THREAD: SGLT2 inhibitors for #diabetes

1/5 Dr. Jamie Falk @jamisonfalk presented "A Deep Dive into #SGLT2i: What Comes to the Surface for Individuals with Diabetes"

👉🏽Watch the presentation here: bit.ly/3FRCEoM 🧑🏾‍💻

#T2DM #medsafety #FOAMed #MedEd
2/5 #AdverseEffects for #SGLT2i to be aware of: genital infections, hypovolemia, DKA, amputations

✅Check out the image ⬇️ for the risk estimates
✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾‍💻

#T2DM #medsafety #FOAMed #MedEd #diabetes #ptsafety
3/5 Evidence to date for #SGLT2i:

The first of the two new classes of medications for type II diabetes to reduce ↘️ risk of CV #AdverseEvents and mortality

✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾‍💻

#T2DM #medsafety #FOAMed #MedEd #diabetes
4/5 Pros and cons of #SGLT2inhibitors ⚖️

#SGLT2i also lead to #WeightLoss; the opposite of what insulin and sulfonylureas do

✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾‍💻

#T2DM #medsafety #FOAMed #MedEd #diabetes
5/5 Dr. Falk also compares effects of #SGLT2i💊to the evidence for #PhysicalActivity in people with #T2DM🚶🏾‍♂️🚴🏾‍♂️🏊🏾‍♂️

✅Watch @JamisonFalk's presentation here: bit.ly/3FRCEoM🧑🏾‍💻

#medsafety #FOAMed #MedEd #diabetes #exercise
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More from @Drug_Evidence

10 Nov
THREAD: Evidence for oseltamivir for #influenza prevention

1/6 Not much #flu last year, yet almost 14,000 BC residents were prescribed #oseltamivir (Tamiflu) for prevention

✅Flu guidelines bit.ly/3wwGJei

✅Systematic review of Tamiflu safety pubmed.ncbi.nlm.nih.gov/27246259
2/6 #Oseltamivir for prevention reduces ↘️ symptomatic influenza by 3%, (NNT=33) with an uncertain effect on asymptomatic #influenza

It likely has a central symptom reducing effect but may not reduce viral transmission
pubmed.ncbi.nlm.nih.gov/27246259

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There is not enough evidence to say it prevents death, hospitalizations, or flu complications
pubmed.ncbi.nlm.nih.gov/27246259
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19 Sep
THREAD: Medication adherence and shared decision-making

1/6 Our TI Letter 132 suggests a more democratic & ethical approach to shared decision-making: ti.ubc.ca/letter132

Here are 5⃣ highlights…

#MedEd #FOAMed #MedicationAdherence #PatientPreferences
2/6 Patients always retain right to say “no, thank you”🛑

Some pts may not want to accept their doctor's recommendations for a prescribed 💊 & have their own reasons to feel that it's not worth it for them.

This "intentional non-adherence" is a choice that should be respected
3/6 Studies have tested adherence aids

While these aids can improve adherence we don’t know if they lead to improved health outcomes 😕

See our TI Letter 132 on medication adherence: ti.ubc.ca/letter132 💻

#MedEd #FOAMed #MedicationAdherence #PatientPreferences
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12 Jul
THREAD: Shedding light on the risks of anticholinergic drugs

1/8 NEW information on risk of dementia and harm in the frail elderly. Free #BestEvidence webinar w/ Dr. Aaron Tejani @amtejani on July 14th

✅Registration: ti.ubc.ca/Anticholinergi…

#MedEd #deprescribing #medsafety
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They include: amitriptyline, cyclobenzaprine, fluoxetine, quetiapine, sertraline, trazadone, venlafaxine, zopiclone, citalopram...

👉🏽More here ti.ubc.ca/2018/09/10/113…

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3/8 What kinds of harms can #anticholingergics cause?
👉🏽Dry mouth 😦

❓Could your patient on an anticholinergic be experiencing bad breath/gum problems/tooth decay/trouble swallowing? 🤔

More here: ti.ubc.ca/2018/09/10/113…

#MedEd #deprescribing
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30 Jun
THREAD:5⃣things to know from 5 recent TI Therapeutics Letters👩🏽‍🔬

1/5: How to choose a good #mirtazapine dose? 🤔

Mirtazapine has a dose response 💊for harm but NOT for efficacy: harm ↗️ after 30mg/day but efficacy doesn't: bit.ly/361LU9E

#MedEd #deprescribing #ptsafety
2/5: Want to learn about recent @GovCanHealth #medsafety or international warnings for medications?

Read our Therapeutics Letter on international drug safety advisories: bit.ly/3wc0ar8 ⚠️ 💊

#drugsafety #SegPac #ptsafety
3/5: Do you like receiving feedback on your #prescribing?👩🏽‍⚕️💊

Read about Personal Prescribing Portraits: bit.ly/3hkf8WO

#MedEd #deprescribing
Read 6 tweets
11 May
THREAD - What if we could track and record repeat Adverse Drug Events? 🤔 💊

1/6: Register for our May 12 #BestEvidence webinar, as @corinne_hohl talks about Assessing the Impact of Information Continuity on Health Outcomes: bit.ly/3ap4FGO #MedEd
2/6: Why do Adverse Drug Events (ADEs) matter?

Each year in British Columbia, ADEs account for:
👉240,000 emergency dept (ED) visits
👉480,000 days in hospital
👉approx. 1 in 9 adult ED visits

More here: bit.ly/2Q7UGi8
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3/6: In Canada, adverse drug events 💊 cause or contribute to almost 2⃣million emergency department visits annually 😯 🆘

See publication list here: actionade.org/referenced-art…

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THREAD: Dr. John Mandrola: “The more you see, the harder the medicine gets”

1/7 Some new views on legacy prescriptions: Beta-blockers, ASA & #statins by Dr. John Mandrola

(based on @drjohnm presentation hosted by @drug_evidence Oct 17, 2020: bit.ly/32fsPiA)

#MedED
2/7 Example 1: Beta blockers in heart failure 💊♥️

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These findings challenge current recommendations: bit.ly/3acX9P7

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