prescribing update
let’s kōrero
panadeine®
The language of reform in health and disability services within Aotearoa
The Medicines Classification Committee has changed the classification of medicines containing codeine. As of the 5th November 2020 allcodeine containing medicines will be classified as prescription only medicines.
System Review. To see the full report visit www.systemreview.health.govt.nz
WHAT DOES THIS MEAN?
Iwi ----------- Tribe
Any medication that contains codeine can only be provided through a prescription. Previously Paracetamol and codeine phosphate – also known as Panadeine – could be provided as a pharmacy only medicine as well as a prescription medicine.
Hapū -------- Sub-tribe
WHAT IS PANADEINE® AND WHAT IS IT FOR?
Kaupapa Māori -------- Synonymously linked to mātauranga Māori and
Paracetamol 500mg and codeine phosphate 8 mg. Panadeine® is an analgesic and provides temporary relief from pain.
underpinned by Te Tiriti o Waitangi; self-determination; cultural validity;
CAN MIDWIVES PRESCRIBE PANADEINE® AND WHAT CAN THEY PRESCRICBE INSTEAD? No, when compounded with another medicine (such as Panadol) Codeine is classified as a C6 controlled drug. Codeine on its own is classified as a Class C2 controlled drug. Both fall outside of the permitted controlled drugs which can be prescribed by a midwife. For most women following a normal birth Paracetamol 1 g QID (maximum of 4gm (8 tablets) within 24 hours) is generally sufficient as ananalgesia. For women with perineal trauma, oedema and perineal repair additional analgesia may be required. Diclofenac slow release (75mg BD) or Ibuprofen 400mg TDS can be used for mild to moderate pain and inflammation. Both Diclofenac and Ibuprofen are non-steroidal anti-inflammatory drugs (NSAIDs). These drugs reduce prostaglandin production by inhibiting cyclooxygenase resulting in analgesic, anti-inflammatory and anti-pyretic effects. They should be avoided if a woman has asthma, heart failure or gastro-intestinal ulceration, bleeding or perforation. square
New Zealand. Drawn from the recently-published Health and Disability
Arotakengia -------- Evaluation, development of scientific understandings Hauora Māori -------- Māori health, holistic health and wellbeing
Kaiarataki -------- Steward Kaitiakitanga -------- Guardianship Kaumātua -------- Elderly Māori
culturally preferred teaching; socioeconomic mediation of Māori disadvantage; whānau connections; collective aspirations; and respectful relationships underpinned by equality and reciprocity Kaupapa Māori Services -------- Led, owned and governed by iwi, pan-tribal, or Māori organisations that are specifically designed with Māori in mind Kaupapa Māori health providers -------- Iwi, pan-tribal, or Māori-led organisations Kaupapa Māori methodologies -------- By Māori, for Māori, with Māori developed methodologies Mana motuhake -------- Self-determination, autonomy Mana whenua -------- Customary authority exercised by an iwi or hapū in an identified area Mātauranga Māori ----------- Māori knowledge systems: reflecting indigenous ways of thinking, relating, and discovering; links indigenous peoples with their environments and is often inspired by environmental encounters; and is conveyed within the distinctiveness of indigenous languages and cultural practices Ngā rautaki haumi -------- Investment strategies Pēpi -------- Baby Rangatiratanga -------- Authority, ownership, leadership Rohe -------- Territory or boundaries of iwi (tribes)
fluconazole The Medicines Adverse Reactions Committee has issued an updated advisory notice regarding fluconazole oral antifungal treatment in pregnancy. Fluconazole oral treatment is contraindicated at any dose, throughout pregnancy. Further evidence of the potential for an increased risk of spontaneous abortion (miscarriage) and cardiac septal closure anomalies adds to the existing advice from the Medsafe data sheet and NZ Formulary advice. Midwives are advised to prescribe topical treatments according to NZ Formulary directions and precautions, and seek further advice as needed. square
Rūnanga -------- Iwi authority Tangata whenua -------- In relation to a particular area, means the iwi or hapū, that holds mana whenua over that area Te Ao Māori ----------- Māori world view Tikanga Māori -------- Protocols and customs. Approaches and protocols embedded in Māori customary values and practices Tikanga / ritenga -------- The correct way to do things Whakawhanake ngā kaimahi -------- Developing the workforce Whānau -------- Family, extended family Whānau ora -------- Healthy Families Whānau rangatiratanga -------- Whānau decision-making, participation and voice
ISSUE 97 JUNE 2020 | 29
