Category Archives: Prescriber

Random prescribing points

Statins: Fluvastatin, simvastatin and atorvastatin are predominantly lipid-soluble, whereas pravastatin and rosuvastatin are predominantly water-soluble. Therefore, if a patient gets SEs on a lipid-soluble statin, it’s worth trying water-soluble.   Remember that the cut-offs for stopping are liver enzymes >3x … Continue reading

Posted in BMJ, Cardiovascular, Credits 2013, Gastroenterology, Medication, Prescriber, Psychiatry | Leave a comment

Beta-blockers

Although beta-blockers can be helpful in the year following MI, they may not be helpful long-term. A large registry-based study showed event rates to be unrelated to beta-blocker use in patients post-MI. For patients with no previous MI (IHD or … Continue reading

Posted in Cardiovascular, Credits 2013, Medication, Prescriber | Leave a comment

DPP-4 inhibitors

I’ve previously written about incretins and the role of incretin mimetics in diabetes treatment. The other part of that, of course, is that you can inhibit the breakdown of the body’s natural incretins to prolong their effect. This is what … Continue reading

Posted in Credits 2012, Diabetes, Medication, Prescriber | 1 Comment

Prescriber 2011 December, Vol 22(23/24)

Low-sodium diets reduce blood pressure in hypertensives by around 5 – 6 mmHg (around 10 in Asians).  However, they increase cholesterol by around 2.5%, and long-term health effects are unknown. Interesting editorial about the recent BMJ meta-analysis of intensive vs. … Continue reading

Posted in Cardiovascular, Clean Living, Diabetes, Endocrinology, Hypertension, Prescriber | Leave a comment

Prescriber 2011 22(19), 5th October

Two useful articles about diabetes. Antidiabetic drugs in renal dysfunction Metformin: Confusing because the summary of product characteristics advise it shouldn’t be used below 60 ml/min creatinine clearance, but NICE advises using it until creatinine clearance drops below 30 ml/min … Continue reading

Posted in Diabetes, Endocrinology, Prescriber | Leave a comment

Gout

I already knew that meat, seafood, and alcohol were bad for gout while skimmed milk and weight loss were good for it.  To the ‘bad for’ column I can now apparently add fructose and sugar-sweetened soft drinks, and to the … Continue reading

Posted in Arthritis UK handouts, Gout, Medication, Prescriber | Leave a comment

Prescriber 2011:22(12) (19th June)

Just a few useful snippets this time: One possible treatment for nocturia due to storage symptoms, in LUTS in men, is Furosemide 40 mg at 4 pm.  Gets the fluid out before bedtime. I don’t think I’ve ever in my … Continue reading

Posted in Pregnancy and Childbirth, Prescriber, Urology, Vascular | Leave a comment

Prescriber 2011: 22(8) (19th April)

Some useful figures related to URTIs.  Length of treatment of AOM should generally be five days; give AOM three days of not responding to antibiotic therapy before changing the antibiotic; and 80% of cases of sinusitis will improve spontaneously within … Continue reading

Posted in Elderly Medicine, Medication, Prescriber | Leave a comment

BMJ 2011; 342: 833 – 882 (16th April)

This issue’s main contribution to me was to disentangle a couple of points I’d struggled with from guidelines.   Firstly, NICE guidance on antiplatelet therapy post-CVA – I had a hell of a time recently trying to figure out whether I … Continue reading

Posted in BMJ, Medicolegal, Prescriber | Leave a comment

Prescriber 2011: 22(5) (5th March)

Lyme disease First off, bear in mind that it’s rare.  If anyone who’s just had a tick bite asks you whether they should get antibiotics just in case, advise them against it – in one study of 1000 tick bites, … Continue reading

Posted in Infectious Diseases, Prescriber | 1 Comment