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Background: Patient harm resulting from drug interactions between conventional and traditional or complementary medicines (CM) are avoidable., Objective: To provide a clinical overview of a selection of CM interactions with drugs commonly used in Australian general practice or in the management of COVID-19., Discussion: Many herb constituents are substrates for cytochrome P450 enzymes, and inducers and/or inhibitors of transporters such as P-glycoprotein. Hypericum perforatum (St John's Wort), Hydrastis canadensis (golden seal), Ginkgo biloba (ginkgo) and Allium sativum (garlic) are reported to interact with many drugs. Simultaneous administration of certain anti-viral drugs with zinc compounds and several herbs should also be avoided. Preventing and identifying unwanted CM-drug interactions in primary care requires vigilance, access to CM-drug interaction checkers and excellent communication skills. Potential risks from interactions should be balanced against the potential benefits of continuing the drug and/or CM and involve shared decision making.

Background and Objectives: The increasing incidence of type 2 diabetes (T2D) is a major Australian and worldwide health concern. The aim of this study was to examine trends in T2D pathology testing by Australian doctors, with a focus on screening and early identification., Method: A secondary analysis was conducted of publicly available data for eight pathology tests, accessed from the nationally funded Medicare Benefits Schedule (MBS). Descriptive statistics were used to analyse the annual trends, according to age and sex, for the calendar years 2010-19., Results: Over the 10 years, screening rates for T2D had doubled while glycated haemoglobin (HbA1c) tests for management remained constant. At the end of 2014, the MBS introduced HbA1c screening tests. By 2019, the HbA1c screening rates were three times higher than glucose tolerance tests, which had halved., Discussion: A strong adoption of the national screening guidelines introduced in 2015-16 was identified. Limitations in MBS data categorisation, such as no item number specific to fasting glucose or insulin, prevented detailed analysis of other potentially relevant tests that might be used to screen for prediabetes and diabetes.

Background: Iron deficiency is one of the most common nutritional deficiencies in Australia, and remains one of the most underdiagnosed conditions in general practice. The consequences of this condition can be subtle and the cause is often multifactorial., Objective: The aim of this article is to review the safety of parenteral iron replacement therapy, and specifically intravenous infusion, in the general practice setting. The results of a recent clinical evaluation of 43 consecutive adult patients are reported., Discussion: Intravenous iron polymaltose infusions are commonly used in the hospital setting with low rates of reported adverse reactions (including low rates of anaphylaxis and anaphylactoid reactions). In a primary care setting, patients were given low dose intravenous iron polymaltose as a slow injection diluted with normal saline, following a diagnosis of iron deficiency or iron depletion, with or without anaemia. Injections were given at intervals no more frequently than weekly. Serum ferritin levels were monitored following treatment, and as routine follow up. A total of 89 injections of intravenous iron were used in 43 patients. No serious adverse reactions occurred. The administration of low dose parenteral iron polymaltose in the primary care setting is well tolerated and is potentially a cost effective alternative to specialist care and hospital admissions.