A 77 year old black patient is admitted to the hospital for a gastrointestinal bleed. He has a past medical history of CAD (MI 15 years ago), CKD (stage 4), atrial fibrillation, PUD, and hyperlipidemia for which he is taking ASA 81 mg daily, metoprolol tartrate 50 mg twice a day, atorvastatin 20 mg daily, lisinopril 20 mg daily, omeprazole 20 mg daily, and dabigatran 75 mg orally twice a day. Initial labs indicate an aPTT of 95 seconds, hemoglobin of 6.8 g/dL, and serum creatinine 2.3 mg/dL.
HughesMedicine - Pharmacotherapy Pearls from the Internal Medicine Clinical Pharmacist
Sunday, October 25, 2015
Recommended for you
-
Let’s start with a patient case. Patient is an 80 year old female hospitalized for pneumonia with sepsis who during this admission expe...
-
Bleeding risk with anticoagulant and antiplatelet medications is something that we struggle with on a regular basis. Should we fully anti...
-
Since it's the time of year again when Lyme disease is a concern for patients in many parts of the United States, I thought it would b...
-
A 65 year old male is being treated for an infection on his forearm that developed purulent drainage within the last few days. He denies ...
-
Let’s start with a patient case. A patient is being treated with methylprednisolone 20 mg IV q6 hours for some inflammatory process and...
-
The American Geriatrics Society recently published their Alternative Treatments to Selected Medications in reference to the most recent upd...
-
A 55 year old business executive is being discharged from the hospital after a brief admission for cellulitis. His only PMH is HTN and o...
-
Thrombocytopenia is a notable adverse effect of linezolid. Some of the evidence behind the onset, duration, and the extent of platelet de...
-
The management of anticoagulant therapy is an important component of the treatment of various disease states. Maintaining the narrow ther...
-
Let’s start with a patient case. A patient is admitted to the hospital with a CHF exacerbation. They are taking warfarin for atrial fi...
