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The Gerijournal

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The Gerijournal Atrial fibrillation dosing varies taking NSAIDs, such as The based on renal function. If Celebrex®, ibuprofen and creatinine clearance (GFR) is naproxen. There is no GeriJournal 30 – 49 ml/min the dose is 15 evidence from clinical studies mg daily. If GFR is greater that it has any benefit when Volume 7, Number 8 than 50 ml/min, the dose is 20 used alone or when applied to August 2012 mg daily. Xarelto® should not any other parts of the body. A publication of GeriatRx Pharmacy be started until the INR (for those being switched from Both Zuacta® and Zostrix® Pradax Has Company warfarin) is at or below 2.5. can cause burning at the site of application over the first few Xarelto® (rivaroxaban) has Although Xarelto® has been days of use, although the joined Pradax® in the ODB used successfully for DVT manufacturer reports that Formulary. It now provides prevention it is not covered by Zuacta® is less problematic in another p.o. option to warfarin ODB for that indication. this regard. Zostrix® has been for stroke prevention in those While daily administration used to effectively treat with atrial fibrillation. gives it an advantage over arthritis in the hands and feet, Pradax® (a BID drug), in addition to back pain and As with Pradax®, the LU Xarelto® is more likely to diabetic neuropathy of the feet. coverage criteria for Xarelto® interact (particularly with It is less expensive and has the are very restrictive. Residents anticonvulsants) than its greater weight of evidence must either be poorly competitor. behind it, so it may be a better controlled on warfarin (i.e. out first option when choosing of INR range at least 35% of between the two products. the time after a minimum of Zuacta two months of therapy) or they Drug reps have been making must not have ready access to the rounds lately. They are Liver Injury & testing facilities. A refusal to flogging a new Rx cream Antibiotics allow blood testing has been called Zuacta® (zucapsaicin) A ten year study of the ODB interpreted by some as for use in the treatment of knee database (CMAJ Aug. 2012) satisfying this second pain caused by osteoarthritis. suggests that Avelox® and requirement. The LU code is Levaquin® can cause serious 435 vs. 431 for Pradax. Zucapsaicin is related to liver injury. The risk is twice capsaicin (Zostrix and Zostrix that of Biaxin®, while Cipro® Xarelto® is also covered for HP®). Capsaicin is the and Ceftin® did not increase short term clotting prevention chemical in cayenne pepper risk. In the period, 144 after hip or knee replacement that heats up your mouth when patients were admitted to surgery (LU 433 – knee; LU you eat it. It also depletes a hospital within 30 days of 434 – hip). The dose is 10 mg chemical called Substance P taking one of the five popular p.o. daily for this indication from nerves in the skin, antibiotics. There were 88 and some studies (e.g. N Engl diminishing the sensation of deaths. Health Canada has J Med. 2008;358(26):2776- pain from the surface or joints issued a warning about this 2786) suggest that it may offer and muscles below. risk. Antibiotics should be superior protection to used judiciously, with the most injectable low molecular Zuacta® is indicated only for appropriate agent carefully weight heparin products, such severe osteoarthritis of the selected, in light of this and as Lovenox®. knee in patients who are also other adverse event data. Prepared by Randy Goodman Certified Geriatric Pharmacist .
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