MDpocket University of Southern California Internal Medicine Resident Edition - 2019
- CHA2DS2-VASc - updated to the January 2019 Atrial Fibrillation (AF) thromboembolic risk assessment, classification and treatment guidelines. This update focuses on the CHADS-VASc risk assessment with guideline changes from 2014 on patient populations to treat with anticoagulation. AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;139
- Anticoagulation - Added newest medications approved - Edoxaban and Betrixaban to the rapidly growing list of anticoagulants. Rearrangement of the table was done to provide more information for the user on dosing, uses, precautions, drug interactions, and monitoring.
- Hypertension (HTN 2019) - 1 page added to the 2019 Hypertension chapter (now a 2 page layout) to define the new blood pressure measurements and classifications. This additional page adds patient specific considerations when selecting blood pressure medications. Recent hypertension guidelines were changed in 2017 as defined by evidence based guidelines and can be found at: Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, Journal of the American College of Cardiology (2017), doi: 10.1016/j.jacc.2017.11.006.
- Medications used for Nausea, Vomiting and Diarrhea updated - 1 additional page added to the 2019 nausea, vomiting and diarrhea chapter. This update now includes current medications and doses for opioid induced constipation (OIC), chronic idiopathic constipation (CIC), irritable bowel syndrome - constipation (IBS-C). Nausea and vomiting medications were organized and brand names added for completeness.
- Microbiology chart antibiotic spectrum - 2019 updated current antibiotic coverage based on the most accurate information to improve the changing spectrum of drug coverage. New antibiotic chart demonstrates spectrum of coverage from ++ to - and improves the original design with guidelines established by Sanford and package inserts.
- Immunizations 2019
Latest immunization guidelines from Advisory Committee on Immunization Practices (ACIP) for 2019 that include infant, child, adolescent, adult, and high risk groups.
Changes to 2018 version:
LAIV has been listed separately from inactivated influenza vaccine (IIV) on the immunization schedule and is an option for adult through age 49 (excluding those listed).
Heplisav-B was add to the 2019 schedule as an option routinely administered in 2 doses given at least 4 weeks apart. It can be used as a substitute in a 3-dose series with a different hepatitis B vaccine, but a valid 2-dose series requires 2 doses of Heplisav-B with at least 4 weeks between doses.
Additional language add to table for precautions, delay and contraindications:
Precaution – vaccine might be indicated if benefit of protection outweighs risk of adverse reaction is highlighted in orange
Delay in vaccination – vaccine that should not be given to pregnant women is highlighted in pink
Contraindicated or use not recommended – vaccine should not be administered because of risk factors for serious adverse reaction is highlighted in red.
Child and Adolescent Schedule
LAIV has been listed separately from inactivated influenza vaccine (IIV) on the immunization schedule.
Precaution added to Meningococcal B vaccine for pregnancy.
Tdap updated to with catch-up vaccination and use in pregnant adolescents.
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