SESSION A2. Top Medication Side Effects and Interactions 2014 Genevieve Pagaglilauan, MD, FACP
|
|
- Jeremy Walton
- 6 years ago
- Views:
Transcription
1 37th Annual Advanced Practice in Primary and Acute Care Conference: October 9-11, :55 SESSION A2 Session Description: Top Medication Side Effects and Interactions 2014 Genevieve Pagaglilauan, MD, FACP S E S S I O N A2 This session is a case-based update on important medication interactions and idiosyncratic medication side-effects of commonly used medications in the care of adult primary care patients. Participants will learn a general and customizable approach to assessing for side-effects in the ever expanding array of pharmacological options. Learning Objectives: Following my presentation, participants will be able to: 1. Review common mechanisms for medication interactions. 2. Develop a general and personalized approach to medication interactions. 3. Review important side effects and medication interactions including statins, antibiotics, warfarin, and antidepressants.
2 Objectives Top Medication Side Effects and Interactions 2014 Genevieve Pagalilauan MD FACP UW Department of Medicine Div. General Internal Medicine Common mechanisms for medication interactions General and personalizable approach Important medication interactions and idiosyncratic side effects Participation in cases P450 P450 P450 Enzyme P450 Enzyme Inducer Inhibitor Binding D2 D2 D2 D2 D2 D2 1
3
4 CYP inducers Rifampin Carbamazepine Dilantin Phenobarbitol Thiozolidinediones RULE 1: CHECK MED INTERACTIONS WITH SEIZURE MEDS RULE 2: CHECK MED INTERACTIONS WITH ANTIFUNGALS Rules of Thumb RULE 3: CHECK MED INTERACTIONS WITH HIV MEDS CYP inhibitors Clarithro/Erythromycin Fluconozole/voriconazole/it raconazole/ketoconazole Diltiazem/verapamil Fluoxetine/bupropion/parox etine > duloxetine Gemfibrozil Indinavir/nelfinavir/ritonavi r Amiodarone Substrate Watch out for meds with a narrow therapeutic index Cyclosporine, tacrolimus Theophylline Warfarin Phenytoin Common medications with risk for toxicity or failure Statins (except pravastatin, rosuvastatin, fluvastatin) Macrolides (except azithromycin) TCAs Calcium channel blockers RULE 4 A 65 yo man presents with cough and fever. He has had severe diarrhea for 2 days. He was on a cruise with a friend who was diagnosed with Legionella yesterday. PMH diabetes, hyperlipidemia,hypertension. Meds: Lisinopril, simvastatin, amlodipine, gemfibrozil,metformin. Chest Xray shows patchy bilateral infiltrates. WBC 17,000 Na 125. What is the most appropriate treatment? A)Amoxicillin/clavulanate B)Clarithromycin C)Levofloxacin D)Cefuroxime E)Trimethoprim/sulfa Interactions in This Case Gemfibrozil- simvastatin (rhabdomyolysis) Simvastatin- clarithromycin (rhabdomyolysis) Amlodipine- clarithromycin (hypotension) Safety Labeling for Simvastatin 80 mg >12 mo, no side-effects -> Ok to continue 80 mg, no side-effects + interacting med -> change Contraindicated: Itraconazole, ketoconazole, posaconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, nefazodone, gemfibrozil, cyclosporine, danazol 10 mg: Amiodarone, verapamil, diltiazem 20 mg: Amlodipine, ranolazine 40 mg, inadequate LDL -> switch to more potent med TAKE HOME: Actively review all patients on simvastatin, make adjustments based on risk factors. PMID: Statins Max Dose LDL Metabolism Fluvastatin 80 mg 31% CYP 2C9 Pravastatin80 mg 34% liver, not CYP Lovastatin 80 mg 40% CYP 3A4 prodrug Pitavastatin 4 mg 41% CYP 2C8/9 minor Simvastatin 80 mg 46% CYP 3A4, 2D6 Atorvastatin 80mg 57% CYP 3A4 Rosuvastatin 40 mg 63% CYP 2C9 minimal TAKE HOME: Pravastatin for low potency, low cost. Pitavastatin moderate potency, high cost. Rosuvastatin high potency, high cost. 2
5 Rules of Thumb - Statins CYP inducers Rifampin Carbamazepine Dilantin Phenobarbitol Thiozolidinediones St. John s Wort Warfarin CYP inhibitors Clarithro/Erythromycin/ Telithromycin Fluconozole/voriconazole/itrac onazole/ketoconazole Diltiazem/verapamil Fluoxetine/bupropion/paroxeti ne > duloxetine Gemfibrozil Indinavir/nelfinavir/ritonavir Amiodarone Top Medication Interactions and Side Effects Statin med interactions rhabdomyolysis A 60 yo man with CAD returns for followup. He has stopped his pravastatin because of myalgias. He previously had myalgias with simvasatin and lovastatin. He is wary of trying another statin because of myalgias. He has been taking coenzyme Q10 without benefit. What do you recommend? A) Restart pravastatin and take naproxen daily B) Red yeast rice 1800 mg BID C) Rosuvastatin 10 mg 2X a week D) Ezetimibe 10 mg a day Side Effects of Statins Rhabdomyolysis (rare) 0.01% Hepatotoxicity (rare) Liver failure % Myalgias 5-18 % Cataracts? Approach to Management of Myalgias on Statins Check CK,TSH. Stop statin, when symptoms disappear restart statin at lower dose or change statin Recurrent symptoms Fluvastatin 80mg XL QD or alternate day 2X weekly 10mg atorvastatin Low dose rosuvastatin QD,QOD or weekly If symptoms continue try ezetimibe PMID: Twice Weekly Rosuvastatin for Statin Myalgias Retrospective chart review of previously statin intolerant patients in a lipid lowering clinic 40 patients received rosuvastatin 5mg twice a week (30) or rosuvastatin 10mg twice a week (10) Mean LDL reduction was 43, with 54% reaching NCEP goal 8 patients (20%) discontinued rosuvastatin due to side effects PMID:
