New Anticoagulant From Daiichi Sankyo Works Well In AF Patients
Edoxaban, a direct oral factor Xa inhibitor under development by Daiichi Sankyo, is the latest in the series of new oral anticoagulants seeking to take over the troubled role of warfarin in clinical practice. The results of ENGAGE-AF-TIMI 48 were presented at the American Heart Association meeting in Dallas and published simultaneously in the New England Journal of Medicine. The results of the trial were promising, but edoxaban may have a hard time finding its footing as the fourth new oral anticoagulant to enter the market, following dabigatran (Pradaxa), Boehringer Ingelheim; rivaroxaban (Xarelto), Johnson &#...
Source: CardioBrief - November 19, 2013 Category: Cardiology Authors: Larry Husten Tags: Heart Rhythms Prevention, Epidemiology & Outcomes apixaban atrial fibrillation Bristol Myers Squibb Daiichi Sankyo Direct Xa inhibitor new england journal of medicine stroke prevention Source Type: blogs
Clopidogrel
is a:
a) P2Y12 receptor antagonist
b) GP IIb/IIIa inhibitor
c) Vitamin K antagonist
d) None of the above
Correct answer: a) P2Y12 receptor antagonist
Clopidogrel, ticlopidine and prasugrel are P2Y12 receptor antagonists. GP IIb/IIIa inhibitors include abciximab, eptifibatide and tirofiban. Warfarin and acenocoumarol are vitamin K antagonists. (Source: Cardiophile MD)
Source: Cardiophile MD - November 3, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance P2Y12 receptor antagonist Source Type: blogs
Will The Bleeding Stop? Pradaxa Topped FDA Side Effect Reports
Will the bleeding stop? Last year, the FDA concluded that bleeding rates associated with Pradaxa, a relatively new bloodthinner, were no higher than among patients given warfarin, a decades-old medical standard. The assessment was designed to allay concerns that Pradaxa, which is used to reduce the risk of stroke and blood clots in patients with atrial fibrillation, but has been linked to hundreds of deaths.
Meanwhile, a new analysis finds that Pradaxa, which was approved two years ago by the FDA, generated the largest number of adverse events reported directly to the agency during 2012. In all, there were 683 such reports...
Source: Pharmalot - October 17, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
A new and very interesting EMR "glitch" - no warnings on stopping a medicine that diminishes the effects of a second medication
A new and very interesting EMR "glitch" from a report I received recently:... I found a glitch with my [name redacted] EMR. It probably happens with all EMRs. I had a patient on primidone (http://en.wikipedia.org/wiki/Primidone) for essential tremor. Later, his primary care put her on warfarin [a "blood thinner" - ed.] for atrial fibrillation. Some time after that, I took her off of primidone. Her INR jumped to 7 or 8. [High - ed.] What happens is that the EMRs warn a physician pretty well if you START a medicine that interacts with warfarin, but fails to warn if you STOP a medicine that interacts with warfarin....
Source: Health Care Renewal - October 16, 2013 Category: Health Medicine and Bioethics Commentators Tags: glitch primidone healthcare IT difficulties warfarin coumadin drug interaction EHR alerts Source Type: blogs
99223 vs 99233: Coding Hospital Inpatient Initial Care Encounters.
When should I code a 99223 vs 99233 for the hospital inpatient initial care encounter? I was recently asked by a busy hospitalist to comment on this scenario as it relates to their consultative role on post operative surgical patients on the orthopedic service. Here is their question in detail:
We see a lot of orthopedic consults on our service. Sometimes 6-8 new consults per day piled on to our starting census. They often have no acute medical condition that we are commenting on. However, they usually have 4 medical conditions and are on opiate PCA as per orthopedic admission orders. In these situations woul...
Source: The Happy Hospitalist - October 9, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
99223 vs 99233: Coding Hospital Inpatient Initial Care Encounters.
When should I code a 99223 vs 99233 for the hospital inpatient initial care encounter? I was recently asked by a busy hospitalist to comment on this scenario as it relates to their consultative role on post operative surgical patients on the orthopedic service. Here is their question in detail:We see a lot of orthopedic consults on our service. Sometimes 6-8 new consults per day piled on to our starting census. They often have no acute medical condition that we are commenting on. However, they usually have 4 medical conditions and are on opiate PCA as per orthopedic admission orders. In these situations would I ...
Source: The Happy Hospitalist - October 9, 2013 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs
FFP versus 4 factor PCC for warfarin reversal
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - October 7, 2013 Category: Internists and Doctors of Medicine Tags: hematology cardiovascular Source Type: blogs
Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated joy of working in healthcare. Physicians often forget just how alien the language of medicine is to people who don't live it everyday. The best part about being a physician is not helping people recover from critical illness. The best part is not about listening and understanding with compassion and empathy. Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process. Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
When Doctors' Names are Bought and Sold
Recently, an envelope arrived for me containing an advertisement from Mercedes-Benz:
Mercedes Benz Offer (Click to enlarge)
The advertisement was co-branding with the American Medical Association, leading me to suspect the obvious: my name was sold.
Why does this bother me so? After all, the AMA advocates for physicians, don't they? Surely they need the money to do all their important (Source: Dr. Wes)
Source: Dr. Wes - September 25, 2013 Category: Cardiology Authors: Westby G. Fisher, MD Tags: rant dabigatran warfarin AMA apixaban pharmaceutical industry rivaroxaban Source Type: blogs
When and if to restart warfarin after a GI bleed
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - September 18, 2013 Category: Internists and Doctors of Medicine Tags: gastroenterology hematology cardiovascular pulmonary Source Type: blogs
Coherex Left Atrial Appendage Occluder Gets CE Mark (VIDEO)
WaveCrest Left Atrial Appendage (LAA) Occlusion System developed by Coherex Medical recently received CE Mark approval. Coherex Medical is a Salt Lake City, Utah company developing novel solutions for treatment of structural heart diseases.
In patients who have atrial fibrillation, slower blood flow through the atria can result in blood clots forming in the left atrial appendage in 10-20% of cases. LAA occlusion is a treatment strategy to prevent thrombosis in patients suffering from atrial fibrillation. LAA occlusion is used as an alternative for patients who cannot use oral anticoagulants such as warfarin. The Coherex ...
Source: Medgadget - September 17, 2013 Category: Technology Consultants Authors: Gaurav Krishnamurthy Tags: Cardiac Surgery Cardiology Radiology Source Type: blogs
Book of Nurses: Jennelle
Jannelle has been nursing since she was 17 and has been qualified since she was 23. She worked in emergency departments in England and NZ before returning to Australia.
She was initially working in an ED in Alice Springs, where she progressed to a senior role, but due to bullying decided she wanted to try something different , and so “went out bush”.
This story happened 1 month later.
Janelle is now back working in Alice Springs, where she is looking forward to undertaking a forensic nursing diploma course.
Reflection on one day as a nurse.
At approximately 2015 on July 1st I received a call from the polic...
Source: impactEDnurse - September 8, 2013 Category: Nurses Authors: impactEDnurse Tags: ectopics Source Type: blogs
