Monthly Archives: August 2019

Managing menopause

(Notes from BMJ module) From 45 yrs onwards, menopause/perimenopause can be diagnosed on history only. FSH or other blood tests are not actually helpful in diagnosis in the >40s because of the wide fluctuation in levels in the perimenopause. FSH … Continue reading

Posted in Gynaecology, HRT | Leave a comment

Antidepressants/NOACs and bleeding risk

A DEN came up while I was sorting out repeat prescriptions: While it’s well known that patients taking an SSRI with NSAIDs or antiplatelet agents should strongly consider GI prophylaxis, does that apply to people taking SSRIs with NOACs? I … Continue reading

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Aspirin + clopidogrel short-term after TIA/ischaemic stroke

I belatedly got round to reading a January BMJ that contained this article, an analysis of previous work on DAPT (dual antiplatelet therapy) after TIA/stroke. The recommendations are: After either a high-risk TIA or a minor ischaemic stroke, use both … Continue reading

Posted in Cardiovascular, Credits 2019, Medication | Leave a comment

Progestagen-only pill

Remember that enzyme inducers exert an effect on other medications for 28 days after their cessation. This means, among other things, that when starting an oral contraceptive within 28 days after finishing an EI it’s necessary to use other precautions … Continue reading

Posted in Contraception, Credits 2019 | Leave a comment

Combined hormonal contraceptives

COC, patch, or vaginal ring. Random notes If a woman with a history of UPSIĀ  within the past three weeks needs contraception and her pregnancy test is negative, she can go ahead and start; however, she should check another pregnancy … Continue reading

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Diabetes management

The alphabet mnemonic is useful for remembering all the things that need to be discussed with patients: Advice – smoking, diet, exercise, weight loss. See about referring to structured educational programmes. Blood pressure Cholesterol Diabetes control Eye checks Foot checks … Continue reading

Posted in Diabetes, Hypertension | Leave a comment