6 Myalgias Case 69M with HTN, HLD, discharging from the hospital after a completed NSTEMI. His FBG in hospital was 123. Discharge Meds: Ec ASA 325 mg qday Metoprolol XL 25 mg qday HCTZ 25 mg qday Lisinopril 40 mg qday Atorvastatin 80 mg qday Ranitidine 150 mg BID Which med his risk for DM2? Which med his risk? Diuretics, B blockers, and Statins May Risk for DM PEACE trial 7000 pts, no DM, stable CAD 60% on beta blocker at randomization. Placebo or ACEI (trandolapril) B blocker + placebo DM2, HR 1.63 p=0.001 B blocker + ACEI no DM2, HR 1.11 p=0.39 ACEI risk DM2, HR 0.83 p=.009 NAVIGATOR trial 24K pts, glucose intolerance New onset DM2 Diuretic HR 1.23 Statin HR 1.32 No risk with B blocker or CCB TAKE HOME: B blockers, diuretics and statins may risk for DM. PMID: , PMID: Statins and Diabetes Risk BMJ Nov 2013 New Zealand national cohort 32K y.o. diclofenac v antihtn v statin Rx metformin 5y Statin HR 3.31 HTN HR 2.32, HR 1.59 Multiple MA data: Statins risk for DM 9-13% all statin Rosuvastatin (20mg) 25%, Atorvastatin (80 mg) 15%, Pravastatin (40 mg) 7% JUPITER Rosuvastatin incident DM2 3.0% vs. 2.4% over 2 y, 26% RR WOSCOPS Pravastatin DM2 by 30% (HR) over 5 y. PMID , PMID: Statins and DM Risk Increased risk Higher potency statins Elderly Women (WOSCOPS all male) Possibly type of statin, lipophilic > hydrophilic Obesity, and other DM risk factors Statins and DM2 Take Home Discuss risks vs. benefits 9:1 benefit:risk. 9 CV events prevented per 1 incident DM2, NNT 155 CV events, NNH 498 DM2 Intensive dose statins 3:1 : 3 CV events prevented, 1 incident DM2 Consider implications of new lipid guidelines 12 M more y.o. qualify for statins (48% total) 87% men and 54% women qualify Consider the specific statin Atorvastatin and rosuvastatin greatest risk, simvastatin and pravastatin may have some risk Pitavastatin seems neutral or protective Consider statin dosing doses of atorvastatin conferred risk PMID:
7 Myalgias, Diabetes Case 69M with HTN, HLD, discharging from the hospital after a completed NSTEMI. Requests to speak to you about his DC meds. Discharge Meds: Ec ASA 81 mg qday Metoprolol XL 25 mg qday Lisinopril 40 mg qday Atorvastatin 80 mg qday Ranitidine 150 mg BID He is worried about the risks of memory loss and will not take which medication? Statins and Memory JUPITER 16K, RCT Rosuvastatin (Crestor) v placebo 18 v 4 pts had confusional state 69 v 76 pt nervous disorder 515 v 533 pt psychiatric disorder FDA 2003 retrospective case report 60 reports, 14/25 improved off statins Lypophylic statins reported more (simvastatin, atorvastatin, lovastatin) Observational studies Cochrane No evidence for protection, started late? Ginko trial 2011, 3000 >75 y.o, All cause dementia HR 0.79, Alzheimers HR City trial 2012, 6.8K, no effect Annals Nov 2013 SR No risk AD, dementia, MCI, memory, attention, motor FDA post marketing low report rates, similar to other cardiac meds 2014 review in CNS Meds Insufficient evidence that statins are protective for AD PMID: ) PMID: , 2) PMID: , 3) PMID: ) PMID: Statins and Memory Take Home TAKE HOME POINT: Rare if any risk for statins causing cognition worsening. Unclear if protective. For concerns use pravastatin, or rosuvastatin. Myalgias, diabetes Minor risk for memory loss 5
8 A 60 yo man develops pain in his feet over the past week. He describes the pain as burning, and sharp. No swelling, or redness. PMH: alcoholism (quit drinking 3 years ago), hypertension, CAD, prostatitis, and diabetes. Meds: rosuvastatin, lisinopril, metformin, levofloxacin, amlodipine. Exam- hyperasthesia both feet. What do you recommend? A) Start B12 supplementation B) Stop Rosuvastatin C) Stop Metformin D) Stop Levofloxacin E) Stop Amlodipine Known since 1990 s Onset 1-7 days Symptoms: paresthesias most common initial symptom (81%) Duration: months to years after discontinuation, maybe permanent Fluoroquinolone Side Effects Tendinopathy, Tendon Rupture % Achilles>shoulder, hand risk with prednisone, elderly Black box warning 2008 PMID: Glycemia Hypoglycemia (rare) elderly, CKD, female, liver disease, sulfonylurea, insulin Gatifloxicin OR Hyperglycemia (still uncommon) DM1 DM2, elderly, steroids, illness Gatifloxicin > levofloxacin. No risk with cipro or moxifloxicin Quinolone Side Effects and Interactions Insomnia/confusion Arrhythmia (QTc prolongation) Levoflox = moxiflox Amiodarone, sotalol, methadone, clarithromycin, erythromycin, thiazide diuretics, hypokalemia Retinal detachment? PMID: , PMID: , PMID: , PMID: Quinolone Treatment Failure Common supplements/otcs Calcium Magnesium Iron Antacids Foods Dairy (potential moderate interaction) Clinical pearl: Risk of quinolone treatment failure with antacids, MVI, supplements via chelation, 16-66%. Dose 2h pre or 4-6 h post quinolone. Micromedex accessed 1/3/ Myalgias, diabetes Minor risk for memory loss Fluoroquinolone side effects Peripheral neuropathy, tendon rupture Fluoroquinolone risk for failure with antacids 6
9 35 F presents to urgent care for an anaphylactic reaction. She was treated by her partner with an epinephrine pen. The 3 days prior she was treated for sinusitis by a provider with moxifloxicin, fluticasone nasal spray, and alternating ibuprofen and naproxen. PMH: Asthma, eczema, allergic rhinitis Baseline Meds: Omalizumab (Xolair), TAC cream prn, diphenhydramine prn Which medication was most likely to blame for the anaphylactic reaction? 