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Potential Drug Interaction Between Warfarin, COVID-19 Treatment Reported

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A probable drug interaction was observed in 2 patients taking warfarin who were initiated on remdesivir and dexamethasone for the treatment of COVID-19, according to a case series recently published in the Journal of Pharmacy Practice.

The patients, a 71-year-old man and a 62 year-old-man, both on long-term warfarin therapy, presented to the emergency department with symptoms of COVID-19. Per the report, each patient’s international normalized ratio (INR) was within their specific goal and both denied any diet, lifestyle, or medication changes prior to admission.

“During admission, both patients experienced a marked elevation in INR within 24 to 48 hours of the initiation of remdesivir with dexamethasone for COVID-19 pneumonia directed therapy,” the authors reported. After several days of modification to their warfarin doses, both patients were stable enough for discharge and were counseled to continue monitoring per the instructions of their outpatient pharmacist.


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Although the exact mechanism of action resulting in the interaction between dexamethasone, remdesivir, and warfarin is unknown, the authors concluded that there is potential for interaction based on a calculated Drug Interaction Probability Scale score of 5. “This probable interaction is demonstrated by marked INR elevations within 24 to 48 hours of initiation of the combination in 2 cases with patients with historically stable INR history,” the authors stated.

Reference

Landayan RP, Saint-Felix S, Williams A. Probable interaction between warfarin and the combination of remdesivir with dexamethasone for coronavirus disease 2019 (COVID-19) treatment: A 2 case report. J. Pharm. Pract. [Published online April 5, 2021]. doi: 10.1177/08971900211008623

This article originally appeared on MPR

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Source: https://www.medicalbag.com/home/medicine/warfarin-remdesivir-dexamethasone-drug-interaction-cases/

Covid19

June 18 Web Event: Asian Immigrant Experiences with Racism, Immigration-related Fears, and the COVID-19 Pandemic

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While the country has collectively experienced health and economic difficulties with the COVID-19 pandemic, certain groups have experienced a disproportionate impact. The Asian American community has had to cope with the burden of pandemic-related racism and, as one of the fastest growing immigrant communities in the nation, immigration-related fears due to policy and regulatory action of recent years. Yet, there is often limited data and focus on the experiences of the expanding Asian immigrant community. KFF is hosting a June 18 public web event to highlight and discuss the complex set of challenges facing Asian immigrants and strategies to address them.

The one-hour interactive web event begins at 12 p.m. ET on Friday, June 18, featuring remarks from U.S. Congresswoman Judy Chu, who has been a leading voice on many of the issues to be discussed and chairs the Congressional Asian Pacific American Caucus. Findings from a new KFF survey of Asian American patients from four community health centers will be released at the event with a panel discussion and audience questions to follow.

Welcome and Keynote Remarks

  • KFF Executive Vice President for Health Policy Larry Levitt (moderator)
  • U.S. Congresswoman and Chair of Congressional Asian Pacific American Caucus The Honorable Judy Chu
  • Chief Program Director of Blue Shield of California Foundation Carolyn Wang Kong

Presentation of Survey Findings

  • KFF Vice President and Director of the Racial Equity and Health Policy Program Samantha Artiga

Panel Discussion

  • Director of Policy and Advocacy at the Association of Asian Pacific Community Health Organizations (AAPCHO) Adam Carbullido
  • Vice President of Strategic Initiatives at International Community Health Services Sunshine Monastrial
  • Chief Deputy of Administration at Asian Health Services Thu Quach

The one-hour event will conclude with a question-and-answer session.

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Source: https://www.kff.org/racial-equity-and-health-policy/event/june-18-web-event-asian-immigrant-experiences-with-racism-immigration-related-fears-and-the-covid-19-pandemic/

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G-7 Leaders Are Set To Pledge 1 Billion Coronavirus Vaccines To Other Countries

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President Biden and British Prime Minister Boris Johnson speak during a bilateral meeting ahead of the G-7 summit on Thursday in Carbis Bay, England. Patrick Semansky/AP hide caption

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Patrick Semansky/AP

World leaders of the Group of Seven are expected to announce today a commitment to share 1 billion of their COVID-19 vaccine resources with the lower income countries struggling to control the spread of the virus.

On Thursday, President Biden announced plans for the U.S. to donate 500 million doses of the Pfizer COVID-19 vaccine globally. The first 200 million are expected to be distributed this year and the rest will follow in 2022.

“Our values call on us to do everything that we can to vaccinate the world against COVID-19,” Biden said of the decision. “It’s also in America’s self-interest. As long as the virus rages elsewhere, there’s a risk of new mutations that could threaten our people.”

Canada, France, Germany, Italy, Japan, the United Kingdom and the U.S. make up the G-7.

The move by the wealthy democracies to share their vaccine stockpiles comes as high vaccination levels in those countries have led to a decline in infections, hospitalizations, and deaths. Enough improvements have been made in the U.S. and U.K. for coronavirus-related protocols to ease.

