Levothyroxine is one of the most common medications that I see used in my everyday practice. I’ve definitely seen a fair share of mistakes with levothyroxine. Here’s a few common ones that come to mind. Dosing levothyroxine based upon TSH is...
Polypharmacy is a big topic in geriatrics. In the case below, I provide an example of diabetes medications and how we can try to minimize medications. Specifically, I look at the use of sulfonylureas with long acting insulin. An 88 year old female with a past...
As many of you well know, I work closely with a lot of folks in the long term care business. Insulin errors can be one of the scariest errors that can happen. Here’s a case scenario I don’t like seeing happen, but have unfortunately seen it a few times....
What to do with an A1C ? For the experienced clinician, this is a very simple question, but I occasional see orders for A1C’s at a rate more frequently than every three months. Remember that it is basically an average blood sugar over a period of approximately...
88 y/o with a history of depressive type symptoms was placed on an antidepressant to manage symptoms shortly after admission to a long term care facility. This particular patient was trialed on Zoloft (sertraline) and then transitioned to Cymbalta (duloxetine),...
A patient’s A1C was chronically high at around 9.0 with poor diet compliance. They were already reciving a fairly high dose of a sulfonylurea (glipizide) – remember that sulfonylureas stimulate the release of insulin. They were also on metformin 1000 mg...