2014 Top 10 Meds: Anaphylaxis and Severe Hypersensitivity Name Hypersensitvity Anaphylaxis 1. Omalizumab 65 (10.4) 59 (9.4) 2. Moxifloxacin 57 (25.6) 39 (17.5) 3. Infliximab 64 (2.3) 35 (1.2) 4. Gadopentetate dimeglumine 32 (21.1) 29 (19.1) 5. Cetuximab 33 (6.7) 23 (4.7) 6. Glatiramer 26 (3.2) 22 (2.8) 7. Amlodipine 28 (5.4) 20 (3.9) 8. Ibuprofen 34 (4.1) 18 (2.2) 9. Lisinopril 146 (20.9) 17 (2.4) 10. Naproxen 26 (2.7) 17 (1.8) Adapted from ISMP Quarterwatch 3/14: Table 2. Anaphylactic shock and overall severe hypersensitivity most frequently reported drugs Myalgias, diabetes Minor risk for memory loss Fluoroquinolone side effects Peripheral neuropathy, tendon rupture Fluoroquinolone risk for failure with antacids Top meds causing hypersensitivity 66 M with spinal stenosis, binge ETOH use, HTN presents with tremor, nausea, and violent thoughts. He feels angry but not depressed or overtly anxious. His last drink was 1 week ago. Meds: Pregabalin, amlodipine, APAP/hydrocodone PRN, duloxetine (stopped 1 week ago), pantoprazole. What is the likely cause of his symptoms? A) Wernicke's encephalopathy due to ETOH + PPI B) Pregabalin C) Narcotic withdrawal D) Duloxetine withdrawal E) Hyponatremia Duloxetine Withdrawal Common symptoms Dizziness, headache, nausea, paresthesias, Short acting antidepressants Duloxetine, paroxetine Ely-Lilly studies on duloxetine 44-50% experience withdrawal with abrupt DC 10% experienced severe symptoms 54% had withdrawal symptoms persist >2 weeks ISMP Quarterwatch Oct 2012 Management of Duloxetine Withdrawal Taper over 6-8 weeks Taper by 10% per week Taper over 8-30 weeks Communicate clearly with patient about risks for withdrawal and monitor ISMP Quarterwatch Oct
10 2014 Top 10 Meds: Suicidal and Homicidal Ideation Indication Number % 1. Varenicline Smoking cessation Montelukast Asthma Paroxetine Major depression Quetiapine Schizophrenia Venlafaxine Major depression Interferon beta Multiple sclerosis Isotretinoin Resistant acne Duloxetine Major depression Pregabalin Neuropathic pain Bupropion Major Depression SSRI s and Hyponatremia Patient Risk Factors Older age Female Concomitant diuretic use Low body weight Meds Associated with Hyponatremia Hydrochlorathiazide/indapa mide (38%) SSRI s SNRI s NSAIDs Carbemazipine MDMA (ecstasy) * Adapted from ISMP 9/14 Quarterwatch: Table 1. Leading suspect drugs in suicidal/self-injurious and homicidal ideation cases, 2007 to 2013 Q3 PMID: PMID: PMID: PMID: Myalgias, diabetes Minor risk for memory loss Fluoroquinolone side effects Peripheral neuropathy, tendon rupture Fluoroquinolone risk for failure with antacids Top meds causing hypersensitivity Duloxetine withdrawal Top meds causing suicidal ideation A 72 y.o. male S/P AVR replacement two years ago for aortic stenosis presents with wide spread bruising on his back/legs and some bruising on the back of both hands. His last INR was three weeks ago and was 3.0. He states he saw an M.D. six days ago for a cough and was put on a medication described as a white tablet. Baseline meds: Coumadin 5 mg qd, Albuterol inhaler 2 puffs 4 times a day and Nortryptiline 25 mg qhs. What medication was he placed on? a) Amoxicillin b) Codeine c) Cefixime d) Azithromycin e) TMP/Sulfa Warfarin A Interactions Antifungals Anti-arrhythmics Amiodarone, propafenone Antibiotics Bactrim, metronidazole, erythromycin > clarithromycin, azithromycin, fluoroquinolones OK to use - cephalosporins, nitrofurantoin, PCNs Antacid PPIs (omeprazole) 8
11 A 39 y.o. woman with a prosthetic aortic valve presents with bruising. Her last INR 6 weeks ago was 2.4, today s INR is 6.5. She has not taken any extra Coumadin. Which of the following when taken on a daily basis could explain her increased INR? a) Acetaminophen b) Calcium carbonate c) OCP d) Ranitidine e) DOSS Warfarin and Acetaminophen 4 studies acetaminophen + warfarin INR > 9100 mg/week led to 10 x risk of having INR > 6* In double blind crossover trial patients on Warfarin + 4 g/d of Acetaminophen had PT 1.75 x control Patients received 2 g or 4 g acetaminophen or placebo with warfarin, 54% of those receiving acetaminophen overshot INR goal vs 17% of placebo. The mean maximal INR increase was 0.70 ± 0.49 and 0.67 ± 0.62 in patients receiving acetaminophen at 2 g/day and 3 g/day PMID: , PMCID: PMC , PMID: , PMID: Warfarin A Interactions Antifungals Anti-arrhythmics Amiodarone, propafenone Antibiotics Bactrim, metronidazole, erythromycin > clarithromycin, azithromycin, fluoroquinolones OK to use - cephalosporins, nitrofurantoin, PCNs Antacid PPIs (omeprazole) Acetaminophen Myalgias, diabetes Minor risk for memory loss Fluoroquinolone side effects Peripheral neuropathy, tendon rupture Fluoroquinolone risk for failure with antacids Top meds causing hypersensitivity Duloxetine withdrawal Top meds causing suicidal ideation Warfarin Interactions: A A 62 yo man with a hx of MI 4 years ago presents with right hip pain. He has had discomfort with walking for the past 6 months. Xray reveals moderate osteoarthritis. Most recent labs: Bun 6 Cr.8 Glu 100 What would be the most appropriate management plan? A) Acetaminophen B) Oxycodone C) Ibuprofen D) Diclofenac E) Celecoxib Risk of MI with NSAID Use Nationwide cohort study in Denmark. 99,187 patients with a mean age of 69 Studied pharmacy records and medical records for all patients over age 30 with a first time admission for MI Subsequent NSAID use was tracked Death with NSAID use HR 1.59 at 1year, 1.63 at 5 years Recurrent MI HR 1.3 at 1 year, 1.41 at 5 years. Even short-term treatment with most NSAIDs was associated with risk of death and recurrent MI in patients with prior MI. PMID: , PMID:
12 Risks of NSAIDS and Coxibs Lancet 2013 Large meta-analysis of 639 RCT. >225,000 participants looking at NSAID/Coxib risk Coxibs and diclofenac were associated with RR of major vascular events Ibuprofen risk of MI All NSAIDS and Coxibs risk for CHF hospitalizations All GI bleeding risk lowest coxibs RR 1.8 highest naproxen RR 4.33 Myalgias, diabetes Minor risk for memory loss Fluoroquinolone side effects Peripheral neuropathy, tendon rupture Fluoroquinolone risk for failure with antacids Top meds causing hypersensitivity Duloxetine withdrawal Top meds causing suicidal ideation Warfarin Interactions: A NSAIDS risk for cardiovascular and GI risks PMID: Resources Institute for Safe Medication Practices ismp.org Prescriber s Letter or Medical Letter Epocrates or Micromedex Check for interactions online or handheld Cochrane Review CAM Natural Standard Natural Medicines About Herbs (handheld) 10
