Practice-changing updates in the December 2020 release

Practice-changing updates in the December 2020 release

As well as including a comprehensive update to the Liver Disorders, Pain and Analgesia, Respiratory and Sexual and Reproductive Health guidelines, the December 2020 release of eTG complete also includes the following practice-changing updates to other guidelines. With each release, we are also continuing to implement drug name changes in line with the Therapeutic Goods Administration.

Cardiovascular guidelines

  • Combination therapy with an endothelin receptor antagonist and a phosphodiesterase type 5 (PDE5) inhibitor is now available on the Pharmaceutical Benefits Scheme for pulmonary hypertension.
  • The immediate-release formulation of nifedipine was discontinued in Australia in October 2020. A footnote has been added to drug recommendations for immediate-release nifedipine to explain this.

Diabetes guidelines

  • Dulaglutide is now indicated as an adjunct to standard of care therapy to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors. The drug recommendation for dulaglutide for patients with type 2 diabetes has now been updated.

Oral and Dental guidelines

  • Advice on using paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with cirrhosis has been updated in line with new advice in the Pain and Analgesia guidelines.

Rheumatology guidelines

  • Advice on using paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with cirrhosis has been updated in line with new advice in the Pain and Analgesia guidelines.

Toxicology and Toxinology guidelines

  • Additional information has been added about avoiding adrenaline in most antipsychotic drug poisonings, as it can worsen hypotension.
  • A dose of sodium thiosulphate can be used as part of the management of cyanide poisoning. Sometimes a repeat dose is needed. Based on feedback and current references, the repeat dose has been reduced to half of the first dose (rather than the same as the first dose).