Anticoagulation Risk-Benefit Analysis in Patients with Atrial Fibrillation.

CARDIOLOGY, Pharmacy and Therapeutics

To weigh the risks and benefits of anticoagulation in patients with atrial fibrillation, use two validated tools, the CHA2DS2-VASc score, and the HAS-BLED score. A CHAD2DS2-VASc of ≥ 2 argues for anticoagulation and a HAS-BLED score of ≥ 3 argues against...

FDA warnings for fluoroquinolone antibiotics

FDA Warnings

The FDA says quinolones are associated with disabling and potentially permanent side effects and recommends that providers limit their use in patients with less serious bacterial infections. Limit their use for acute bacterial sinusitis, acute bacterial exacerbation...

Conditions that Require Higher Doses of Thyroid Medication (Levothyroxine)

ENDOCRINOLOGY, Pharmacy and Therapeutics

Will need to increase the dose of levothyroxine if the patient is: Pregnant (about 30% increase by week 8), On estrogen replacement, or On meds that accelerate T4 catabolism  (e.g. phenytoin, phenobarbital), On meds that impair absorption of levothyroxine. Sucralfate,...

Direct Observational Therapy (DOT)

INFECTIOUS DISEASES, Pharmacy and Therapeutics

Benefits of DOT are that it has been shown to: Decrease both the acquisition and transmission of drug-resistant tuberculosis, and Increase treatment success in HIV-positive patients     Further Reading Clin Infect Dis. 2016 Oct 1;63(7):e147-e195. Official...

Sigmoid Dose-Response Curve in Loop Diuretics

NEPHROLOGY, Pharmacy and Therapeutics

Loop diuretics have a sigmoid dose-response curve with a threshold dose and ceiling dose.  Threshold Doses and Ceiling Doses in Loop Diuretics Loop diuretics have a sigmoidal dose-responsive effect. Doses smaller than the threshold dose produce little or no diuretic...

Diuretics and Diuresis

NEPHROLOGY, Pharmacy and Therapeutics

Daily weight is the best way to track successful diuresis. Diuretics inhibit sodium reabsorption in specific parts of the nephron, resulting in increased urinary sodium and water excretion. “Loop diuretics are the most potent diuretics.” Electrolyte &...