ASCP10-Don’t use strong CYP3A4 and P-glycoprotein inhibitors or inducers with Direct Oral Anticoagulants (DOACs) and periodically assess the medication regimen for such drug-drug interactions. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP9-Don’t prescribe tramadol for older adults without due consideration of the potential risks and harms related to serotonergic excess, seizures, falls and drug-drug interactions. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP8-Don’t combine opioids with benzodiazepines or gabapentinoids to treat pain in older adults and re-evaluate routinely for deprescribing during chronic use. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP7-Don’t use three or more CNS-active medications (antidepressants, benzodiazepines, Z-drugs, opioids, gabapentinoids, antipsychotics, antiepileptics), especially in older adults. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP6-Don’t prescribe or routinely continue medications for older adults with limited life expectancy without due consideration to individual goals of care, presence of comorbidities and time-to-benefit for preventive medications. Posted June 8th, 2022 by Nick Mackara & filed under .
SHMAM11-Do not routinely prescribe VTE prophylaxis to all hospitalized patients; use an evidence-based risk stratification system to determine whether a patient needs VTE prophylaxis. If they do warrant prophylaxis, use a bleeding risk assessment to determine if mechanical rather than pharmacologic prophylaxis is more appropriate. Posted May 31st, 2022 by Nick Mackara & filed under .
SHMAM10-Don’t order daily chest radiographs in hospitalized patients unless there are specific clinical indications. Posted May 31st, 2022 by Nick Mackara & filed under .
SHMAM9-Don’t order creatine kinase (CK) or Creatine Kinase-Myocardial Band (CK-MB) in suspected Acute Coronary Syndrome or Acute Myocardial Infarction. Posted May 31st, 2022 by Nick Mackara & filed under .
SHMAM8-Don’t wake patients at night for routine care; redesign workflow to promote sleep at night. Posted May 31st, 2022 by Nick Mackara & filed under .
SHMAM7-Don’t maintain a peripheral capillary oxygen saturation (SpO2) of higher than 96% when using supplemental oxygen, unless for carbon monoxide poisoning, cluster headaches, sickle cell crisis, or pneumothorax. Posted May 31st, 2022 by Nick Mackara & filed under .
SHMAM6- Avoid using opioids for treatment of mild, acute pain. For moderate to severe acute pain, if opioids are used, it should be in conjunction with non-opioid methods with the lowest effective dose for the shortest required duration. Posted May 31st, 2022 by Nick Mackara & filed under .
ASRM11-Don’t use tests of ovarian reserve (oocyte quantity measures such as AMH or FSH levels) to judge a woman’s reproductive potential (whether someone is likely or unlikely to become pregnant). Posted March 31st, 2022 by Nick Mackara & filed under .
AMSSM8-Consider evaluating rotator cuff tears with ultrasound before ordering an MRI. Posted March 29th, 2022 by Nick Mackara & filed under .
AMSSM7-Do not order ankle or midfoot X-rays for patients older than 6 years old without positive criteria per the Ottawa ankle rules. Posted March 29th, 2022 by Nick Mackara & filed under .
AMSSM6-Do not forget to routinely assess activity levels and recommend appropriate physical activity to your patients. Posted March 29th, 2022 by Nick Mackara & filed under .
