Haramaya University Hiwot Fana Comprehensive Specialized Hospital Drug Information Service (HrU-HFCSH DIS)
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Channel Posts
◆ Piperacillin-Tazobactam
- Coverage: Gram-negative, anaerobes,
*Pseudomonas*
Common Uses: Severe hospital-acquired infections,
intra-abdominal infections
### **
Clinical Tips for Effective Antibiotic Use:**
1. Narrow-spectrum first: Minimize broad-spectrum
use to reduce AMR.
2. Local antibiogram: Always check for regional
resistance patterns.
3. Avoid overprescription: Be mindful to use antibiotics only when necessary.
... Share this guide for better clinical decision-making! Together, we can fight antimicrobial resistance.
https://t.me/HFSUHDIC
| 2 |  Antibiotic Spectrum: A Quick Reference for Healthcare Professionals
◆ Penicillin G/V
- Coverage: Gram-positive, *Treponema pallidum*
Common Uses: Strep throat, Syphilis
• Vancomycin
Coverage: Gram-positive, MRSA, *C. difficile*
Common Uses: MRSA infections, C. diff colitis
• Aminoglycosides *(Gentamicin, Amikacin)*
Coverage: Gram-negative aerobes, *Pseudomonas*
- Common Uses: Sepsis, UTIs, synergy with other agents for Gram-positive infections
• Fluoroquinolones *(Ciprofloxacin, Levofloxacin)*
- Coverage: Gram-negative, atypicals,
*Pseudomonas*
Common Uses: UTIs, GI infections, respiratory infections
◆ Carbapenems *(Meropenem, Imipenem)*
Coverage: Broad-spectrum, ESBL-producing
organisms
Common Uses: Severe infections, intra-abdominal
sepsis
• Metronidazole
- Coverage: Anaerobes, protozoa
- Common Uses: C. diff colitis, IAI , dental abscesses
◆ Macrolides *(Azithromycin, Clarithromycin)*
Coverage: Atypicals, Gram-positive
Common Uses: CAP, STIs (Chlamydia), RTI.
To be Continued 👇👇👇 | 260 |
| 3 |  Early Celecoxib Use in Spontaneous Intracerebral Hemorrhage is Associated with Reduced Mortality | Neurocritical Care
https://link.springer.com/article/10.1007/s12028-024-01996-2
Original article 👇👇👇
https://link.springer.com/article/10.1007/s12028-024-01996-2 | 275 |
| 4 |  +1Safety Alert: Unauthorized Artemether 80 mg/ml Injection, Batch No: R213H04F4
Among counted efforts that the Ethiopian Food and Drug Authority making, legalizing and bringing unauthorized floating medicines on the market which may definitely are available in health facilities for treating patients into a track is the vital one. in the legalization process medicine and medicinal product are passing in different regulatory assessment levels.
In the evaluation process a product like the attached ones, often not meet the minimum quality standard even with out having API. So, healthcare professionals need always be curios to at least look into the status of the medicinal product before administration and use them at any level.
Stay vigilant and prioritize patient safety!
https://t.me/HFSUHDIC | 388 |
| 5 | t.me/empirebot/game?startapp=hero726362185
🔥Play with me, grow your startup.
💸 +5k coins as your first gift
💵 +25k coins if you have Telegram Premium | 45 |
| 6 | 2024 ESC Guidelines for the management of elevated blood pressure and hypertension
https://t.me/HFSUHDIC | 490 |
| 7 | 👉Hypertension in women is under-studied in basic, clinical, and population research.
👉Hypertension-mediated organ damage (HMOD) suggests long-standing or severe hypertension and is associated with increased CVD risk.
👉Absolute CVD risk must be considered when assessing and managing elevated BP.
👉Despite the growing number of hypertension guidelines, the rates of diagnosis, treatment, and control of hypertension (and elevated BP) remain suboptimal. A major factor underlying this is poor implementation of evidence-based guidelines in real-world clinical practice.
👉One of the most important changes in the 2024 Guidelines is the focus on evidence related to CVD outcomes of BP-lowering interventions rather than BP lowering alone.
👉Irrespective of the threshold BP above which BP-lowering treatment (lifestyle or pharmacological or other treatment) is recommended, the on-treatment BP target is 120-129/70-79 mmHg for all adults, provided this treatment is well tolerated. There are several important exceptions to these targets and individualized decision-making is always the most important priority.
https://t.me/HFSUHDIC
Full pdf of original article 👇👇👇 | 438 |
| 8 |  New Guidelines from the European Society of Cardiology: 2024 ESC Guidelines for the management of elevated blood pressure and hypertension (attached at the end):
Key Messages:
👉Given the demographic transition and the worldwide ageing of populations, the number of individuals with elevated BP or hypertension is increasing worldwide.
