el·e·ga·tion: being highly effective, yet simple
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cardiology
ePocrates and post MI care
I have had ePocrates on my iPhone for about 24 hrs. It has been a dream so far. I havent had any patient interactions, as it is my day of the week off.
However, I have been quite impressed with the formulary function. I have been able to quickly see which of the frequently prescribed medications are on the Madison formulary.
I will run in to this clinical situation many times in the next month on the cardiology ward:
A patient with no known history enters the hospital emergently due to an acute myocardial infarction (heart attack). They have previously not taken any medication. If all goes well, they will be discharged in 3-4 days on multiple new medicaitons, including:
Aspirin (generic, over the counter)
B-blocker (metoprolol tartrate or carvedilol are both covered on the Target 4$ Program)
Ace-inhibitor (lisinopril is covered)
Statin (simvastatin and atorvastatin are most commonly used, but quite expensive). Pravastatin and Lovastatin are covered, but not as well studied.
Plavix, or clopidogrel: very expensive still. There was a lawsuit back in 2007 to keep it under patent.
Fish Oil, or omega 3 fatty acids
If on-patent drugs are prescribed, this can be quite expensive quite quickly.
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Podcast: ACC Conversations with Experts
During my Cardiology Ward Month, I am very much enjoying listening to Adolph Hutter's ACC Conversations with Experts.
The timely topics include Early Initiation of Statin Therapy in Acute Coronary Syndromes
and the Update on UA/NSTEMI Management
(I admitted 3 UA/NSTEMIs this afternoon, and 1 STEMI).
Unfortunately it is not frequently updated (only 4 podcasts in 2008 thus far). However they are a treat to listen to, as they are attendings, and frequently cheifs of cardiology from around the nation discussing real-life patient care mixed in with evidence based medicine.
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