POTENTIAL HARMS OF ANTIBIOTIC USE. A Ben Appenheimer MD Infectious Diseases University of Iowa Hospitals and Clinics
POTENTIAL HARMS OF ANTIBIOTIC USE A Ben Appenheimer MD Infectious Diseases University of Iowa Hospitals and Clinics alpheus-appenheimer@uiowa.edu CONFLICTS OF INTEREST No disclosures GOALS AND OBJECTIVES
More informationECHO: Management of URIs. Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018
ECHO: Management of URIs Charles Krasner, M.D. Sierra NV Veterans Affairs Hospital University of NV, Reno School of Medicine October 16, 2018 Infectious causes of URIs change over time Most ARIs are viral
More informationOFLOXACIN TABLETS MEDICATION GUIDE
OFLOXACIN TABLETS MEDICATION GUIDE Read the Medication Guide that comes with ofloxacin before you start taking it and each time you get a refill. There may be new information. This Medication Guide does
More informationVI.B.2 Elements for a public summary. VI.B.2.1 Overview of disease epidemiology
VI.B.2 Elements for a public summary VI.B.2.1 Overview of disease epidemiology [Moxifloxacin] 400mg/250ml solution for infusion Moxifloxacin is a fluoroquinolone antibiotic with a broad spectrum of activity
More informationMEDICATION GUIDE FLOXIN [Flox in] (ofloxacin)
MEDICATION GUIDE FLOXIN [Flox in] (ofloxacin) Read the Medication Guide that comes with FLOXIN before you start taking it and each time you get a refill. There may be new information. This Medication Guide
More informationAZITHROMYCIN, DOXYCYCLINE, AND FLUOROQUINOLONES
AZITHROMYCIN, DOXYCYCLINE, AND FLUOROQUINOLONES Update in Medicine and Primary Care Whitney R. Buckel, PharmD, BCPS-AQ ID System Antimicrobial Stewardship Pharmacist Manager OBJECTIVES 1. List three antibiotics
More informationREAD THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICATION PATIENT MEDICATION INFORMATION. Moxifloxacin tablets (as moxifloxacin hydrochloride)
READ THIS FOR SAFE AND EFFECTIVE USE OF YOUR MEDICATION PATIENT MEDICATION INFORMATION Pr Sandoz Moxifloxacin Moxifloxacin tablets (as moxifloxacin hydrochloride) Read this carefully before you start taking
More informationFDA-Approved Medication Guide MEDICATION GUIDE Moxifloxacin Hydrochloride Tablets (mox'' i flox' a sin hye'' droe klor' ide) Rx only
FDA-Approved Medication Guide MEDICATION GUIDE Moxifloxacin Hydrochloride Tablets (mox'' i flox' a sin hye'' droe klor' ide) Rx only Read the Medication Guide that comes with moxifloxacin hydrochloride
More informationUpdate on Fluoroquinolones. Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO
Update on Fluoroquinolones Charles Krasner, M.D. June 16, 2016 Antibiotic Stewardship Program -ECHO Potential fluoroquinolone side-effects Increased risk, greater than with most other antibiotics, for
More informationPATIENT INFORMATION LEAFLET
PATIENT INFORMATION LEAFLET AMLOTAN 5mg TABLETS AMLOTAN 10mg TABLETS Amlodipine (as mesilate monohydrate) Read all of this leaflet carefully before you start taking this medicine. - Keep this leaflet.
More informationThe Perils of Mixing Warfarin & Antibiotics: A Potentially Deadly Combination
The Perils of Mixing Warfarin & Antibiotics: A Potentially Deadly Combination Lynn McNicoll, MD, FRCPC, AGSF Associate Professor of Medicine, Department of Medicine Warren Alpert Medical School of Brown
More informationANNEX III AMENDMENTS TO THE SUMMARY OF PRODUCT CHARACTERISTICS AND PACKAGE LEAFLET
ANNEX III AMENDMENTS TO THE SUMMARY OF PRODUCT CHARACTERISTICS AND PACKAGE LEAFLET 1 AMENDMENTS TO BE INCLUDED IN THE RELEVANT SECTIONS OF THE SUMMARY OF PRODUCT CHARACTERISTICS FOR MOXIFLOXACIN CONTAINING
More information3/23/2017. Kathryn G. Smith, PharmD PGY1 Pharmacy Resident Via Christi Hospitals Wichita, Inc. Kathryn G. Smith: Nothing to disclose
Kathryn G. Smith, PharmD PGY1 Pharmacy Resident Via Christi Hospitals Wichita, Inc Kathryn G. Smith: Nothing to disclose Describe the new updates and rationale for them Relay safety concerns with use of
More informationAMLODIPINE 5 MG TABLETS AMLODIPINE 10 MG TABLETS Amlodipine
Package Leaflet: Information For The User AMLODIPINE 5 MG TABLETS AMLODIPINE 10 MG TABLETS Amlodipine Read all of this leaflet carefully before you start taking this medicine because it contains important
More informationJMSCR Vol 05 Issue 03 Page March 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i3.219 Comparative Study of Adverse Effect of
More informationHigh Risk Emergency Medicine. Antibiotic Pitfalls
High Risk Emergency Medicine Antibiotic Pitfalls David, MD MS Assistant Professor Department of Emergency Medicine University of California, San Francisco I. Antibiotic Resistance Development of resistance
More informationPrescription Medications Alphabetical Listing
Prescription Medications Alphabetical Listing INTRODUCTION The Prescription Savings Club provides its members with significant savings on prescription medications. The medications listed are available
More informationElements for a Public Summary
VI.2 Elements for a Public Summary VI.2.1 Overview of disease epidemiology 400 mg film-coated tablets is a fluoroquinolone antibiotic with a broad spectrum of activity and bactericidal action. In the European
More informationPACKAGE LEAFLET: INFORMATION FOR THE USER. Amlodipine 5 mg Tablets Amlodipine 10 mg Tablets (Amlodipine Besilate)
PACKAGE LEAFLET: INFORMATION FOR THE USER Amlodipine 5 mg Tablets Amlodipine 10 mg Tablets (Amlodipine Besilate) Read all of this leaflet carefully before you start taking this medicine. - Keep this leaflet.