👉The trajectory of BP control appears to be worsening in North America, in some (but not all) European countries, and elsewhere around the world.
👉The risk for CVD attributable to BP is on a continuous log-linear exposure variable scale, not a binary scale of normotension vs. hypertension.
👉BP-lowering drugs can reduce CVD risk even among individuals not traditionally classified as hypertensive. Accordingly, a new BP category called 'elevated BP' is introduced. Elevated BP is defined as an office systolic BP of 120-139 mmHg or diastolic BP of 70-89 mmHg. Hypertension remains defined as office BP of ≥140/90 mmHg.
CONTINUE.... | 357 |
| 9 |  +1Safety Alert:
Recall of Ringer Lactate Infusion
Dear Healthcare Community, Ringer Lactate Infusion, manufactured by Pharmacure Pvt. Ltd., is currently under recall due to quality defects.
What You Need to Do:
Check Your Inventory: Review your stock of Ringer Lactate Infusion. If you have any batches from Pharmacure, pay close attention.
Report Any Affected Batches: If you identify any affected batches, promptly report them to Pharmacure. Cooperation is essential for a successful recall.
Prioritize Patient Safety: Our collective efforts matter. By participating in this recall, we safeguard public health and protect our patients.
https://t.me/HFSUHDIC | 502 |
| 10 | Diabetes and Foot Care Recommendations: American Diabetes Association (ADA) Standards of Care 2024:
Perform a comprehensive foot evaluation at least annually to identify risk factors for ulcers and amputations.
The examination should include inspection of the skin, assessment of foot deformities, neurological assessment (10-g monofilament testing with at least one other assessment: pinprick, temperature, or vibration), and vascular assessment, including pulses in the legs and feet.
Individuals with evidence of sensory loss or prior ulceration or amputation should have their feet inspected at every visit.
Obtain a prior history of ulceration, amputation, Charcot foot, angioplasty or vascular surgery, cigarette smoking, retinopathy, and renal disease and assess current symptoms of neuropathy (pain, burning, numbness) and vascular disease (leg fatigue, claudication).
All people with diabetes should be assessed for diabetic peripheral neuropathy starting at diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes and at least annually thereafter.
Assessment for distal symmetric polyneuropathy should include a careful history and assessment of either temperature or pinprick sensation (small-fiber function) and vibration sensation using a 128-Hz tuning fork (for large-fiber function). All people with diabetes should have annual 10-g monofilament testing to identify feet at risk for ulceration and amputation.
In asymptomatic individuals with diabetes and age ≥50 years, microvascular disease in any location, or foot complications or any end-organ damage from diabetes, screening for PAD with ankle-brachial index testing is recommended to guide treatment for cardiovascular disease prevention and limb preservation. In individuals with diabetes duration ≥10 years, screening for PAD
should be considered.
Initial screening for peripheral arterial disease (PAD) should include assessment of lower-extremity pulses, capillary refill time, rubor on dependency, pallor on elevation, and venous filling time. Individuals with a history of leg fatigue, claudication, and rest pain relieved with dependency or decreased or absent pedal pulses should be referred for ankle-brachial index with toe pressures and for further vascular assessment as appropriate.
✔ Provide general preventive foot self-care education to all people with diabetes, including those with loss of protective sensation, on appropriate ways to examine their feet (palpation or visual inspection with an unbreakable mirror) for daily surveillance of early foot problems.
https://t.me/HFSUHDIC | 391 |
| 11 |  No text... | 314 |
| 12 |  Product Quality Defect Alert: Cimetidine 400 mg/2ml Injection
product quality issue flagged by the Ethiopian Food and Drug Authority (EFDA). The locally manufactured Cimetidine 400 mg/2ml injection, produced by Humanwell Pharmaceutical Ethiopia PLC, has encountered significant quality defect.
