Results for “drug-recommendation”

Bedside prescribing reference for Bemdec (bempedoic acid / NEXLETOL) — indication check, dose, statin co-prescribing safety caps, monitoring plan, warnings for hyperuricemia and tendon rupture, and special population guidance. Use when a clinician asks "can I start bempedoic acid", "Bemdec indication", "is bempedoic acid safe with my statin", "patient on Nexletol has joint pain or high uric acid", "bempedoic acid in CKD or liver disease or pregnancy", or any prescribing or monitoring question about bempedoic acid.

Complete bedside prescribing reference for Mirago (mirabegron, beta-3 adrenoceptor agonist) for overactive bladder — covering contraindications, safety screening, drug interactions, dose selection in special populations, titration, and administration. Use when a clinician asks how to start mirabegron, what dose to use in renal or hepatic impairment, is mirabegron safe in this patient, mirabegron drug interactions, or Mirago for OAB.

Guides dose escalation for obesity pharmacotherapy based on efficacy and tolerability while staying within approved upper dose limits. Triggers include clinician questions like "How should I titrate naltrexone/bupropion if the starting dose is tolerated?" or "What is the maximum liraglutide dose I can use?"

This skill suggests using approved weight‑loss medication over no pharmacological therapy to ameliorate comorbidities and improve physical activity in adults with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one comorbid condition. It is triggered when a clinician asks, for example, 'Should I add medication to help maintain weight loss in this patient with BMI 31 and diabetes?' or 'Is pharmacotherapy appropriate for long‑term weight control in a patient with BMI 28 and hypertension?'.

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Guides choice among spironolactone, eplerenone, and esaxerenone for primary aldosteronism based on comparative efficacy, safety, and patient-specific factors. Triggers include when initiating MRA therapy and asking 'Which MRA should I prescribe?' or considering switching agents due to adverse effects, cost, or need for potassium supplementation.

Recommends using weight‑neutral antipsychotic alternatives when possible and employing shared decision‑making that provides quantitative estimates of expected weight effect to guide drug choice. Triggered when a clinician asks, “How do I involve this patient in choosing an antipsychotic with minimal weight gain?” or “What resources show weight‑change projections for risperidone vs aripiprazole?”.

Recommends weight‑losing and weight‑neutral medications as first‑ and second‑line agents for managing overweight/obese patients with type 2 diabetes. Triggers include when a clinician asks, 'Which diabetes medications will not worsen weight in this obese patient?' or 'Should I avoid sulfonylureas in this patient with T2DM and obesity due to weight gain risk?'

In patients with primary aldosteronism receiving mineralocorticoid receptor antagonist therapy, the guideline recommends titrating the MRA dose upward to raise renin when blood pressure remains uncontrolled and renin is suppressed. Consider this step when hypertension is not at goal despite MRA therapy and plasma renin activity (or direct renin concentration) is low.

Calculates the lowest effective glucocorticoid dose (dexamethasone or prednisone) to normalize blood pressure and serum potassium in glucocorticoid-remediable aldosteronism (GRA/FH-I) by titrating to biochemical and clinical targets. Indicated when initiating medical treatment for confirmed GRA, triggered by findings such as early-onset hypertension, family history of stroke before age 40, spontaneous hypokalemia, or suppressed plasma renin activity with elevated aldosterone.

Recommends ACE inhibitors, ARBs, or calcium channel blockers as first-line hypertension therapy rather than β‑adrenergic blockers in obese patients with type 2 diabetes. Triggers include when a clinician asks, 'What antihypertensive should I start for this obese patient with T2DM to avoid weight gain?' or 'Should I avoid β‑blockers in this patient with diabetes and hypertension?'

Advises against testosterone therapy in men with biochemical recurrence after prostate cancer treatment due to very limited data and potential risk of progression. Consider when a patient has a rising PSA after definitive therapy and the clinician evaluates testosterone for hypogonadism, questioning whether TTh is safe in BCR.

Assess pharmacotherapy eligibility based on BMI/comorbidity

Recommends hydrocortisone replacement dosing of 15–20 mg total daily, administered as a single dose or divided doses with the highest dose given in the morning upon awakening and the second dose in the afternoon (two-dose regimen) or second and third doses at lunch and late afternoon (three-dose regimen). Use when initiating glucocorticoid replacement for adrenal insufficiency; triggers include diagnosing adrenal insufficiency requiring glucocorticoid replacement.

Recommends a shared decision‑making process that provides patients with quantitative estimates of the expected weight effect of antidepressants to inform drug choice, also considering expected treatment length. Triggers include clinician questions such as ‘How should I discuss weight‑change risks with this patient starting an antidepressant?’ or ‘What tool can I use to show expected weight impact of sertraline vs bupropion?’.