More informationTB Grand Rounds. MDR-TB: Management of Adverse Drug Reactions. Reynard J. McDonald, M.D. September 18, Patient History
TB Grand Rounds MDR-TB: Management of Adverse Drug Reactions Reynard J. McDonald, M.D. September 18, 2007 Patient History This 30 y/o H/M was born in Ecuador and immigrated to the US in 2001 On 11-22-05
More informationPACKAGE LEAFLET: INFORMATION FOR THE USER. Amlodipine 10 mg Tablets. (Amlodipine Besilate)
PACKAGE LEAFLET: INFORMATION FOR THE USER Amlodipine 5 mg Tablets Amlodipine 10 mg Tablets (Amlodipine Besilate) Read all of this leaflet carefully before you start taking this medicine because it contains
More informationAmlodipin Bluefish 10 mg tablets. amlodipine
Package leaflet: Information for the user Amlodipin Bluefish 5 mg tablets Amlodipin Bluefish 10 mg tablets amlodipine Read all of this leaflet carefully before you start taking this medicine because it
More informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationOral antibiotics are not always straight forward
Oral antibiotics are not always straight forward OPAT Regional Workshop 1 st May 2018 Fiona Robb, Antimicrobial Pharmacist NHS Greater Glasgow & Clyde Introduction Describe NHS GGC s Oral vs IV Antibiotics
More informationPackage leaflet: Information for the user. Amlodipin Accord 10 mg tablets. Amlodipine
Package leaflet: Information for the user Amlodipin Accord 5 mg tablets Amlodipin Accord 10 mg tablets Amlodipine Read all of this leaflet carefully before you start taking this medicine because it contains
More informationPackage leaflet: Information for the user. Amlodipin Aurobindo 10 mg tablets. Amlodipine
Package leaflet: Information for the user Amlodipin Aurobindo 5 mg tablets Amlodipin Aurobindo 10 mg tablets Amlodipine Read all of this leaflet carefully before you start taking this medicine because
More informationAntimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018
Antimicrobial Update Alison MacDonald Area Antimicrobial Pharmacist NHS Highland alisonc.macdonald@nhs.net April 2018 Starter Questions Setting the scene... What if antibiotics were no longer effective?
More informationAntibiotics & Common Infections: Stewardship, Effectiveness, Safety & Clinical Pearls. Welcome We will begin shortly.
Antibiotics & Common Infections: Stewardship, Effectiveness, Safety & Clinical Pearls Welcome We will begin shortly. The Canadian Pharmacists Association is pleased to be collaborating with the following
More informationMoxifloxacin APOTEX Contains the active ingredient moxifloxacin (as hydrochloride monohydrate)
Contains the active ingredient moxifloxacin (as hydrochloride monohydrate) Consumer Medicine Information For a copy of a large print leaflet, Ph: 1800 195 055 What is in this leaflet Read this leaflet
More informationNL/H/880/01-02 FINAL SMPC
SUMMARY OF THE PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Amlodipine ratiopharm tablets 5 mg, tablets Amlodipine ratiopharm tablets 10 mg, tablets 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
More informationChapter 9: Antiinfective Medications Edmunds: Introduction to Clinical Pharmacology, 8th Edition
Instant download and all chapters Test Bank Introduction to Clinical Pharmacology 8th Edition Marilyn Winterton Edmunds https://testbankdata.com/download/test-bank-introduction-to-clinical-pharmacology-8thedition-marilyn-winterton-edmunds/
More informationAntibiotic Updates: Part I
Antibiotic Updates: Part I Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures
More informationMeloxicam vs etodolac cox 2 inhibition
Meloxicam vs etodolac cox 2 inhibition The Borg System is 100 % Meloxicam vs etodolac cox 2 inhibition of GI. Aspirin inhibits plt aggregration via inhibition of platelet COX. Meloxicam least. Etodolac
More informationReminder to Pharmacists. Issuance of Bulletin #58
Corporate and Provincial Program Support 300 Carlton, Winnipeg MB R3B 3M9 www.manitoba.ca/health Reminder to Pharmacists Issuance of Bulletin #58 Bulletin #58, effective April 29, 2008, completes the initial
More informationQUALITY HEALTH CARE YOUR PREFERRED PARTNER IN. For better health
YOUR PREFERRED PARTNER IN QUALITY HEALTH CARE For better health Manufacturer of Pharmaceutical Products Eka Pharma 308, Samanvay Zillion, Gotri - Sevasi Road, Opp. Shaishav School, Vadodara-391 101, (Guj.)
