How steroids affect our blood gluocse?

Steroids are divided into glucocorticosteroid and mineralocorticosteroid (refer table below).

From the name, glucocorticosteroid, the word "gluco-" tells us that this group of steroid can affect glucose level. The glucocorticosteroid can cause hyperglycemia.

·         The effect is dose dependent.

·         From a clinical standpoint, corticosteroids primarily increase postprandial blood glucose levels, whereas fasting levels are unaffected or only mildly elevated.

·         Dexamethasone & betamethasone elevate blood glucose more (25x of the elevation caused by hydrocortisone), followed by fludrocortisone (10 x), triamcinolone &methyl-prednisolone (5 x), prednisolone & prednisone (4 x) if compared with hydrocortisone. * Based on their glucocorticoid potency.

Content of elemental iron in different iron formulation

*Please note that Iberet Folic 500 contains other vitamin as well.


This information is useful if your prescriber in your facility prescribes an iron formulation which is not available in your facility, then you can choose an alternative iron formulation with equivalent dose of elemental iron after discussed with your prescriber.


P/s: this information is just for sharing purpose.

Interaction between PPI and clopidogrel

Here, I have read a good article which I would like to be share:
Issue regarding interaction between PPI and clopidogrel.

It's often that we will see clopidogrel is given together with PPI, but the concern is the interaction. If you check in the micromedex, the interaction is major.

Is the interaction really an issue? This article is a latest clinical study (2012) carried out to study the interaction between these 2 groups of medications. The conclusion of this study suggested that the interaction between proton pump inhibitors and clopidogrel is clinically unimportant.

http://www.bmj.com/content/345/bmj.e4388.pdf%2Bhtml

This article may be helpful when your prescriber queries about this issue.

 

Anyway, in practice, we can counsel patient to seperate the administration of these 2 medications, one in the morning, the other one in the evening.

P/s: this is for sharing purpose.

Mean Plasma glucose to HbA1c conversion

Is your facility encounter the problem of not having HbA1c testing? Well, there is a method which can be employed to estimate your patient HbA1c percentage based on average (mean) plasma glucose.

This is the conversion chart which you can refer to.

This chart is based on a formula:

HbA1c = [Mean plasma glucose (mmol/L) + 4.29]

                                        1.98

In order for you to remember the formula easily, you can actually use a simpler formula:

HbA1c = [Mean plasma glucose (mmol/L) + 5]

                                        2

Bear in mind, this is just an estimation.