MOST Form Review
§ Cannot
be required for admission. The
form is voluntary. Per C.R.S. 15-18.7-108, a healthcare facility shall not
require a person to have executed a MOST form as a condition of being admitted
to, or receiving medical treatment from, the healthcare facility.
§
Not technically an advanced directive. It is
a medical order set.
§
Fax and photocopies of the MOST form are
valid
§ Can
be partially completed and still be valid.
§ Verbal
orders for the MOST form can be given.
Alzheimer’s drug controversy -aducanumab (Aduhelm)
The link above has a pretty good summary.
Patient information - It's a New Day | Aducanumab Approved for Treatment | alz.org
-
FDA recently approved aducanumab for treatment
of AD
-
Trials specifically enrolled patients with early
memory changes and abnormal beta amyloid seen on brain scans.
-
MRI will likely be required before starting the
drug and intermittently during therapy.
-
The drug attempts to reduce beta amyloid
accumulation in the brain. It is thought
that beta amyloid may be a significant component to the development of AD and
other dementias. That theory has come
under fire in recent years because other drugs reducing beta amyloid production
have not shown enough efficacy for FDA approval. There are other proteins that appeared to,
potentially, be more important than beta amyloid
-
No specific indication was given but it MAY have
some efficacy in early disease.
-
It MAY prevent the speed of progression.
-
Controversy exists because the data are not very
impressive.
-
FDA is requiring a phase 4 trial along with the
approval and reserves the right to resend its approval depending on the data
from this trial.
-
Side effects (Aduhelm (aducanumab) dosing, indications, interactions,
adverse effects, and more (medscape.com))
o ARIA-E
(amyloid-imaging abnormalities- Edema) =
Brain swelling or bleeding ~40%. Most were asymptomatic. Requires monitoring.
o Headache
21%
o Microhemorrhages
19%
o Superficial
siderosis 15%
o Falls
15%
o Confusion/delirium/altered
mental status/disorientation 8%
-
More to come…..
COVID-19 Infections More Likely in Unvaccinated
Healthcare Workers.
o VA
Study
o fully
vaccinated personnel were 19 times less likely than unvaccinated personnel to
be diagnosed with COVID-19.
o In
14 weeks of follow-up, 6% of 1,408 the unvaccinated employees were diagnosed
with COVID-19 versus 0.3% of 4,222 vaccinated employees.
o At least one large
nursing home study shows similar data
§ With
few exceptions, vaccinated residents and staff generally do not transmit virus
as effectively and do not get very sick.
§ There
will be breakthrough infections with ANY vaccine.
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