More informationBlooms The Chemist Amlodipine / Atorvastatin
Blooms The Chemist Amlodipine / Atorvastatin 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40 & 10/80 TABLETS Contains the active ingredients amlodipine (as besylate) and atorvastatin (as calcium propylene
More informationCommunity Acquired Pneumonia: An Update on Guidelines
Community Acquired Pneumonia: An Update on Guidelines Claudia Summa, BScPhm Pharmacy Resident September 12, 2006 Objectives To give a brief description of the pathophysiology of community acquired pneumonia
More informationKeep this leaflet with your medicine. You may want to read it again. What this medicine is used for
Blooms The Chemist Amlodipine/Atorvastatin 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40 & 10/80 TABLETS Contains the active ingredients amlodipine (as besylate) and atorvastatin (as calcium propylene glycol
More information10/13/14. Low: not well absorbed. Good: [blood and tissue] < than if given IV. High: > 90% absorption orally
Low: not well absorbed PO agent not for serious infection nitrofurantoin Good: [blood and tissue] < than if given IV [Therapeutic] in excess of [effective] eg. cephalexin High: > 90% absorption orally
More informationNICE consultation on key therapeutic topics: June Comments and responses: September Key Therapeutic Topic
NICE consultation on key therapeutic topics: June 2014 Comments and responses: September 2014 Key Therapeutic Topic Laxatives NHS Southern Derbyshire CCG What is the purpose or benefit of this topic? Laxatives
More informationPACKAGE LEAFLET: Information for the user. amlodipino cinfa 5 mg tablets
PACKAGE LEAFLET: Information for the user amlodipino cinfa 5 mg tablets Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. Keep
More informationNL/H/880/01-02 FINAL PL
PACKAGE LEAFLET: INFORMATION FOR THE USER Amlodipine Amlodipine Read all of this leaflet carefully before you start taking this medicine. - Keep this leaflet. You may need to read it again. - If you have
More informationDrug monograph of CADUET
Drug monograph of CADUET Generic name: Amlodipine and Atorvastatin Brand name: Caduet Manufacturer: Pfizer Classification: Prescription only medicine Strength (amlodipine mg/ atorvastatin mg): 2.5/10,
More informationYOUR COMPLETE SOURCE FOR MEDICAL MISSIONS SUPPLIES.
YOUR COMPLETE SOURCE FOR MEDICAL MISSIONS SUPPLIES. When disasters strike, Blessings International provides pharmaceuticals and medical supplies quickly, so you can bring healing to the hurting. Where
More informationDisclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials
Disclosures Principles of Antimicrobial Therapy None Lori A. Cox MSN, ACNP-BC, ACNPC, FCCM Penn State Hershey Medical Center Neuroscience Critical Care Unit Obtaining an Accurate Diagnosis Determine site
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationTreatment of Helicobacter pylori infection in adults
APPROPRIATENESS OF CARE Treatment of Helicobacter pylori infection in adults May 2017 Helicobacter pylori (H. pylori) infection plays a major role in the development of gastroduodenal ulcer and gastric
More informationHost, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus
Host, Syndrome, Bug, Drug: Introducing 2 Frameworks to Approach Infectious Diseases Cases with an Antimicrobial Stewardship Focus Montana ACP Meeting 2018 September 8, 2018 Staci Lee, MD, MEHP Billings
More informationYOUR COMPLETE SOURCE FOR MEDICAL MISSIONS SUPPLIES.
YOUR COMPLETE SOURCE FOR MEDICAL MISSIONS SUPPLIES. When disasters strike, Blessings International provides pharmaceuticals and medical supplies quickly, so you can bring healing to the hurting. Where
More informationHOW TO INTERPRET CULTURE RESULTS. Karen Brust, MD November 29, 2012
HOW TO INTERPRET CULTURE RESULTS Karen Brust, MD November 29, 2012 DISCLOSURES NONE CULTURE RESULTS Based on susceptibility patterns CLSI: international, interdisciplinary, Nonprofit,
More information1. A patient with an allergy to sulfa (sulfonamides) should not take A) Augmentin. B) tetracycline. C) minocycline D) Bactrim DS.
Name: Date: 1. A patient with an allergy to sulfa (sulfonamides) should not take A) Augmentin. B) tetracycline. C) minocycline D) Bactrim DS. 2. An example of a drug that should not be used in children
More informationOutpatient Antimicrobial Therapy. Role of Antibacterials in Outpatient Treatment of Respiratory Tract Infection. Acute Bacterial Rhinosinusitis
Outpatient Antimicrobial Therapy B. Joseph Guglielmo, Pharm.D. Professor and Chair Department of Clinical Pharmacy University of California San Francisco Role of Antibacterials in Outpatient Treatment
More informationAntibiotics 101: Outpatient URIs
Antibiotics 101: Outpatient URIs B. Joseph Guglielmo, Pharm.D. Professor and Dean School of Pharmacy University of California San Francisco Disclosures No disclosures regarding conflict of interest Acute
More informationDuke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients
Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients PURPOSE Fever among neutropenic patients is common and a significant cause of morbidity
More informationPharmacokinetics. Absorption of doxycycline is not significantly affected by milk or food, but coadministration of antacids or mineral supplements
Pharmacokinetics. Absorption of doxycycline is not significantly affected by milk or food, but coadministration of antacids or mineral supplements should be avoided. PDR Drug Summaries are concise point-of-care
More informationNurse Prescribing: Key Principles and Developments. Elissa Ladd, PhD, FNP-BC MGH Institute of Health Professions Boston, Massachusetts USA
Nurse Prescribing: Key Principles and Developments Elissa Ladd, PhD, FNP-BC MGH Institute of Health Professions Boston, Massachusetts USA No disclosures to report Objectives: 1) To provide an overview
More informationN.C. A and T List of Approved Analgesics 1 of 5
1 of 5 Note to user: This list of commonly used analgesics and sedatives is not all-inclusive. The absence of an agent does not necessarily mean it is unacceptable. For any questions, call the Clinical
More informationContent. In the beginning Antimicrobial Stewardship 2. Antimicrobial Prescribing with cases to cover
Content Safe & Effective Prescribing of Antimicrobials: Whistle-stop update for non-medical prescribers Elaine Roberts Lead Pharmacist, Antimicrobials BCUHB East 1. Antimicrobial Stewardship 2. Antimicrobial
More informationTreatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani
Treatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani 30-1-2018 1 Objectives of the lecture At the end of lecture, the students should be able to understand the following:
More informationCLINICAL PROTOCOL FOR COMMUNITY ACQUIRED PNEUMONIA. SCOPE: Western Australia. CORB score equal or above 1. All criteria must be met:
