Drug & Disease Updates
Readers’ Favorites: Most Popular DocAlert Messages of 2011
FDA MedWatch Alerts
The Flu and You: Why and How to Get Healthcare Personnel Vaccinated
Clinical Tip of the Month
An Integrated EHR and PM for Small Practices
App Directory
Updating Your Formulary Information
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What's This Disease?

Daylight hours grow shorter and the smell of hearth fires abound. As 2011 draws to a close, we gather to share with you our year-end favorites.

Dr. Meneghetti’s compilation of most-popular DocAlert messages reveals a fascinating constellation of current health concerns, discoveries, and treatment trends. Read on as Joshua L. Conrad, Pharm.D describes “hidden gems”—useful Epocrates app features you may not know of. Plus, learn about EHR and Practice Management, the advantages of flu vaccination for healthcare professionals and more.

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Clinical Editorial

Readers’ Favorites: Most Popular DocAlert Messages of 2011
Anne Meneghetti, MD
Director, Clinical Communications, Epocrates

The medical news tells a different story unique to each year. In 2011, hot topics in DocAlert messages included guidelines for cardiovascular disease prevention and treatment as well as CDC updates on STDs and immunizations. Two areas of ongoing controversy made the list: PSA testing and Vitamin D recommendations. Epocrates DocAlert readers typically enjoy messages about the health benefits of chocolate; this year, the effects of alcoholic drinks on heart disease biomarkers edged out a message chocolate’s effect on cardiometabolic disorders. As newer devices support better graphics displays, we have discovered that our readers enjoy picture quizzes, so we will keep these coming in 2012!

Here are your favorite DocAlert messages of the year, with the content source:

   •   New CDC 2010 STD Treatment Guidelines (CDC)
   •   AHA/ACC Guideline Update: Cardiovascular Risk Assessment in Asymptomatic Adults (Cardiosource and Journal Watch)
   •   New ACC Guidelines for Unstable Angina/Non-ST-Elevation Myocardial Infarction: 10 Points to Remember (Cardiosource)
   •   Picture Quiz DocAlert Messages: (BMJ):
   •   Unusual Gum Lesion, Abnormal Chest CT,
   •   A Pruritic Rash in Pregnancy
   •   Rusty Joints
   •   Clinical Guidelines for Pharmacological Prevention of Migraine (BMJ)
   •   Updated Vitamin D and Calcium Recommendations (McGraw-Hill/Access Medicine)
   •   Journal Watch General Medicine 2010 Readers' Picks (Journal Watch)
   •   Management of Abdominal Pain, Bloating, and Diarrhea in Patients With Inflammatory Bowel Disease (BMJ)
   •   CDC Adult Immunization Schedule Update 2011 (CDC)
   •   Statins Do Not Help Evade Myocardial Infarction When HDL Cholesterol Is Low (BMJ)
   •   What Is the Valuable Tool to Identify a Patient's Decision-Making Capacity? (Journal Watch)
   •   Evolving Opioid Demographics and Prescribing Safety Guidelines (CDC)
   •   Prostate-Specific Antigen Screening: Imperfections, Expense, and Effect on Mortality (Journal Watch)
   •   Effect of Alcohol Consumption on CHD Biological Markers: Beer, Wine, or Spirits? (BMJ)
   •   Should Statins Be Given to Patients With Fatty Liver Disease and Mildly Elevated Transaminases? (Journal Watch)

With newer platforms like iPhone, readers can easily share DocAlert messages with friends and colleagues. We always welcome hearing your feedback about our DocAlert messaging service.

You are warmly invited to email your insights and comments to docalert@epocrates.com. Let us know what you would like to hear about through DocAlert messages in 2012.

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Drug and Disease
Reactive arthritis
Erythema multiforme
Evaluation of breast mass
Evaluation of acute motor deficit
Stable ischemic heart disease
Measles infection
Overview of acid-base and electrolyte disorders
Thyroid function testing
drug updates
caffeine citrate
(generic for Cafcit)
Doan’s Extra Strength
(magnesium salicylate)
(generic for Dopram)
(asparaginase Erwinia chrysanthemi)
fluocinolone otic
(first-time generic for DermOtic)
(etonogestrel subdermal implant)
(first-time generic for Nor-QD)
norethindrone/ethinyl estradiol
(first-time generic for Femcon Fe)
(nystatin topical)
Ovace Plus
(sulfacetamide topical)
Percogesic Maximum Strength Backache Relief
(magnesium salicylate)
tranexamic acid (first-time generic for Cyklokapron)

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FDA Medwatch Safety Alerts

Prescription drugs: Trilipix (fenofibric acid): May not lower risk of heart attack or stroke. Stimulants: FDA study did not find an association between certain ADHD medications and adverse cardiovascular events. TNF blockers, azathioprine, and/or mercaptopurine: Healthcare professionals should remain vigilant for cases of hepatosplenic T-cell lymphoma and report them to MedWatch. Xigris [drotrecogin alfa (activated)]: Withdrawn for failing to show a survival benefit for patients with severe sepsis and septic shock. Drospirenone: FDA report suggests a link between drospirenone-containing birth control pills and blood clot risk.

OTC products: Virility Max: Contains an undeclared drug ingredient, sulfoaildenafil, an analog of sildenafil, which is an active ingredient of an FDA-approved drug for erectile dysfunction.

Medical devices: CareFusion EnVe Ventilators: Potential for interrupted ventilation. Mizuho OSI Modular Table Systems: Reports of patient injury. ShoulderFlex Massager by King International: Risk of strangulation.

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Joshua L. Conrad, Pharm.D.
Managing Editor, Medical Information, Epocrates

Newer mobile operating systems are more flexible than ever before, allowing us to add functionality that our users have long requested. Since the theme of this month’s Pulse is “the best of”, I thought I’d use the opportunity to highlight my pick for the three best features of Epocrates on iOS and Android devices that you might not know existed. I hope you find these hidden gems helpful.

Add to InteractionCheck
Location: bottom leftmost icon on drug monograph (iOS); bottom of drug monograph section list (Android)
Function: opens InteractionCheck feature and adds the current drug to the list
Utility: when you decide to prescribe the drug, quickly add it to InteractionCheck to check drug interactions against the patient’s current medications

Home Button
Location: top right corner (iOS) or bottom
right corner (Android) on almost every screen in Epocrates
Function: takes you to the main Epocrates Home page, where you can start new searches or open new features
Utility: quickly multitask between different sections of Epocrates

Lab Interpretation
(Epocrates Essentials only)

Location: under the Interpretation section of any Lab monograph
Function: lists potential causes for abnormal laboratory test results, including drug causes and links to these monographs
Utility: quickly see a list of potential causes for your patient’s lab abnormality

Let us know what your favorite Epocrates hidden gem is or suggest a new one at suggestionbox@epocrates.com.

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The Flu and You: Why and How to Get Healthcare Personnel Vaccinated
Anju Goel, MD, MPH
Physician Editor, Medical Information

3 Reasons for Healthcare Personnel (HCP) to Get Vaccinated Against Flu:

        1. It reduces transmission of flu to HCP, their families and their patients.
        2. It reduces HCP absenteeism by 22-52%.
        3. It decreases long-term care facility patient flu mortality by 42-44%.

3 Steps for Healthcare Facilities to Increase HCP Flu Vaccination Rates:

        1. Offer free vaccination onsite for multiple days.
        2. Personally remind employees to get vaccinated.
        3. Require employees to get vaccinated.

All HCP are advised to receive flu vaccine annually. The CDC estimated that 63.5% of HCP were vaccinated in the 2010-11 flu season. Learn More


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