But in South Asia and Latin America, countries are still struggling to contain the virus.

In late May, the World Health Organization urged wealthier countries to contribute more to COVAX and requested at least 1 billion excess doses by the end of 2021. The COVAX program distributes mass quantities of vaccines to countries based on their populations.

“By donating vaccines to COVAX alongside domestic vaccination programmes, the most at-risk populations can be protected globally, which is instrumental to ending the acute phase of the pandemic, curbing the rise and threat of variants, and accelerating a return to normality,” WHO said in a statement in May.

Biden and the other G-7 leaders are in the U.K. for the first meeting in about two years. The meeting is set to open today at Carbis Bay, a seaside resort in Cornwall in southwest England.

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/06/11/1005437511/g-7-leaders-to-pledge-1-billion-vaccines-to-countries-struggling-with-covid-19

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COVID-19 and heart attack risk

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COVID-19 and heart attack

Does a positive diagnosis of COVID-19 increase the risk of heart attacks for those with pre-existing atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH)?

It has been shown that higher rates of COVID-19 deaths can be associated with hypertension, heart failure, and cardiovascular disease. However, there were fewer patients reporting acute myocardial infarction (AMI), or heart attacks, when visiting hospitals during the pandemic.

Researchers from across the United States gathered the data from approximately 55 million individuals for this study. They were divided into six categories based on the information available, which included combinations of diagnosed FH, probable FH, diagnosed ASCVD, and none of the above. Differences amongst individuals were examined, and included variables such as sex, age, ethnicity, and education levels. Other diseases or medical conditions, cholesterol prescriptions, and any history of cardiac issues were all taken into account to develop a baseline for the study.

Establishing these factors and taking them into consideration accounted for any baseline differences among the participants. Those conducting the study were then able to compare the six groups, and more effectively compare who tested positive for COVID-19 among the groups, and who did not.

When testing positive for COVID-19, it was found that there was a higher risk of AMI for those individuals with both diagnosed and probable FH and those with pre-existing ASCVD. There was also a higher risk of AMI observed when compared to other COVID-19 positive patients without ASCVD or FH.

The complete medical history wasn’t available for all of the participants included in this study, resulting in some notable limitations. Individuals that had a history of ASCVD or FH may have not been placed in the correct group for comparison due to missing data.

Although many variables were taken into account to establish baseline difference amongst group members, other factors such as obesity were not considered. The researchers also investigated whether there were any correlations between lipid lowering therapies (LLT) and people with FH who did and did not test positive for COVID-19. There wasn’t a significant relationship between people taking LLT and those not, as the analyses lacked statistical power.

These findings may encourage those with ASVD and FH to receive a COVID-19 vaccination due to the increased risk of AMI. Additionally, this highlights the importance of diagnosing familial hypercholesterolemia, which could help to improve the health of the individual and providing proper treatment.

Source:

Myers, K, D., et al. (2021) COVID-19 associated risks of myocardial infarction in persons with familial hypercholesterolemia with or without ASCVD. American Journal of Preventive Cardiology. doi.org/10.1016/j.ajpc.2021.100197.

Image by PIRO4D from Pixabay 

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Source: https://medicalnewsbulletin.com/covid-19-and-heart-attack-risk/

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Hey Washingtonians! Get A Vaccine. Smoke A Joint.

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Washington is offering free, pre-rolled joints to adults who get the COVID-19 vaccine. Here, a person smokes a joint in The Netherlands. Robin Van Lonkhuijsen/AFP via Getty Images hide caption

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Robin Van Lonkhuijsen/AFP via Getty Images

Still anxious about getting the COVID-19 vaccine? Washington state is offering adults a relaxing new incentive — marijuana joints.

The program, launched by the state’s Liquor and Cannabis Board and named “Joints for Jabs,” runs until July 12 and allows state-licensed dispensaries to give qualifying customers one pre-rolled joint at an in-store vaccination clinic.

Eligible participants must be 21 years old or older and have to have received their first or second dose during that visit.

This is only the latest among Washington’s abundant vaccination incentives, which include free tickets to sports events and a lottery totaling up to $1 million. Just a few weeks ago, the Liquor and Cannabis Board announced an incentive that allows breweries, wineries, and restaurants to offer free drinks to vaccinated adults.

Washington’s newest promotion reflects a multitude of unique vaccination incentives being offered across the country, and the state isn’t the first to offer weed.

In exchange for proof of vaccination, an Arizona dispensary’s “Snax for Vaxx” campaign provides free joints and edibles. In Washington, D.C., cannabis advocacy group D.C. Marijuana Justice distributed joints at vaccination sites on April 20.

As of June 9, nearly 49% of Washington residents have been fully vaccinated.

Josie Fischels is an intern on NPR’s News Desk.

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/06/09/1004752026/washington-offers-marijuana-cannabis-vaccine

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