CLINICAL PROTOCOL F COMMUNITY ACQUIRED PNEUMONIA SCOPE: Western Australia All criteria must be met: Inclusion Criteria Exclusion Criteria CB score equal or above 1. Mild/moderate pneumonia confirmed by
More informationLifting the lid off CAP guidelines
Lifting the lid off CAP guidelines Dr. Andrew M. Morris September 5, 2007 12:00-13:00 web.mac.com/idologist Objectives 1. To review the epidemiology of community-acquired pneumonia (CAP) 2. To explore
More informationISMP Canada HYDROmorphone Knowledge Assessment Survey
ISMP Canada HYDROmorphone Knowledge Assessment Survey Knowledge Assessment Questions 1. In an equipotent dose, HYDROmorphone is more potent than morphine. True False Unsure 2. HYDROmorphone can be given
More informationCLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES
CLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu THE AMINOGLYCOSIDES: 1944-1975 Drug
More informationCOMMUNITY MEDICINE PHARMACY
COMMUNITY MEDICINE PHARMACY SELECTED GENERIC PLAN AVAILABLE IN 30, 60, AND 90 DAY SUPPLIES 1 P age *ALLERGIES & COLD & FLU $3.99,30 DAY $7.98,60 DAY $9.99 90 DAY BENZONATATE 100 MG CAPS 15 30 45 CETIRIZINE
More informationmelatonin amlodipine generic for amlodipine benazepril amlodipine angioedema amlodipine feline amlodipine 5 mg description
Follow all directions on your computer even when amlodipine for sale you buy Ambien. Call your doctor or dial 911 immediately. Ativan can cause tolerance, physical dependence, addiction and withdrawal
More information1.1. ACE-inhibitors and flushing
1.1. ACE-inhibitors and Introduction Angiotensin-converting enzyme (ACE) inhibitors are widely used for the treatment of and heart failure. The following ACE-inhibitors are registered in the Netherlands:
More informationPATIENT INFORMATION LEAFLET ACCEL-AMLODIPINE. Amlodipine Tablets 5 mg and 10 mg amlodipine (as amlodipine besylate) Antihypertensive-Antianginal Agent
PATIENT INFORMATION LEAFLET Pr ACCEL-AMLODIPINE Amlodipine Tablets 5 mg and 10 mg amlodipine (as amlodipine besylate) Antihypertensive-Antianginal Agent ACTION AND CLINICAL PHARMACOLOGY ACCEL-AMLODIPINE
More informationJASPER DRUGS AT FOOTHILLS
JASPER DRUGS AT FOOTHILLS Low-cost prescriptions make a difference At Jasper Drug, we think medications should be affordable for everyone. Our $4.99 prescriptions can save families hundreds of dollars
More informationOne Amlodipine KRKA 5 mg or 10 mg tablet contains amlodipine maleate equivalent to either 5 mg or 10 mg amlodipine per tablet.
1. NAME OF THE MEDICINAL PRODUCT Amlodipine KRKA 5 mg tablets Amlodipine KRKA 10 mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION One Amlodipine KRKA 5 mg or 10 mg tablet contains amlodipine maleate
More informationWARNING: CERTAIN ANTIBIOTICS MAY CAUSE PERMANENT NERVE DAMAGE
WARNING: CERTAIN ANTIBIOTICS MAY CAUSE PERMANENT NERVE DAMAGE By Dr. Michael John Badanek, BS, DC, CNS, CTTP, DACBN, DCBCN, MSGR./CHEV In the past 36 plus years of clinical practice of Integrative/Functional
More informationStudy of the Side effects profile of different antihypertensive drugs among the Hypertensive patient
Study of the Side effects profile of different antihypertensive drugs among the Hypertensive patient Shrestha RK 1, Khan GM 1, Thapa P 1, Koju R 2 1 Department of Pharmacy, Kathmandu University 2 Department
More informationDiscussion Points. Decisions in Selecting Antibiotics
Antibiotics in Acute Care Fredrick M. Abrahamian, D.O., FACEP, FIDSA Clinical Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical
More informationPRESCRIPTION PATTERN OF ANTI HYPERTENSIVE DRUGS IN SHRI SATHYA SAI MEDICAL COLLEGE & RESEARCH INSTITUTE
Original Article PRESCRIPTION PATTERN OF ANTI HYPERTENSIVE DRUGS IN SHRI SATHYA SAI MEDICAL COLLEGE & RESEARCH INSTITUTE Annamalai Maduram 1, Harikrishna 2 INTRODUCTION High blood pressure, termed "hypertension,"
More information11/10/2016. Skin and Soft Tissue Infections. Disclosures. Educational Need/Practice Gap. Objectives. Case #1
Disclosures Selecting Antimicrobials for Common Infections in Children FMR-Contemporary Pediatrics 11/2016 Sean McTigue, MD Assistant Professor of Pediatrics, Pediatric Infectious Diseases Medical Director
More informationPrescribing Management
Prescribing Management Aim - To consistently promote and improve the safe, clinical and cost effectiveness of prescribing Margaret Maskrey, Lead Clinical Pharmacist, Inverclyde CHCP Why is prescribing
More informationNewsflash: Hospital Medicine JOHN C. CHRISTENSEN, MD FACP AMERICAN COLLEGE OF PHYSICIANS, UTAH CHAPTER SCIENTIFIC MEETING FEBRUARY 10, 2017
Newsflash: Hospital Medicine JOHN C. CHRISTENSEN, MD FACP AMERICAN COLLEGE OF PHYSICIANS, UTAH CHAPTER SCIENTIFIC MEETING FEBRUARY 10, 2017 Newsflash: Fluoroquinolones Newsflash: Fluoroquinolones Don t
More informationDEPO-MEDROL methylprednisolone acetate
DEPO-MEDROL methylprednisolone acetate Consumer Medicine Information What is in this leaflet Please read this leaflet carefully before being treated with DEPO-MEDROL suspension for injection. This leaflet
More informationChoosing the Ideal Antibiotic Therapy and the Role of the Newer Fluoroquinolones in Respiratory Tract Infections
...CLINICIAN INTERVIEW... Choosing the Ideal Antibiotic Therapy and the Role of the Newer Fluoroquinolones in Respiratory Tract Infections An interview with Robert C. Owens, Jr., PharmD, Clinical Pharmacy
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Amlodipine Bluefish 5 mg tablets Amlodipine Bluefish 10 mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains
More informationIrish Medicines Board
IRISH MEDICINES BOARD ACT 1995 EUROPEAN COMMUNITIES (ANIMAL REMEDIES) (No. 2) REGULATIONS 2007 (S.I. No. 786 of 2007) VPA:10778/003/002 Case No: 7003735 The Irish Medicines Board in exercise of the powers
More informationNEW ZEALAND DATA SHEET
NEW ZEALAND DATA SHEET 1. PRODUCT NAME NORVASC 5 mg and 10 mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each 5 mg coated tablet contains amlodipine besilate equivalent to 5 mg amlodipine. Each
More informationCLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES THE AMINOGLYCOSIDES:
CLINICAL USE OF AMINOGLYCOSIDES AND FLUOROQUINOLONES Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu THE AMINOGLYCOSIDES: 1944-1975 Drug
More informationPrescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children
Prescribing Guidelines for Outpatient Antimicrobials in Otherwise Healthy Children Prescribing Antimicrobials for Common Illnesses When treating common illnesses such as ear infections and strep throat,
More informationmoxifloxacin intravenous, 400mg/250mL, solution for infusion (Avelox ) SMC No. (650/10) Bayer Schering
moxifloxacin intravenous, 400mg/250mL, solution for infusion (Avelox ) SMC No. (650/10) Bayer Schering 05 November 2010 The Scottish Medicines Consortium (SMC) has completed its assessment of the above
More informationPrepared: August Review: July Common Infections. A Medicines Optimisation Antibiotic Prescribing Guide.