Issue Summary:
Product: Cimetidine 400 mg/2ml injection
Manufacturer: Humanwell Pharmaceutical Ethiopia PLC
Concerns: Precipitation and Color change
Action Taken:
A Prohibition of further manufacturing and distribution
B Recall of all batches from the market
numerous health facilities have reported these issues, prompting EFDA's swift response. As professionals in the healthcare and pharmaceutical sectors, let's remain vigilant and prioritize patient safety. If you encounter this product, please follow the recall instructions promptly.
https://t.me/HFSUHDIC | 1 090 |
| 13 | DCRM 2.0: Multispecialty practice recommendations for the management of diabetes, cardiorenal, and metabolic diseases .pdf'
https://t.me/HFSUHDIC | 520 |
| 14 | Comorbid heart failure and CKD:
👉Persons with comorbid HF and CKD face markedly elevated risks of clinical progression and mortality yet are often inadequately treated with disease-modifying therapies targeting each condition ("a risk-treatment paradox").
👉Guideline-recommended HF therapies have been studied across a broad range of individuals with comorbid CKD. The SGLT2 inhibitors have been studied and demonstrated to be safe and well-tolerated in persons with HF at eGFRs as low as 20. Other therapeutic classes, including ACE inhibitors, ARBs, ARNI, and steroidal MRAs (spironolactone and eplerenone) have been mostly studied at eGFR as low as 30. Although limited evidence exists for use of beta-blockers among those who require kidney-replacement therapy, no overt safety risks have been identified, and their use in those with HF may be considered.
👉From the novel class of nonsteroidal MRAs, finerenone has been shown to reduce cardiovascular and kidney disease events in persons with T2D and CKD with an eGFR as low as 25. In persons with comorbid HFmrEF or HFpEF, T2D, and CKD with albuminuria, the use of finerenone as the nonsteroidal MRA of choice appears reasonable. In other individuals with HFrEF, steroidal MRAS (spironolactone or eplerenone) are preferred if tolerated by the individual.
👉Hyperkalemia can occur with ACE inhibitors, ARBs, and MRAs, especially if eGFR is ≤45. Hyperkalemia can limit up-titration or use of evidence-based doses of these therapies in HF and CKD. The use of an SGLT2 inhibitor has been shown to lower risks of hyperkalemia related to MRA, and combination use may promote treatment persistence in practice. Likewise, compared with an ACE inhibitor, ARNI carries a lower risk of hyperkalemia among individuals receiving MRA and may lead to less MRA discontinuation. The use of potassium binders such as patiromer and sodium zirconium cyclosilicate may be considered to facilitate use of these therapies among individuals who experience therapy-related hyperkalemia.
👉Many therapies used in both HF and CKD lower intra-glomerular pressures, and treatment initiation may result in acute eGFR decline, especially if the individual has volume depletion. This eGFR decline is not associated with renal safety signals in clinical trials with or without HF. As such, this hemodynamic effect should not prompt treatment discontinuation or de-escalation in most cases. If eGFR declines by >30% within a week of treatment initiation, and volume depletion is excluded, alternative etiologies should be evaluated and concomitant diuretic adjustments may be considered.
👉Monitoring of UACR and natriuretic peptides may be considered to evaluate CKD and HF progression. Declines in these biomarkers with therapy have been associated with improved clinical outcomes. Specifically, a sustained reduction of ≥30% in albuminuria is considered a surrogate for good renal outcome.
https://t.me/HFSUHDIC
Read the full information of this article 👇👇👇 | 544 |
| 15 |  No text... | 357 |
| 16 |  Sepsis detection and management algorithm.
This post aims to help health professionals to detect sepsis early, enhancing patient care and saving lives.
https://t.me/HFSUHDIC | 435 |
| 17 | Continued....
How and When to use Sodium-Glucose Cotransporter 2 Inhibitors (SGLT-2 Inhibitors)? Recommendation from the ADA Standards of Care 2024:
👉In adults with type 2 diabetes and established or high risk of atherosclerotic cardiovascular disease, heart failure (HF), and/or chronic kidney disease (CKD), the treatment plan should include agent(s) that reduce cardiovascular and kidney disease risk (e.g., sodium-glucose cotransporter 2 inhibitor [SGLT2] and/or glucagon-like peptide 1 receptor agonist [GLP-1 RA]) for glycemic management and comprehensive cardiovascular risk reduction, independent of A1C and in consideration of person-specific factors.
👉Among people with type 2 diabetes who have established ASCVD or established kidney disease, a sodium-glucose cotransporter 2 (SGLT2) inhibitor or glucagon-like peptide 1 (GLP-1) receptor agonist with demonstrated cardiovascular disease benefit is recommended as part of the comprehensive cardiovascular risk reduction and/or glucose-lowering treatment plans.