Advises assessing efficacy and safety at least monthly for the first 3 months, then at least every 3 months for all patients prescribed weight‑loss medications. Triggers include clinician questions such as “How often should I check progress after starting orlistat?” or “What is the follow‑up schedule for a patient on liraglutide?”.

Guides comorbidity-stratified selection of initial and further glucose-lowering medicines for adults with type 2 diabetes using the NICE NG28 (2026) framework, covering six clinical profiles: no relevant comorbidity, heart failure, atherosclerotic cardiovascular disease, early onset, obesity, chronic kidney disease, and frailty.

Select oral and injectable glucose-lowering agents for a newly diagnosed patient with type 2 diabetes using a compelling-indication hierarchy (heart failure → ASCVD → DKD → obesity) followed by glucose-pattern matching. Incorporates modern GLP-1 receptor agonists — Ozempic (semaglutide SC, T2D), Mounjaro (tirzepatide), and Wegovy/Noveltreat (semaglutide 2.4 mg, obesity). Use when a clinician asks "what drug to start for newly diagnosed T2D", "which OAD to use", "first-line diabetes medication", "SGLT2i vs GLP-1 in new T2D", or presents a newly diagnosed T2D patient needing a personalised medication plan.

Suggests a 3- to 6‑month trial of testosterone dosing to achieve a mid‑normal premenopausal value in a reference assay for postmenopausal women with properly diagnosed HSDD and no contraindications. Triggered when a postmenopausal woman requests therapy for low sexual desire after appropriate HSDD workup and exclusion of contraindications.

Recommends using NSAIDs or DMARDs instead of glucocorticoids for chronic inflammatory disease (e.g., rheumatoid arthritis) to limit weight gain. Triggered when clinicians ask, “What anti‑inflammatory should I choose for this RA patient to avoid weight gain?” or “Should I avoid steroids in this obese patient with RA?”

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Recommends using mineralocorticoid receptor antagonists rather than epithelial sodium-channel inhibitors for medical treatment of primary aldosteronism. Use when a clinician asks whether to use an MRA or ENaC inhibitor for medical treatment of PA.

This skill recommends monitoring desmopressin (DDAVP) doses and adjusting them as needed in patients who have recently started antiepileptic drugs (AEDs). It is triggered when a patient initiates AED therapy and requires DDAVP management for diabetes insipidus.

This skill guides clinicians in sharing decision‑making when selecting an antiepileptic drug (AED) by providing quantitative estimates of each drug’s expected weight effect. It is triggered when a clinician asks how to discuss weight‑change risks when choosing an AED or what information to provide on weight effects of specific agents such as valproate versus lamotrigine.

Recommends mineralocorticoid receptor antagonists for all primary aldosteronism patients to prevent target organ damage, irrespective of blood pressure control or serum potassium levels. Triggered when a clinician encounters a PA patient with well‑controlled BP and normal K and wonders, 'Do I still need to treat with MRA?' or considers stopping therapy.

Medicinal chemistry filters. Apply drug-likeness rules (Lipinski, Veber), PAINS filters, structural alerts, complexity metrics, for compound prioritization and library filtering.

Determines whether to recommend unilateral laparoscopic adrenalectomy or medical therapy with a mineralocorticoid receptor antagonist for patients with confirmed unilateral PA (aldosterone-producing adenoma or unilateral adrenal hyperplasia). Triggered when discussing treatment options after confirming unilateral PA in a hypertensive patient with hypokalemia or resistant hypertension.

Applies medicinal-chemistry filters with the medchem library — drug-likeness rules (Lipinski, Veber), PAINS filters, structural alerts, and molecular complexity metrics for compound prioritization and library cleanup. Use when filtering or triaging a compound library, flagging PAINS or reactive groups, or assessing drug-likeness of candidate molecules. Part of the AlterLab Academic Skills suite.

Titrates GH replacement dose to keep IGF-1 below the upper limit of normal and reduces dose when side effects appear. Use when monitoring GH replacement therapy; triggers include patient on GH replacement needing dose adjustment.

Recommends administering stress-dose glucocorticoids before surgery and tapering after surgery in patients with adrenal insufficiency before repeat testing. Triggers include preoperative planning for surgery in a patient with known or suspected adrenal insufficiency.

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Medicinal chemistry filters. Apply drug-likeness rules (Lipinski, Veber), PAINS filters, structural alerts, complexity metrics, for compound prioritization and library filtering.

ATA RAI Remnant Ablation / Adjuvant Therapy Decision Tool

Recommends using the lowest tolerable hydrocortisone dose to potentially decrease risks of metabolic and cardiovascular disease in central adrenal insufficiency. Triggers include managing a patient with central adrenal insufficiency requiring glucocorticoid replacement.

Structure a hard business decision — frame the choice, score options against weighted criteria, run a pre-mortem and stress-test, and produce a recommendation + decision record for any active brand