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Polypharmacy and Deprescribing
from: https://www1.racgp.org.au/ajgp/2023/april/deprescribing-considerations-for-older-people-in-g Importance of Deprescribing Inappropriate Polypharmacy High-Risk Prescribing in Older Patients Deprescribing Strategy Benefits of Deprescribing for Older People Patient Attitudes Toward Deprescribing Barriers and Enablers to Deprescribing Available Tools for Deprescribing Tools to aid deprescribing Tool Purpose Example of applicability Reference Open access? MATCH-D criteria (Medication Appropriateness Tool…
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Anticholinergic Burden
Importance of Managing Anticholinergic Burden Reducing Anticholinergic Burden Deprescribing Anticholinergic Medicines: Considerations for Deprescribing Anticholinergic Medicines: Factors In Favour of Deprescribing: Factors Against Deprescribing: Medicines and Their Risk of Withdrawal Events or Symptom Recurrence: Monitoring Withdrawal Effects: Additional Considerations: Deprescribing Guide for: Additional Topics with Relevant Resources
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Medication Non-compliance / Non-adherence
Social and economic Cost of treatment Health system related Condition related Patient related Therapy related Management
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Anti-Lipids
STATINS Most Potent Oral Lipid-Modifying Agents First-Line Therapy for elevated LDL-C (low-density lipoprotein cholesterol). Lipid Reduction: Lowers LDL-C and triglycerides. Non-lipid Benefits: Antiplatelet properties. Potency of Statins: Effectiveness: Administration Timing: Factors to Consider When Choosing a Statin: Baseline Tests Before Statin Therapy: Avoiding Drug Interactions: Statin Metabolised by Statin concentration…
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Clonidine
Clonidine has a vast array of uses including anxiety, ADHD, hypertension, withdrawal (opitates, alcohol and smoking), migraines, menopausal flushing, diarrhoea and finally pain. It causes the classic triad of drowsiness, miosis and bradycardia in overdose. USED IN Off-Label Uses Mechanism of Action centrally acting alpha-2 adrenergic agonist. Its primary effects…
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Anticoagulation in Pregnancy for DVT/PE
First-line Therapy: Low Molecular Weight Heparin (LMWH) Unfractionated Heparin (UFH) Fondaparinux Warfarin Monitoring and Adjustment Peripartum Management Summary
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NOACs
Available NOACs Indications Advantages over Warfarin NOAC Dose PBS Listed Indications Contraindications Dabigatran (Pradaxa) – 150 mg twice daily – 110 mg twice daily (for patients >75 years or with increased bleeding risk) – Non-valvular AF: Prevention of stroke and systemic embolism – Treatment and prevention of recurrent DVT and…
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Warfarin
Contraindications to Warfarin Other Risk Factors for Adverse Events on Warfarin Advice on Warfarin Nature of Warfarin Benefits Risks Interactions Monitoring Complications to Watch Out For Warfarin Reversal No Bleeding Bleeding
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Major Medication adverse reactions and toxicities
Neuroleptic Malignant Syndrome (NMS) 2. Serotonin Syndrome 3. Lithium Toxicity 4. QT Prolongation 5. Hepatotoxicity 6. Rhabdomyolysis 7. Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) 8. Agranulocytosis 9. Neutropenia 10. Thrombocytopenia 11. Acute Kidney Injury (AKI) 12. Ototoxicity 13. Hyponatremia 14. Hyperglycemia 15. Hyperkalemia 16. Angioedema 17. Anaphylaxis
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Medications in Psychiatry
1. Antidepressants SSRIs (Selective Serotonin Reuptake Inhibitors) SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) Tricyclic Antidepressants (TCAs) 2. Antipsychotics Typical Antipsychotics Atypical Antipsychotics 3. Mood Stabilizers Lithium Valproate (Valproic Acid) 4. Anxiolytics Benzodiazepines 5. Stimulants Used primarily for ADHD
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Loperamide
Development and Regulatory History Medical Applications Mechanism of Action Pharmacokinetics Dosage and Administration Special Populations Adverse Effects and Toxicity Contraindications Toxicity
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Oral Steroids
1. Hydrocortisone 2. Triamcinolone 3. Prednisone/Prednisolone 4. Methylprednisolone 5. Dexamethasone 5. Betamethasone Uses Short-Term Complications Long-Term Complications Monitoring of patients taking long-term corticosteroids Baseline monitoring WeightHeightBody mass indexBlood pressure Complete blood countGlucoseLipidsBone mineral density (BMD) Subsequent monitoring Bone health Annual height assessment for fragility fracturesBMD four months post–steroid initiation If…