Textbook Error: The book lists Xarelto under the antiplatelet section in the table on page 418. It is not an antiplatelet drug. It is an anticoagulant, as mentioned on page 416.
Textbook Error: In Chapter 18, page 423, 2nd paragraph, the book reads, “Inhibitors of CYP 1A2, 2C9, or 3A4 isoenzymes increase the effect of warfarin. Inhibitors of CYP 1A2,2C9, or 3A4 decrease the effectiveness of warfarin.” It should read, “Inhibitors of CYP 1A2, 2C9, or 3A4 isoenzymes increase the effect of warfarin. Inducers of CYP 1A2,2C9, or 3A4 decrease the effectiveness of warfarin.”
Update: Your textbooks says that there is no antidote for dabigatran (Pradaxa) overdose. The FDA approved idarucizumab (Praxabind) in October, 2015.
Textbook Omission: There is some important information about dabigatran that your textbook fails to mention. Because it disintegrates rapidly, patients should be notified to:
Keep it in the specially designed bottle. It has specialized diskette to inhibit disintegration.
Do not put the tables in a pillbox or medication organizer. (Suggest that they put an M&M or other small candy in the organizer as a reminder to take pradaxa.)
Discard tablets 120 days after opening. (If prescribed appropriately and if taken as prescribed, this should not be a problem.)
Each year in January, the American Diabetes Association releases new guidelines. In the Standards of Care for Diabetes – 2020, section 9 Pharmacologic Approaches to Glycemic Treatment at https://care.diabetesjournals.org/content/diacare/43/Supplement_1/S98.full.pdf please read the sections on Noninsulin Treatment for Type 1 Diabetes and Pharmacologic Therapy for Type 2 Diabetes. Both are on page S101.
Not attached, see link
Textbook Error: In Chapter 33 page 998 it says, “Insulin production is necessary for metformin to be effective.” Insulin does not have to be produced by beta cells; it can be provided from an exogenous source. Although metformin does not currently have FDA approval for management of type 1 DM, it has been used in research for management of type 1 DM. You can read about this in the ADA guidelines for DM management.
Update: First-generation sulfonylureas have been discontinued in the U.S.
Side note: An important item that I am not finding in your readings is this: Sulfonylureas lose their effectiveness over time. After 10 years of therapy, only 50% of patient who responded well initially will have adequate glycemic control. For a large number of patients, this decline in efficacy occurs much sooner.
A Note: On page 998 in your text, 2nd paragraph under Biguanides, reads, “Insulin production is necessary for metformin to be effective” which is sort of correct; however, when exogenous insulin is given, this is no longer true. Although metformin does not currently have FDA approval for management of type 1 DM, it has been used in research for management of type 1 DM.
Chapter 44 – Sexually Transmitted Infections and Vaginitis
Chapter 47 – Urinary Tract Infections
Chapter 48 – Women as Patients (PP not attached, refer to chapter)
Chapter 49 – Men as Patients (PP not attached, refer to chapter)
Chapter 22 Omission: Chapter 22 doesn’t mention that finasteride is a teratogen (perhaps because the focus in this chapter is on BPH which, of course, doesn’t afflict women). The reason this is important is because pregnant women shouldn’t even handle these drugs.
Here is the excerpt from the derm module where it is discussed related to management of baldness. “Finasteride should be prescribed with caution in patients with hepatic dysfunction because the drug is metabolized extensively in the liver. It causes a decrease in serum prostate specific antigen (PSA) levels, even in the presence of prostate cancer. It is Pregnancy Category X. Finasteride exposure during pregnancy, even in small quantities, may produce abnormalities of the external genitalia in male offspring. Pregnant women or a woman planning a pregnancy should not handle crushed tablets. Finasteride may be potentially absorbed from the semen. When a male patient’s sexual partner is pregnant or may become pregnant, the patient should either avoid exposing his partner to his semen or discontinue finasteride.” (Woo & Robinson page 988)