Josh Jacobs
@joshjpharmd.bsky.social
Cardiovascular Medicine Clinical Pharmacist | Aspiring Clinician-Scientist - Cardiovascular Disease, Pharmacotherapy Optimization, Health Services Research
It’s wild how everyone determines their initial diuretic dosing. Crazy to think we still don’t know what’s best with all the data that exists out there. We tried looked at “optimal” initial dosing as 2x the home dose here: www.jacc.org/doi/10.1016/...
Optimal Initial Intravenous Loop Diuretic Dosing in Acute Decompensated Heart Failure:
www.jacc.org
January 4, 2025 at 4:54 PM
It’s wild how everyone determines their initial diuretic dosing. Crazy to think we still don’t know what’s best with all the data that exists out there. We tried looked at “optimal” initial dosing as 2x the home dose here: www.jacc.org/doi/10.1016/...
Dr. Cornelio discusses strategies for how to deprescribe
Some include CDS 💻 & patient decision aids/education 📚
Some include CDS 💻 & patient decision aids/education 📚
November 17, 2024 at 5:02 PM
Dr. Cornelio discusses strategies for how to deprescribe
Some include CDS 💻 & patient decision aids/education 📚
Some include CDS 💻 & patient decision aids/education 📚
Dr. Mehling offers insight into truly how toxic NSAIDs are
- 3x 🫀dz risk
- ⬆️ SBP by 14 mmHg
- 3x 🫀dz risk
- ⬆️ SBP by 14 mmHg
November 17, 2024 at 5:02 PM
Dr. Mehling offers insight into truly how toxic NSAIDs are
- 3x 🫀dz risk
- ⬆️ SBP by 14 mmHg
- 3x 🫀dz risk
- ⬆️ SBP by 14 mmHg
Dr. Orkaby up next with a geriatrician viewpoint!
- We prescribe complex and overwhelming “guideline-based regimen” for patients
- Careful about the prescribing cascade
- we do have a framework for de-prescribing in 🫀💊 to help cardiology clinicians
- We prescribe complex and overwhelming “guideline-based regimen” for patients
- Careful about the prescribing cascade
- we do have a framework for de-prescribing in 🫀💊 to help cardiology clinicians
November 17, 2024 at 5:02 PM
Dr. Orkaby up next with a geriatrician viewpoint!
- We prescribe complex and overwhelming “guideline-based regimen” for patients
- Careful about the prescribing cascade
- we do have a framework for de-prescribing in 🫀💊 to help cardiology clinicians
- We prescribe complex and overwhelming “guideline-based regimen” for patients
- Careful about the prescribing cascade
- we do have a framework for de-prescribing in 🫀💊 to help cardiology clinicians
3️⃣ not clear outcomes or great evidence in de-prescribing so far - huge need for future methodology and research
Some potential high-value targets do exist though!
Some potential high-value targets do exist though!
November 17, 2024 at 5:02 PM
3️⃣ not clear outcomes or great evidence in de-prescribing so far - huge need for future methodology and research
Some potential high-value targets do exist though!
Some potential high-value targets do exist though!
Now Dr. Hernandez talks about some potential issues with de-precribing. Will we make it worse??💊
1️⃣ trust in science 🧪🔬- it’s worsening over time and pretty low in the US
2️⃣ will sending mixed messages delay or prevent important med use like GDMT in HFrEF
1️⃣ trust in science 🧪🔬- it’s worsening over time and pretty low in the US
2️⃣ will sending mixed messages delay or prevent important med use like GDMT in HFrEF
November 17, 2024 at 5:02 PM
Now Dr. Hernandez talks about some potential issues with de-precribing. Will we make it worse??💊
1️⃣ trust in science 🧪🔬- it’s worsening over time and pretty low in the US
2️⃣ will sending mixed messages delay or prevent important med use like GDMT in HFrEF
1️⃣ trust in science 🧪🔬- it’s worsening over time and pretty low in the US
2️⃣ will sending mixed messages delay or prevent important med use like GDMT in HFrEF
What are potential targets in CVD?
- ASA with AC
- HF-exacerbating 💊 (NSAIDs, TZDs)
- Inappropriate DOAC dosing
- 💊 w/o indications (ex: nitrates for angina post PCI, or even BB in HFpEF?)
- 💊 w/ low likelihood of benefit (ex: palliative care)
- ASA with AC
- HF-exacerbating 💊 (NSAIDs, TZDs)
- Inappropriate DOAC dosing
- 💊 w/o indications (ex: nitrates for angina post PCI, or even BB in HFpEF?)
- 💊 w/ low likelihood of benefit (ex: palliative care)
November 17, 2024 at 5:02 PM
What are potential targets in CVD?
- ASA with AC
- HF-exacerbating 💊 (NSAIDs, TZDs)
- Inappropriate DOAC dosing
- 💊 w/o indications (ex: nitrates for angina post PCI, or even BB in HFpEF?)
- 💊 w/ low likelihood of benefit (ex: palliative care)
- ASA with AC
- HF-exacerbating 💊 (NSAIDs, TZDs)
- Inappropriate DOAC dosing
- 💊 w/o indications (ex: nitrates for angina post PCI, or even BB in HFpEF?)
- 💊 w/ low likelihood of benefit (ex: palliative care)
Dr. Goyal talks about complications from polypharmacy 💊💊💊
- Adherence, ADRs, and lack of optimization, especially GDMT in HFrEF 🫀
- Need to focus on practical prescribing ⬆️ and de-prescribing ⬇️ rules
- Adherence, ADRs, and lack of optimization, especially GDMT in HFrEF 🫀
- Need to focus on practical prescribing ⬆️ and de-prescribing ⬇️ rules
November 17, 2024 at 5:02 PM
Dr. Goyal talks about complications from polypharmacy 💊💊💊
- Adherence, ADRs, and lack of optimization, especially GDMT in HFrEF 🫀
- Need to focus on practical prescribing ⬆️ and de-prescribing ⬇️ rules
- Adherence, ADRs, and lack of optimization, especially GDMT in HFrEF 🫀
- Need to focus on practical prescribing ⬆️ and de-prescribing ⬇️ rules
Lots of tools to help with de-prescribing. But where is the sweet “Goldilocks” spot? We don’t quite know yet
November 17, 2024 at 5:02 PM
Lots of tools to help with de-prescribing. But where is the sweet “Goldilocks” spot? We don’t quite know yet