Edrophonium and Atropine and Twinrix Preservative-Free

• Generic Name: atropine / edrophonium
• Dosage Forms: n.a.
• Other Brand Names:

Reduction in the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

Do not use in patients with Clcr >95 mL/minute. (See Boxed Warning.)

Noninferior to well-controlled (mean time in therapeutic INR range: 65%) warfarin therapy in preventing stroke and systemic embolism, and associated with lower rates of bleeding and cardiovascular death.

The American College of Chest Physicians (ACCP), American Stroke Association (ASA), ACC, AHA, and other experts recommend antithrombotic therapy in all patients with nonvalvular atrial fibrillation considered to be at increased risk of stroke, unless contraindicated.

Choice of antithrombotic therapy based on patient's risk for stroke and bleeding; in general, oral anticoagulant therapy recommended in patients who have a moderate to high risk for stroke and acceptably low risk of bleeding; consider aspirin or no antithrombotic therapy in patients at low risk. Patients at increased risk of stroke generally include those with prior ischemic stroke or TIA, advanced age (e.g., ≥75 years), history of hypertension, diabetes mellitus, or CHF. In addition, female sex considered an important risk factor for stroke in patients with atrial fibrillation, particularly in patients ≥75 years of age.

Although warfarin traditionally has been used for oral anticoagulation in patients with atrial fibrillation at increased risk of stroke, non-vitamin K antagonist oral anticoagulants such as edoxaban may be useful alternatives in selected patients at moderate to high risk of stroke who are unable to comply with warfarin monitoring requirements or in whom a consistent therapeutic response to warfarin cannot be achieved; warfarin may still be preferred in patients who are optimally managed and have well-controlled INRs.

Relative efficacy and safety of the non-vitamin K antagonist oral anticoagulants (e.g., apixaban, dabigatran, edoxaban, rivaroxaban) remain to be fully elucidated.

When selecting an appropriate anticoagulant, consider factors such as the absolute and relative risks of stroke and bleeding; costs; patient compliance, preference, tolerance, and comorbidities; and other clinical factors such as renal function and degree of INR control (if the patient has been taking warfarin).

Safety and efficacy of edoxaban not established in patients with mechanical heart valves or moderate to severe mitral stenosis; use not recommended in such patients.

Treatment of DVT and/or PE, following initial treatment with a parenteral anticoagulant for 5–10 days.

Noninferior to warfarin in reducing the risk of recurrent venous thromboembolism; associated with substantially reduced rates of clinically important bleeding.

• Generic Name: hepatitis a adult vaccine / hepatitis b adult vaccine
• Dosage Forms: injection, suspension
• Other Brand Names: Twinrix Preservative-Free, Twinrix

Hepatitis A and B are serious diseases caused by virus.

Hepatitis A is spread through contact with the stool (bowel movements) of a person infected with the hepatitis A virus. This usually occurs by eating food or drinking water that has become contaminated as a result of handling by an infected person.

Hepatitis B is spread through blood or bodily fluids, sexual contact or sharing IV drug needles with an infected person, or during childbirth when a baby is born to a mother who is infected.

Hepatitis causes inflammation of the liver, vomiting, and jaundice (yellowing of the skin or eyes). Hepatitis can lead to liver cancer, cirrhosis, or death.

The hepatitis A and B vaccine is used to help prevent these diseases in adults. The vaccine works by exposing you to a small dose of the virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

This vaccine is recommended for adults with risk factors for getting hepatitis A or B, including:

• having chronic liver problems, such as cirrhosis or hepatitis C, or needing a liver transplant;

• using intravenous (IV) drugs;

• living with a person who has either hepatitis A or B infection;

• having sexual contact with an infected person;

• having more than one sex partner in 6 months;

• being male and having sex with other men;

• having a blood clotting disorder such as hemophilia;

• being on dialysis or receiving blood transfusions;

• living in a correctional institution;

• being in the military or traveling to high-risk areas; and

• working in healthcare or public safety and being exposed to infected blood or body fluids.

Like any vaccine, the hepatitis A and B vaccine may not provide protection from disease in every person.