👉In people with type 2 diabetes and established ASCVD, multiple ASCVD risk factors, or diabetic kidney disease, an SGLT2 inhibitor with demonstrated cardiovascular benefit is recommended to reduce the risk of major adverse cardiovascular events and/or heart failure hospitalization.
👉In adults with type 2 diabetes who have CKD (with confirmed estimated glomerular filtration rate [eGFR] of 20-60 and/or albuminuria), an SGLT2 inhibitor should be used for minimizing progression of CKD, reduction in cardiovascular events, and reduction in hospitalizations for HF; however, the glycemic benefits of SGLT2 inhibitors are reduced at eGFR <45.
👉For people with type 2 diabetes and CKD, use of an SGLT2 inhibitor is recommended to reduce CKD progression and cardiovascular events in individuals with eGFR ≥20 and urinary albumin ≥200 mg/g creatinine.
👉For cardiovascular risk reduction in people with type 2 diabetes and CKD, consider use of an SGLT2 inhibitor (if eGFR is ≥20), a glucagon-like peptide 1 agonist, or a nonsteroidal mineralocorticoid receptor antagonist (if eGFR is ≥25).
👉Individuals with type 1 diabetes and those with type 2 diabetes who are ketosis prone and/or those consuming ketogenic diets who are treated with SGLT inhibition should be educated on the risks and signs of ketoacidosis and methods of risk management and provided with appropriate tools for accurate ketone measurement (i.e., serum ẞ-hydroxybutyrate).
https://t.me/HFSUHDIC | 381 |
| 18 |  👉In people with type 2 diabetes and established ASCVD or multiple risk factors for ASCVD, combined therapy with an SGLT2 inhibitor with demonstrated cardiovascular benefit and a GLP-1 receptor agonist with demonstrated cardiovascular benefit may be considered for additive reduction of the risk of adverse cardiovascular and kidney events.
👉 In people with type 2 diabetes and established heart failure with either preserved or reduced ejection fraction, an SGLT2 inhibitor (including SGLT1/2 inhibitor) with proven benefit in this patient population is recommended to reduce the risk of worsening heart failure, cardiovascular death, to improve symptoms, physical limitations, and quality of life.
👉For people with type 2 diabetes hospitalized with heart failure, it is recommended that an SGLT-2 inhibitor be initiated or continued during hospitalization and upon discharge, if there are no contraindications and after recovery from the acute illness.
How and When to use SGLT-2 Inhibitors?
Continued 👇👇👇👇👇👇 | 308 |
| 19 |  Comparison of Therapies for Type 2 Diabetes Added to Metformin.
https://t.me/HFSUHDIC | 383 |
| 20 | OVERVIEW OF DIGOXIN TOXICITY
👉Acute digitalis toxicity can result from unintentional, suicidal, or homicidal overdose of the digitalis preparation digoxin, or accidental ingestion of plants that contain cardiac glycosides.
👉Chronic toxicity in patients on digoxin therapy may result from deteriorating renal function, dehydration, electrolyte disturbances, or drug interactions.
SIGN AND SYMPTOMS
👉Digitalis toxicity produces CNS, visual, GI, and cardiac manifestations. Nausea, vomiting, and drowsiness are among the most common extracardiac manifestations.
ELECTROLYTE
👉In acute toxicity, hyperkalemia is common
👉Chronic toxicity is often accompanied by hypokalemia and hypomagnesemia
ELECTROCARDIOGRAPHY
👉Digoxin toxicity may cause almost any dysrhythmia
👉Classically, dysrhythmias associated with increased automaticity and decreased AV conduction occur.
👉Sinus bradycardia and AV conduction blocks are the most common ECG changes in the pediatric population, while ventricular ectopy is more common in adults.
👉Nonparoxysmal atrial tachycardia with heart block and bidirectional ventricular tachycardia are particularly characteristic of severe digitalis toxicity.
MANAGEMENT
👉The best way to guide therapy is to follow the digoxin level and correlate it with serum potassium concentrations and the patient's clinical and ECG findings.
General supportive care and overall management considerations of digitalis toxicity includes the following:
👉Hydration with IV fluids
👉Oxygenation and support of ventilatory function
👉Discontinuation of the drug, and, sometimes, the correction of electrolyte imbalances
👉GI decontamination.
👉Treatment of electrolyte imbalance
👉Digoxin immune Fab
👉Management of dysrhythmias
Reference & detailed information👇
Digitalis Toxicity: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/154336-overview#a1
https://t.me/HFSUHDIC | 401 |