Prepared: August 2013 Review: July 2014 Common Infections. A Medicines Optimisation Antibiotic Prescribing Guide. Contents Page: Page No Why do we want to review antibiotics? 2 What do NICE say? 3 Acute
More informationIMPORTANT MEDICINE SAFETY INFORMATION
07 January 2019 IMPORTANT MEDICINE SAFETY INFORMATION Dear Healthcare Professional RE: SYSTEMIC AND INHALED QUINOLONE AND FLUOROQUINOLONE ANTIBIOTICS - RISK OF DISABLING AND POTENTIALLY LONG-LASTING SIDE
More informationAmlodipine Pfizer 5 mg and 10 mg tablets Amlodipine
Package leaflet: Information for the user Amlodipine Pfizer 5 mg and 10 mg tablets Amlodipine Read all of this leaflet carefully before you start taking this medicine because it contains important information
More informationPeriod of study: 12 Nov 2002 to 08 Apr 2004 (first subject s first visit to last subject s last visit)
Study Synopsis This file is posted on the Bayer HealthCare Clinical Trials Registry and Results website and is provided for patients and healthcare professionals to increase the transparency of Bayer's
More informationNL/H/882/ / Amlodipine CT 5 mg, tabletten Amlodipine CT 10 mg, tabletten
Package leaflet: Information for the user Amlodipine CT 5 mg, tabletten Amlodipine CT 10 mg, tabletten Amlodipine Read all of this leaflet carefully before you start taking this medicine because it contains
More informationAntimicrobial Stewardship in Ambulatory Care
Antimicrobial Stewardship in Ambulatory Care Nila Suntharam, M.D. May 5, 2017 Dr. Suntharam indicated no potential conflict of interest to this presentation. She does not intend to discuss any unapproved/investigative
More informationHEATHER ARMANINI - MEDICAL TIMELINE THE LAST WEEK OF HER LIFE
HEATHER ARMANINI - MEDICAL TIMELINE THE LAST WEEK OF HER LIFE DATE TIME MEDICATION Patient reported taking 4 Hydrocodone tablets prior to going to ER for headache and facial pain. Severe distress. Medication
More informationInteractive session: adapting to antibiogram. Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe
Interactive session: adapting to antibiogram Thong Phe Heng Vengchhun Felix Leclerc Erika Vlieghe Case 1 63 y old woman Dx: urosepsis? After 2 d: intermediate result: Gram-negative bacilli Empiric antibiotic
More informationPRODUCT MONOGRAPH. amlodipine besylate and atorvastatin (as atorvastatin calcium propylene glycol solvate) tablets
PRODUCT MONOGRAPH Pr APO-AMLODIPINE-ATORVASTATIN amlodipine besylate and atorvastatin (as atorvastatin calcium propylene glycol solvate) tablets 5/10 mg, 5/20 mg, 5/40 mg, 5/80 mg, 10/10 mg, 10/20 mg,
More informationClinical Manifestations and Treatment of Plague Dr. Jacky Chan. Associate Consultant Infectious Disease Centre, PMH
Clinical Manifestations and Treatment of Plague Dr. Jacky Chan Associate Consultant Infectious Disease Centre, PMH Update of plague outbreak situation in Madagascar A large outbreak since 1 Aug 2017 As
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT Efestad 5 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 5 mg desloratadine. Excipient: 31.5
More informationCommunity-acquired pneumonia: Time to place a CAP on length of treatment?
LOGIN TO LEARN: An Engaging and Interactive Journal Club for Pharmacists and Students Community-acquired pneumonia: Time to place a CAP on length of treatment? Jennifer Ball, PharmD Learning Objectives
More informationPerichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV
Empiric Antibiotics for Pediatric Infections Seen in ED NOTE: Choice of empiric antibiotic therapy must take into account local pathogen frequency and resistance patterns, individual patient characteristics,
More informationLevofloxacin induced bilateral achilles tendonitis
CASE REPORT Levofloxacin induced bilateral achilles tendonitis Muhammad Ishaq, Chand Sudham, Kumar Ajeet, Adnan Baig, Shaikh M. Ishaq Department of Medicine, Authors: 1. Dr. Muhammad Ishaq M.B.B.S., F.C.P.S.
More informationMICU Antibiotics and Associated Drug Interactions
MICU Antibiotics and Associated Drug Interactions Resistant Bacteria MICU patient are at risk for resistant organisms: Recent hospitalizations From a skilled nursing facility Immunocompromised patients
More informationPneumonia considerations Galia Rahav Infectious diseases unit Sheba medical center
Pneumonia considerations 2017 Galia Rahav Infectious diseases unit Sheba medical center Sir William Osler (1849 1919) "Father of modern medicine Pneumonia: The old man's friend The captain of the men of
More information