on febrile seizures; European Medicines Database now available.

 February 2007, Volume 8, Issue 2 (TT-02-07.pdf | 102 KB)

Contents: Valvular heart disease and anti-Parkinson's disease drugs; Do SSRIs increase the risk of fracture?; How to manage trigeminal neuralgia; Update on Ankylosing Spondylitis.

 Frequently Asked Questions on the Use of Medicines During Pregnancy (Medicines_in_Pregnancy.pdf | 92 KB)

Few medicines are specifically licensed for use during pregnancy; Up to 80% of pregnant women use at least one medicine, many before pregnancy is confirmed; Although only a small number of congenital malformations are caused by medicines, it is not possible to designate medicines as totally safe; The possibility of pregnancy should be borne in mind when prescribing for women of reproductive age.

 January 2007, Volume 8, Issue 1 (TT-01-07.pdf | 138 KB)

Contents: Urinary Incontinence; Stay off the juice when taking warfarin!; For how long are bisphosphonates needed?; Update on Rheumatic Fever.

 December 2006, Volume 7, Issue 12 (TT-12-06.pdf | 116 KB)

Contents: You can ditch the necktie; But always wear a smile!; Keep on taking the tablets; New Year Workout; You can't turn back the clock!

 Update on Lipid-Lowering Therapies (Update_on_Lipid-Lowering_Therapies.pdf | 127 KB)

Contents: Hypercholesterolaemia is a major risk factor for the development of cardiovascular disease (CVD); Statins are the drug of choice in the secondary prevention of CVD, irrespective of an individual's cholesterol level.

 November 2006, Volume 7, Issue 11 (TT-11-06.pdf | 125 KB)

Contents: Ulcerative colitis: a brief overview; Help is at HAND for healthcare-associated infection; Inhaled corticosteroids may protect against COPD mortality; Update on NSAIDs; Bleeding risk with dual antithrombotic therapy.

 October 2006, Volume 7, Issue 10 (TT-10-06.pdf | 127 KB)

Contents: Ireland's National Porphyrin Specialist Centre; "Tis the season for influenza"; Flying Diabetics; No more "Grumpy Old Men"?

 September 2006, Volume 7, Issue 9 (TT-09-06.pdf | 115 KB)

Contents: Bell's palsy; Poor memory?; Are there alternatives to HRT for menopausal symptoms?; How to manage cough in adults

 The Contemporary Management of Atrial Fibrillation (Atrial_Fibrillation.pdf | 58 KB)

Contents: Atrial fibrillation is the commonest sustained cardiac arrhythmia. Untreated atrial fibrillation is a significant risk factor for stroke and other morbidities. Treatment involves rhythm and/or rate control and prevention of thromboembolism. Choice of either warfarin or aspirin should be based on the individual's stroke risk stratification and risk of bleeding.

 Congestive Heart Failure (Congestive_Heart_Failure[1].pdf | 87 KB)

Contents: Congestive heart failure is a complex clinical syndrome affecting 6-10% of people aged >65 years; Early diagnosis and treatment reduces mortality and morbidity; Standard treatment involves use of a diuretic, ACE inhibitor and ß-blocker; Treatment of concomitant / underlying diseases improves outcome.

 August 2006, Volume 7, Issue 8 (TT-08-06.pdf | 133 KB)

Contents: Depression after acute myocardial infarction; Statins are (cost) effective in preventing coronary heart disease; Asthma; Hypertension guidance update; Warning of potential liver injury with Black Cohosh.

 July 2006, Volume 7, Issue 7 (TT-07-06.pdf | 103 KB)

Contents: New safety data on use of drugs during pregnancy; Statins useful in preventing breast cancer? Corticosteroids and atrial fibrillation; Corticosteroids and atrial fibrillation; Don't panic!

 Management of Pain in Cancer (Pain (3).pdf | 83 KB)

Contents: While pain is a common symptom, occurring in up to 70% of patients with cancer, with a systematic approach up to 9 out of 10 patients will get satisfactory relief.

 June 2006, Volume 7, Issue 6 (TT-06-06.pdf | 141 KB)

Contents: Update on Dysmenorrhoea; Calcium supplementation may work - when it is taken!; Getting to the root of drug side-effects; Joys of "going foreign"!; Best information and best treatment for all.

 May 2006, Volume 7, Issue 5 (TT-05-06.pdf | 117 KB)

Contents: Delirium in older people; Reassuring news about suicide risk with antidepressant treatment; Medication safety in Ireland; Pills to make you fat?

 April 2006, Volume 7, Issue 4 (TT-04-06.pdf | 115 KB)

Contents: Dual anti-platelet therapy may not be that charismatic; Benzodiazepines are still prescribed on a chronic basis; NMIC - if you need us, phone, fax or e-mail!

 March 2006, Volume 7, Issue 3 (TT-03-06.pdf | 148 KB)

Contents: Hepatitis C for the Primary Care Physician; Update on Avian Influenza; Reassuring news about congenital malformations with antiepileptic drugs; Drugs may cause cognitive deficits or counteract Alzheimer treatment benefits; Safety reminder with oral methotrexate.

 Current Management of Acute Coronary Syndrome (Current Management of ACS.pdf | 127 KB)

Contents: Although the mortality rates from coronary heart disease (CHD) have fallen in Ireland in recent years they are still among the highest in Europe. Continued improvement in the mortality rate can be achieved by earlier access to treatment for patients with acute coronary syndrome (ACS) and by primary and secondary prevention to improve risk factors.

 February 2006, Volume 7, Issue 2 (TT-02-06.pdf.pdf | 176 KB)

Contents: Data on benefits of oral protein/energy supplementation for all older people still lacking!; Clostridium difficile and gastric acid-suppressive agents - is there a link?; DIY monitoring of oral anticoagulation!; Now eating your greens prevents stroke!; Thiazides and electrolyte abnormalities.

 January 2006, Volume 7, Issue 1 (TT-01-06.pdf | 170 KB)

Contents: How to maintain a CHARMED life; Stay off the (grapefruit) juice!; Is hypnotic use beneficial for the elderly?; How should low HDL Cholesterol levels be treated?; Malaria Alert!

 December 2005, Volume 6, Issue 12 (TT-12-05.pdf | 162 KB)

Contents: Unhealthy alcohol use; Downsizing needs multimodal management; Chocolate may be good for you!; But chocolate is bad for our four-legged friends!; Illicit drug use (doping) in sport.

 November 2005, Volume 6, Issue 11 (TT-11-05.pdf | 122 KB)

Contents: Avian Influenza; Long acting reversible contraception and bone mineral density; Amlodipine + perindopril a good bet for hypertension?

 Management of Attention-Deficit Hyperactivity Disorder (ADHD) (Management of ADHD NMIC.pdf | 190 KB)

ADHD is a disorder of inattention, impulsivity and hyperactivity. Diagnosis is based on clinical evaluation using internationally validated systems. Early diagnosis and appropriate management are important to reduce adverse consequences for the ADHD patient and his/her family. Methylphenidate should only be prescribed as part of a comprehensive treatment programme and its continued use re-evaluated at regular intervals.

 Update on Hormonal Contraception (Update on Hormonal Contraception.pdf | 98 KB)

Hormonal methods of contraception are used by 32% of women in Ireland aged 15-44 years. Available methods of contraception have a low risk of failure if they are used correctly and consistently. Hormonal methods are available by a variety of routes and have both short and long term duration of action. Sufficient options are available to individualise contraceptive choices for women with concurrent medical conditions.