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Writer's pictureDr. Chris Le
May 10, 2020

Spending Wisely by Choosing Wisely | Clinical Pearls

Title: Spending Wisely by Choosing Wisely

Presenter(s): Dr. Michael Kolber and Tony Nickonchuk

Date: March 7, 2020

PEARL: Summary of 6 Prescribing Wisely Interventions

  • All PPIs the same efficacy

  • ACEi: use ramipril or lisinopril to save cost

  • Stop prescribing DPP4s, no significant patient-oriented outcomes: linagliptin (Trajenta), saxagliptin (Onglyza), sitagliptin (Januvia)

  • Use NPH for long-acting insulin rather than Lantus, less expensive, non-inferior

  • Use Symbicort instead of Advair, less expensive

PEARL: Alberta Health's Maximum Allowable Cost Policy, i.e. start here for lowest cost

  • ACE: ramipril, lisinopril

  • CCB: amlodipine

  • Statin: rosuvastatin, atorvastatin

  • PPI: pantoprazole magnesium, rabeprazole sodium


DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

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Writer's pictureDr. Chris Le
May 10, 2020

What Family Doctors Need to Know to Provide Excellent Palliative Care | Clinical Pearls

Updated: May 15, 2020

Title: What Family Doctors Need to Know to Provide Excellent Palliative Care

Presenter: Dr. Aynharan Sinnarajah

Date: March 6, 2020

PEARL: Dyspnea, non-pharmacologic

  • Often not associated with SpO2

  • Fan, cool air, focus on anxiety

PEARL: Opioid pharmacology

  • Time to maximal plasma concentration: 6 min (IV), 30 mins (SC/IM), 60 min (PO/PR)

  • T1/2 = 3-4 hours

PEARL: Opioid rotation

  • Note that data is based on healthy patients, so consider stepping down 30% for palliative patients

DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

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Writer's pictureDr. Chris Le
May 10, 2020

Dyspareunia & Chronic Pelvic Pain | Clinical Pearls

Updated: May 15, 2020

Title: Dyspareunia & Chronic Pelvic Pain

Presenters: Dr. Annick Poirier and Dr. Erin Kelly

Date: March 6, 2020

PEARL: Vulvar hygiene

  • Don't be shy to ask if there's anything PV

PEARL: Pelvic floor physiotherapy

  • It works, and it's available in community

PEARL: local medications

  • Remember to use locally, so PV and PR

PEARL: topical medications

  • Esp. Useful for pudendal neuropathy or vulvodynia

DISCLAIMER: This post contains my interpretation of the presentation. This post is not intended as medical advice. If you have medical concerns, contact a health care provider for assessment. If there are any copyright concerns, please contact me directly to remove the relevant material.

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