#40 Prescribing Meds Day vs. Night Part 1: Mind the Gap Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 8 May 2019

⏱️ 20 minutes

🔗️ Recording | iTunes | RSS

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Summary

Dive deeper into why we prescribe medications in the morning vs. at night ! * Why do we dose warfarin at night? (2:45) * Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28) * Practical matters - so what should we tell patients (6:14) * Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32) * The surprising link between dipping and cardiovascular outcomes (11:15) * Timing is everything… or is it? The evidence behind taking BP meds at night (11:58) * Review of teaching points (15:58) What is your prescribing practice with blood pressure medications? Leave a comment (https://www.coreimpodcast.com/2019/05/08/medications-daytime-vs-nighttime-part-1/), tweet (https://twitter.com/COREIMpodcast) us or share with us on instagram (https://www.instagram.com/core.im.podcast/) or facebook (https://www.facebook.com/COREIMpodcast/) on how you dose BP meds? Transcript with references and show notes (https://www.coreimpodcast.com/2019/05/08/medications-daytime-vs-nighttime-part-1/) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	So Janine, I have a really cool fact for you and of all things it's actually about
0:05.9	warfarin.
0:06.9	Wait is this like a cool cool fact Steve or a nerdy cool fact?
0:10.6	That's totally a cool cool fact.
0:13.0	Uh-huh. Well, if it's about how Warfarin was named after the Wisconsin Alumni Research Foundation,
0:18.0	I've heard that one before, probably from Marty Freed, actually.
0:21.0	No, Janine, that's old news because Marty's already
0:23.6	tried to convince me that Bucky the Badger came up with it. No this is about
0:27.3	war for endosing. Did you know that you actually don't need to dose it at night?
0:31.1	Wait really? You mean all those default order sets
0:33.7	I put in as a resident?
0:34.8	We're totally wrong?
0:36.2	Well, not wrong, wrong, but kind of wrong.
0:40.4	It's kind of overkill.
0:41.7	Okay, stop. But before we talk anymore about warfarin we should really slow down. With all these doax out now I feel like med students these days rarely see warfarin anymore.
0:50.4	Yeah, but don't worry Janine I'm well prepared. I was just at
0:53.6	SHM and they had a workshop for how to teach millennials medicine and well we
0:58.0	recognize that a lot of you guys out there are millennials. Actually we are two steels.
1:02.0	Wait what?
1:03.0	I mean, technically.
1:04.0	So you're telling me I learned how to teach myself.
1:07.0	Yes, super meta.
	...

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