For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Anticoagulation with a mitral valve mechanical replacement
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In print
Heartbeat
Anticoagulation with a mitral valve mechanical replacement
Wednesday 30 August 2017, 10:54 AM
The ECG shows atrial fibrillation, a normal axis and a heart rate of 86 beats/minute, without other significant changes
A working mother visits for a medications review. Cardiologist Chris Ellis explains her INR test result, her anticoagulation and the need for well-funded rheumatic fever prevention strategies
A 46-year-old New Zealand-born female of Samoan ethnicity comes in for a review and her normal prescription. She takes warfarin 6mg, diltiazem CD 120m
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
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References
1. Cardiac Society of Australia and New Zealand and the Heart Foundation of New Zealand. The New Zealand guidelines for rheumatic fever: 2014 update. Available at www.heartfoundation.org.nz (100 pages)
2. Woulfe C. Fever pitch. New Zealand Listener, 21 July 2017.