Most patients who are found to have a pulmonary embolism are started on a medication to prevent future clots. For years, the drug of choice has been warfarin, a vitamin K antagonist that decreases the level of clotting factors. This medication works well but is notoriously complicated to use, requiring frequent monitoring with blood draws… Read More…
All of us who have completed an internship are well-familiar with the poly-pharmacy-discharge challenge. The patient comes in on eight medications. Now it’s time to go home, and you’ve gone and added another four. Surely the patient doesn’t need all of these, but as you review her list, it’s not clear that any can be… Read More…
A new trial from Verstovsek and others showed clinically significant responses in spleen size and quality of life among patients with myelofibrosis receiving the ruxolitinib, a JAK1 and JAK2 inhibitor. The agent has some myelotoxicity, but this study showed a survival advantage with ruxolitinib. Myelofibrosis, a myeloproliferative neoplasm, is manifested by abnormal blood counts (anemia, thrombocytosis… Read More…
A 65 year-old man with known coronary disease comes to your office seeking advice. He had his first MI at age 56, had PCI at the time, and has been medically managed since. His LDL is below 70 on 40 mg of simvastatin, but his HDL has always been stubbornly low, hovering in the low… Read More…
