Medication Pearls

Question 1

When can you use Dapagliflozin (farxiga)

Answer 1

Type 2 DM
Anyone at risk for hospitalization for heart failure
Diabetic males over 55 or women over 60 with risk factors.
Risk factors HTN, HLD, smoking, statin use

Question 2

Long term use of metformin can be associated with what deficiency?

Don’t use metformin if GFR less than what?

What is discontinuation rate?
Rate of GI side effects?

Answer 2

Vitamin B12

<30 leads to decreased clearance and increased risk of Lactic acidosis

1% d/c rate
GI side effects to 10%

Question 3

things that may contribute to statin induced myalgias

Answer 3

Low BMI, heavy exercise, lots of grapefruit juice, alcohol, dehydration, hypothyroidism, Vit D Def.

Question 4

Antidepressant that can exacerbate HTN

Answer 4

Effexor

Question 5

Benefits of Vitamin E?

Answer 5

Vitamin E supplementation appears to have a beneficial effect on progression of macular degeneration. It has not been proven to prevent Alzheimer’s dementia or mild cognitive impairment.
vitamin E supplementation has not shown any benefit for prevention of cardiovascular disease in the general population, clinical trial data from the HOPE (Heart Outcomes Prevention Evaluation), ICARE (Israel Cardiovascular Events Reduction with Vitamin E), and Women’s Health Study clinical trial data has shown that in individuals with diabetes mellitus and the Hp2-2 genotype, vitamin E supplementation is associated with an approximately 35% reduction in cardiovascular disease. A meta-analysis from 2014 showed that vitamin E is safe in dosages up to 800 IU daily.