Purple Pen Podcast

  This episode we celebrate the release of the new Therapeutic Guidelines - Antibiotic! Jane and Kristin are joined by Senior Editor Jess Gibney and Dr Emily Tucker, ID Physician from Flinders Medical Centre to discuss what’s new and what’s changed. Things we learnt include: How to say Happy Easter in Greek How Therapeutics Guidelines put its expert groups together The process of updating guidelines Why TG is no longer being published in hard copy Changes to surgical prophylaxis recommendations The new inclusion of intravenous Amoxicillin/Clavulanate as a treatment option, and the behind the scenes discussion around the use of this agent, including dosing controversies New advice for Ceftriaxone dosage The choice to expand advice around “watching and waiting” and when NOT to use antibiotics A new approach to the classification of community acquired pneumonia Significant changes to advice around antibiotic allergies (side chains!) Some challenges in updating the paediatric section of the

Kristin and Jane are joined by Professor Jonathan Iredell, ID and Microbiology Consultant at Westmead and Professor of Medicine and Microbiology and Sydney Medical School. We discuss: What is a bacteriophage? How can they help in a battle against antimicrobial resistance? How do we use them? What’s the dose and route of administration? Which infections can they be used for? How can they be regulated? What adverse effects can we expect from phage therapy? Further reading: The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug : A Memoir by Stephanie Strathdee and Thomas Patterson, available at the Book Depository Professor Iredell’s research page at Sydney Uni A review of phage therapy published this year by Patey and colleagues (Full text available)

Jane and Kristin spoke to David Ellis, a senior specialist pharmacist and team leader for non-sterile production at the Women's and Children's hospital in Adelaide. He's also a contributor to the Australian Don't Rush to Crush Handbook. We spoke to David about the newest edition of Don't Rush to Crush. Monographs now contain information on the best way to give a dose that is less than a whole tablet or capsule. David talks us through the development of the new information and common pitfalls in giving a partial oral dose. This episode is brought to you by two upcoming conferences: The Alcohol and Drug Foundation 2019 National Prevention in Practice Conference (Melbourne, June 24th and 25th) https://adf.org.au/conference/ The SHPA 2019 Electronic Medication Management Conference (Sydney, June 22nd and 23rd) https://shpa.eventsair.com/emm-conference/   

Jane and Kristin spoke to Dr Sam Costello, a gastroenterologist from South Australia about Faecal Microbiota Transplants - more loosely known as "poo transplants". It's a fascinating discussion about the practicalities around screening donors, administration of FMT and the emerging evidence for this treatment.

Kristin and Jane caught up with Professor Anne Duggan, a gastroenterologist, and Meredith Page, a pharmacist, who work at the Australian Commission on Safety and Quality in Health Care  We spoke about:   What is healthcare variation and why do we measure it? Is variation necessarily a bad thing? How does Australia compare internationally with what is measured in our Atlas, for example medication us or surgery? How measuring healthcare variation can be used to enact change  Find out more about the Australian Atlas of Healthcare Variation

f you found any of the topics discussed in this episode distressing, you can reach out for confidential advice to Pharmacists Support Service at supportforpharmacists.org.au or on 1300 244 910. Our medical colleagues can visit the Australasian Doctors’ Health Network - adhn.org.au Dan and Jane are joined by Dr Ash Witt, a Physician trainee to discuss the issue of wellbeing in the medical workforce. We discuss: How the current system lets down junior doctors What a typical career path for a junior doctor looks like The brave and moving blog post by Dr Yumiko - “The Ugly Side of Becoming a Surgeon” Rostering, overtime and nightshifts How to choose a coffee! We are indebted to Ash for her bravery in speaking out on these key issues. Follow her on twitter: @dr_ashwitt - please be sure to thank her if you enjoyed the episode.

Kristin and Dan get back to basics in Haematology from Dr Ian Bilmon,  a Haematologist & BMT Physician at Crown Princess Mary Cancer Centre, Westmead and Sydney Adventist Hospital  We talk about: the most common haematological malignancies and how they differ How these conditions present, what initial treatment looks like and how the prognosis differs What's on the horizon for Haematology  

Dan and Kristin spoke to Dr Juanita Westbury, Senior Lecturer with the Wicking Dementia Research & Education Centre at the University of Tasmania about the best practice use of antipsychotics in aged care. We spoke to Juanita about: The roles for pharmacists in aged care facilities Common issues with medicines use in aged care facilities Complexities around the term “chemical restraint” Best practice for the management of behavioural symptoms of dementia

We caught up with Dr Simone Taylor from Austin Health and Amy McRae from Alfred Health about their work. Both Simone and Amy had projects featured in the “Time To Shine” session at last year’s SHPA Medicines Management Conference. Amy’s paper is titled “Collaboration Between Healthcare and Industry to Improve the Safety of Neuromuscular Blocking Agents in Australia”. It describes an initiative to improve the packaging and labelling of these high-risk medicines. Simone’s paper is titled “Emergency Department Screening Tools to Assist Pharmacists Targeting Patients at Risk For Medication Related Problems”. It describes the development of a tool to help pharmacists to identify patients who are at highest risk and would benefit most from pharmacist intervention.

