By Andrew J. Dionne
The Little Black booklet of sanatorium medication presents sensible, concise evidence-based info at the prognosis and remedy around the spectrum of disease and harm within the clinic atmosphere. This ebook contains a basic, obtainable template for every topic, and speedy and simple references to the proper literature. The Little Black e-book of health facility medication is a handy source supplying rapid entry to important info and is the correct source for this present day s hospitalist.
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Additional info for Little Black Book of Hospital Medicine (Jones and Bartlett's Little Black Book)
75 mg qd; consider 300 mg one-time oral loading dose. 8%, NNT 200) (Lancet 1996;348:1329). 7%, NNH 100); results similar for pts with medical therapy only vs PCI vs CABG. • Consider avoiding if pt likely to need CABG during initial hospitalization because of perioperative bleeding; high risk for CABG would be diabetes, EKG or clinical sx suggestive of multivessel or left main disease. • Clopidogrel is the primary alternative antiplatelet agent in pts allergic to ASA. • Good additional med (with ASA) for up to 3–12 mo postUA/NSTEMI in pts not deemed candidates for further interventions.
Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the clinician or reader is responsible for determining FDA status of the drug, reading the package insert, and prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used.
Also consider strongly in AMI pts with HTN or DM (even if preserved LV function). • Nitroglycerin preparations for sx (angina) control • Lipid management: • Consider statin therapy in all post-MI pts regardless of baseline cholesterol. • A 2008 meta-analysis of statins in approximately 20,000 pts older than 65 showed significant reductions in all mortality (NNT 28), CHD mortality (NNT 34), nonfatal MI (NNT 38), and stroke (NNT 58) (J Am Coll Cardiol 2008;51:37). • A meta-analysis of 121,000 pts showed that statins reduced all-cause mortality by 12% (NNT 89) and CV mortality by 19% (Am J Med 2008;121:24).