Why I like Warfarin and Why You Should too

I am aware the love for Novel Oral Anticoagulants (NOACs) is growing and that warfarin is falling out of favour, especially in the setting of stroke prevention in atrial fibrillation or in the management of venous thromboembolism.  But hear me out on this one. Warfarin should stay and here’s why.

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Single Pill Combination for Hypertension

This year for Hypertension Awareness Month and World Hypertension Day (May 17), I want to discuss about the role of single pill combination in the management of hypertension.  Single Pill Combination has been consistently recommended in various Hypertension Guidelines to assist with blood pressure control.  However, there is no great resource to guide available options of single pill combination in Ontario.

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Talk Diabetes 2018 – Part I

Talk Diabetes 2018 was an education event presented by The Diabetes Education and Management Centre of Kingston Health Sciences Centre – Hotel Dieu Site on May 11, 2018. It was a day packed with many valuable contents to be shared among health care professionals looking for an updates in diabetes, especially with the recent release of the 2018 Diabetes Canada Clinical Practice Guidelines.  Here are some notes I took:

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SUSTAIN-6: Another Medication for Diabetes with Cardiovascular Benefits?

Semaglutide (Ozempic) recently received its Notice of Compliance from Health Canada and is therefore now available for Canadians with Type 2 diabetes. So it only makes sense to take a closer look at its evidence, particularly the evidence for its cardiovascular benefits which was studied in SUSTAIN-6 and published in New England Journal of Medicine in 2016..

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Romosozumab – Results from the ARCH Trial

After the introduction of denosumab few years ago, another monoclonal antibody is making its way in the market for osteoporosis treatment – romosozumab.  While denosumab is a RANKL inhibitor which inhibits osteoclast activity and bone resorption, romosozumab targets and inhibits sclerotin, thereby increasing the osteoblast activities and bone formation.  The ARCH study was recently published in the New England Journal of Medicine; this study has highlighted both the benefits of romosozumab in the treatment of osteoporosis as well as its potential safety concerns in cardiovascular health.

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The Cardiovascular Risk Associated with the Use of Long Acting Bronchodilators

It seems the pendulum is always swinging back and forth with the management of COPD. Few years ago, we have pulled away from the use of high dose inhaled corticosteroids when we found its association with increased risk of pneumonia and related mortalities. Here’s my post on this topic. And thus, the treatment strategy has shifted to using more long acting bronchodilators. These bronchodilators include LABA (long acting beta agonist) and LAMA (long acting muscarinic antagonist).

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