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Informatics in Pharmacy

Gastrointestinal

Clostridium/Clostridiodes Difficile

August 26, 2020 By Dr. G, PharmD

Clostridiodes difficile is a pretty big problem, causing quite a bit of morbidity and mortality every year, and it’s becoming more and more common. It can be pretty tricky to treat. C. diff is an anaerobic, spore-forming rod and it makes a toxin that contributes to the severity of the disease. It causes diarrhea and […]

Gout

August 13, 2018 By Dr. G, PharmD

Caused by uric acid over-production or underexcretion Factors: DKA, myeloproliferative and lymphoproliferative disease, acute EtOH, hypothyroidism, acromegaly, hypo or hyperparathyroidism, chronic hemolytic anemia, obesity Medications: Decrease uric acid filtration: diuretics (thiazide and loop diuretics), nicotinic acid (Niaspan), salicylates (ASA), alcohol (EtOH), levodopa/carbidopa, ethambutol, pyrazinamide, ticagrelor Acute treatment: Colchicine, NSAIDs, corticosteroids (if NSAIDS contraindicated) Chronic treatment: Allopurinol or […]

Inflammatory Bowel Disease

August 12, 2018 By Dr. G, PharmD

Ulcerative Colitis: Rectum and colonic mucosa involvement, no small intestine involvement, no skip lesions Blood diarrhea, spasm of anal sphincter (Tenesmus), weight loss, fever Staging: Mild < 4 stools a day, no symptoms Mod > 4 stools a day, minimal symptoms Severe > 6 stools a day, temp > 99.5 F, HR > 90, ESR […]

GERD, PUD, Stress Ulcer Prophylaxis

August 12, 2018 By Dr. G, PharmD

GERD (gastroesophageal reflux disease) Only screen for H. pylori in the case of PUD, history of documented peptic ulcer disease or gastric mucosa-associated lymphoma.  No endoscopy needed unless there are alarm symptoms. Lifestyle Modifications: Avoid alcohol, caffeine, chocolate, citrus, garlic, onions and mint Reduce fat Avoid eating 2-3 hours before bedtime Remain upright for 2 hours after […]

Helicobacter Pylori Treatment

August 12, 2018 By Dr. G, PharmD

PPI Triple Treatment:  3 drugs, 10-14 days PPI BID + clarithromycin 500 mg BID and amoxicillin 1000 mg BID or metronidazole 500 mg BID Bismuth-based treatment: 4 drugs, 14 days PPI BID+ metronidazole 250 mg TID and tetracycline 500 mg four times a day and bismuth 2 tabs four times a day Salvage Therapy: levofloxacin-based treatment for 10 […]

Liver Disease

August 12, 2018 By Dr. G, PharmD

Child-Pugh Scores for Cirrhosis Variable 1 Point 2 Points 2 Points encephalopathy absent mild-moderate severe to coma ascites absent slight moderate bilirubin <2 2-3 >3 albumin >3.5 2.8-3.5 <2.8 prothrombin time 1-4 4-6 >6 Class A = 5 points, class B=7-9 points, class C=10 or more points Ascites: Reduce dietary sodium, restrict fluid to 1.5 […]

Hepatitis

August 12, 2018 By Dr. G, PharmD

Hepatitis A – viral – spread person to person via feces. Pre-exposure prophylaxis Vaccines are available. Children are routinely vaccinated between their first and second birthdays. People who should consider vaccine – are traveling to countries where hepatitis A is common, are a man who has sex with other men use illegal drugs, have a […]

Spontaneous Bacterial Peritonitis

August 12, 2018 By Dr. G, PharmD

What Causes SBP Gram-Negative Bacteria (50%) E.coli (37%) Klebsiella other Gram-Positive Bacteria (50%) Strep pneumonia (10%) Other Strep Staphylococcus aureus Treatment of SBP SPB has a high mortality rate. Start treatment immediately. If ascitic fluid polymorphonuclear cell count is less than 250, start antibiotics.  Poor prognosis if bilirubin < 8, albumin < 2.5 or creatinine > 2.1 Antibiotic […]

Pancreatitis and Irritable Bowel Syndrome

August 12, 2018 By Dr. G, PharmD

Pancreatitis: The early stage has a systemic inflammatory response (SIRS) or organ damage. Late associated with local complications. Signs: Abdominal pain, nausea and vomiting, jaundice, fever Local complications: necrosis, hemorrhage, pseudocyst, abscess, infection Systemic complications: SIRs, acute respiratory distress, shock, organ failure Causes: Alcohol, gallstones, drugs (azathioprine, adenosine, diuretics, estrogens, exenatide, mesalamine, pentamidine, sitagliptin, tetracycline, […]

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020