Discover and read the best of Twitter Threads about #NSAIDS

Most recents (5)

@MondayNightIBD 1/Differential of Non-infectious Non -IBD colitis:
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy

🤔Can you think of other dx?
#MondayNightIBD
@MondayNightIBD 2/Immune Checkpoint Inhibitor Enterocolitis
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized Image
@MondayNightIBD @SanjeevaniTomar @halesj126 @JosephHabibi_MD @RomyChamoun @MarcelYibirin @ifrahfatima @GroverDheera @dunleavy_katie @drsophiadar @Spencerkelley7 3/ICI + Diarrhea:
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
#IBDAlgorithm👇
Image
Read 16 tweets
🧵 Reducing #PrescribingCascades ⬇️

1/ What are #Prescribing Cascades?

1⃣ A drug is prescribed 💊
2⃣ #AdverseEvent occurs but is misinterpreted as a new medical condition ⚠️
3⃣Another drug is prescribed for the drug-induced adverse event 💊💊

ti.ubc.ca/letter138 #MedEd Image
2/ Anticholinergics ➡️ cognitive dysfunction ➡️ drugs for #dementia

#Anticholinergic 💊 block acetylcholinergic neurotransmission in the brain, impairing cognition & memory

Can lead to new Rx or ↗️ acetylcholinesterase inhibitor doses

ti.ubc.ca/letter138 #MedEd #FOAMed Image
3/ Drugs for #dementia ➡️ incontinence ➡️ anticholinergics

Conversely, AChE-I can cause urinary or fecal incontinence, that may "cascade" to prescription of an #anticholinergic

👉🏽 full Letter here: ti.ubc.ca/letter138

#MedEd #PrescribingCascades #MedTwitter Image
Read 10 tweets
H pylori #tweetorial for resistant H pylori
#AGA released CPU in 4/21 revisiting topic of resistance/treatment failures, not a guideline, but the expert opinion @BradSpellberg loves! (1/x)
gastrojournal.org/article/S0016-…
@ABsteward @RushCCH_ID #MedEd #medtwitter #idtwitter
As GN bacteria go, it's an interesting bug:
Highly motile, curved, GNR, #Urease-positive, catalase-positive, oxidase-positive
Related to Campylobacter, for family fun
Nice crossover with our #Gastroenterology colleagues, eh #IDtwitter and @IDSAInfo
(2/x)
GN, and as such should be sensitive to most #antibiotics that target GN with pretty good susceptibilities over time for:
#amoxicillin #tetracycline #aminoglycoside #nitroimidazole #macrolide
(3/x)
Read 25 tweets
#MAMA : Pharm, I want to get these medications.👇
Lisinopril, Ibuprofen and Frusemide.

#PHARMACIST : Are you the one taking all these medications?

#MAMA : Yes Pharm. What's wrong?

#PHARMACIST : These medications can cause "TRIPLE WHAMMY EFFECT".

Let me Explain 👇

A Thread Image
👉 The concurrent use of an #ACE_Inhibitors or #ARBs (such as LisinoPRIL & candeSARTAN), a #DIURETIC (such as Frusemide ), plus an #NSAIDs (Ibuprofen, Diclofenac, Aspirin) when taken together, increases the RISK of precipitating #KIDNEY_FAILURE!

2/cont...
And elderly people over the age of 65 are more likely to develop kidney disease because as people age, so do their kidneys.

So taking such combination PLUS ur AGE will increase ur risk of developing impaired Renal function.

*I wrote a note to d Doctor to review d prescription*
Read 5 tweets
Features of #COVID19 @ACCinTouch #CCAACC
🔹fever predominant feature
🔹cough (less often productive)
🔹cough presents on discharge (Lancet paper)
🔹 more than pneumonia
🔹 abnormal coagulation: ⬆️ d-dimer so anticoag needed
@TheLancet @Drroxmehran @CMichaelGibson @hmkyale
Rapid deterioration seen quite often. Cases below demonstrate this: #COVID19
Discussion of this dilemma of ACEI and ARBs: question still remains. We don’t have evidence to stop these and shouldn’t yet.
🔹48% have HTN, less with HTN who survive (~20%)
🔹limited data to say stop anti-RAS
🔹 need studies
@ACCinTouch @hmkyale @DrJenniferCo_Vu
Read 17 tweets

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