Recorded live at MM2018 in Brisbane, Dan and Kristin sat down with Erica Tong, Deputy Director of Pharmacy and Chief Pharmacy Information Officer for Alfred Health about partnered pharmacist medication charting. We spoke to Erica about her team’s work developing a model for partnered pharmacist medication charting on admission to hospital and the safety outcomes that have been achieved.

Happy holidays! The team is taking an episode off over Christmas, and in honour of Rohan’s Clinical Pharmacy award at 2018, we are re-broadcasting this “classic hit”. We will see you all in the new year with some great new episodes Jane and Dan spoke to Dr Rohan Elliott, senior pharmacist in aged care at Austin Health, adjunct senior lecturer at Monash University, and a research consultant with the Royal District Nursing Service Institute.  We talk to Rohan about: ·      The definition of geriatric medicine, and what it means to be frail ·      How the geriatric medicine approach differs from other specialties ·      Decision making in geriatric medicine

In this very special holiday episode, Dan and Kristin are joined by Dr Lindsey Fitzharris. Lindsey has a PhD in History from Oxford University and authored the wonderful book “The Butchering Art” which details the efforts of Joseph Lister to make surgery safer. We discuss: What surgery was like before anaesthetics and antiseptics How these agents were introduced to Britain Why you didn’t want surgery in a hospital in the 1800s Two key surgeons in Victorian Britain: Liston and Lister Joseph Lister’s relentless drive to introduce antiseptics to surgical practice Lots of gory details about surgery 150 years ago!

Recorded live at MM2018, the 44th SHPA National Conference, Jane, Dan and Kristin caught up with keynote speaker Prof Brian Dolan. Brian is Director of Health Service 360 (UK) and Director of Service Improvement, Canterbury District Health Board, NZ where his role includes whole system culture engagement and change. why boredom could be worse than smoking for our patients the language that we use in healthcare that can be problematic for our patients what is meant by the term “PJ Paralysis” and how this became a movement

This is Part 2 of our episode recorded live at the Antibiotic Allergy in Practice Workshop at Austin Health. We spoke to Prof Elizabeth Phillips, Professor of Medicine at Vanderbilt University (USA); Prof Connie Katelaris, Allergist and Immunologist at the University of Western Sydney and Campbelltown Hospital; and Dr James Yun, Allergist and Immunologist and the University of Sydney. We were really lucky to get to speak to this panel of experts. We asked them about: practical aspects of delabelling antibiotic allergies the emerging role of genetic testing why not all SCARs are created equal emerging treatment options for severe cutaneous adverse reactions (SCARs) the long-term sequelae of a severe adverse reaction

Jane and Dan attended the Antibiotic Allergy in Practice Workshop, held at Austin Health. In this bumper episode we speak with a number of distinguished guests around the management of antibiotic allergy: Dr Ar Kar Aung, ID Physician from The Alfred discusses the classification and detection of antibiotic adverse reactions Dr MIchelle Goh, Dermatologist at Alfred Health, Austin Health and Peter MacCallum regarding characterising allergy phenotypes Dr Natasha Holmes, ID and Antibiotic Allergy Physician, on drug induced acute interstitial nephritis Karen Urbancic, ID Pharmacist at Austin Health and the National Centre for Antimicrobial Stewardship, on the practicalities of desensitisation protocols.

Back by popular demand, Prof Jason Roberts joins Dan to discuss ceftriaxone. They discuss situations where ceftriaxone is useful (spoiler: it's not "being an inpatient") and some pharmacokinetic quirks.

Jane caught up with A/Prof Ernie Butler, neurologist and head of the Monash MS Clinic at the SHPA Vic Branch symposium. We discuss: Why neurology is the most interesting specialty Background to MS - the link to the sun and its symptoms and progression Management of MS with traditional drugs, and how the monoclonal antibodies fit into practice Monitoring for side effects, including screening for JC virus Managing these side effects  

Jane chats with Dr Jenny Stephens, pain specialist and anaesthetist at St Vincent’s Hospital, Sydney. Jane and Jenny discuss: The significance of Australia’s problem with prescription opioids How the risks of post-operative opioids may start before admission The problems, beyond dependance, caused by long term opioid use Risk factors for opioid dependance post-discharge How Australia compares to the rest of the world with regard to problems with prescription opioids The impact of a pharmacy-led intervention at St Vincent’s Sydney Empowering junior doctors to stand up for good opioid prescribing Simple interventions pharmacists can make to help Empowering patients and managing their expectations around analgesia

Jane and Dan caught up with Chris Braithwaite, a pharmacist with the Galambila Aboriginal Health Service in Northern NSW. Chris spoke to us about: his journey to working with indigenous communities what an average day looks like the challenges posed by existing funding models for home medicines reviews cultural competence and institutional racism

Dr Kimberley Haines, Vice Chair of ANZICS Victorian Branch and ICU Physio at Western Health joins Dan and Jane to discuss survival following ICU admissions. Dr Kimberley discusses her journey to research, what happens to patients following ICU discharge and how we can improve the ICU journey for patients, staff and family.