Piperacillin/tazobactam-induced coagulopathy in a patient through a vitamin K-dependent mechanism
European Journal of Hospital Pharmacy
Case report describes 70-year-old female patient whose INR increased following piperacillin/tazobactam (PTZ). Coagulopathy was reversed with vitamin K, suggesting PTZ can induce coagulopathy through a vitamin K-dependent mechanism.
DTB Select: DOAC dose adjustment in renal impairment
Drug and Therapeutics Bulletin
Commentary and context are provided for a US registry-based study (n=6,682) which found that of the 4% of people treated with a DOAC who met the criteria for a dose reduction, only 20% of them had an appropriate dose adjustment.
Journal of the American Medical Association
RCT (n=3056) found composite endpoint of major bleeding and CV and cerebrovascular events was less frequent with ticagrelor monotherapy vs dual therapy with aspirin (3.9% vs 5.9%, HR 0.66, p=0.01) but lower than expected event rates should be considered when interpreting results.
The Lancet
This RCT in adults with severe GI bleeding (n=12,009) found no difference between tranexamic acid and placebo in death due to bleeding within 5 days (4% v 4%; RR 0.99; 95% CI 0.82-1.18) with a higher risk of VTE events (1.85; 95% CI 1.15-2.98) and seizures (1.73; 1.03-2.93).
Circulation
Meta-analysis of 5 RCTs (n=32,145) found discontinuation of aspirin therapy 1-3 months post PCI reduced major bleeding risk vs continued dual antiplatelet therapy (1.97% vs 3.13%; HR 0.60, 95% CI 0.45-0.79), with no observed increase in MACE (2.73% vs 3.11%; HR 0.88, 0.77-1.02).
The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:
http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services