Pocket Notebook: Pocket Primary Care, 2e by Meghan M. Kiefer MD MPH & Curtis R. Chong MD PhD MPhil FACP

Pocket Notebook: Pocket Primary Care, 2e by Meghan M. Kiefer MD MPH & Curtis R. Chong MD PhD MPhil FACP

Author:Meghan M. Kiefer, MD, MPH & Curtis R. Chong, MD, PhD, MPhil, FACP
Language: eng
Format: epub

All patients: Frequent movement, adequate hydration, ankle/knee exercises

High-risk pts: Fitted compression stockings or single dose of LMWH; ASA alone ineffective (Chest 2004;126:338; JGIM 2007;22:107)

Medication timing: If time-critical meds, keep dosing at “home” times or for longer trips gradually shift to “local” times; for other meds, ok to dose at “local” times right away; DM: Eastbound travel = shorter day = less insulin, vice versa

Jet lag: Usually develops if time difference >5 h; manifests as insomnia/daytime fatigue (NEJM 2010;362:440); adjustment typically worst eastbound due to “shorter” day, harder to shorten Circadian cycle; natural adjustment takes ∼1 d/time zone; melatonin can be helpful: 0.5–3 mg taken 30 min before local bedtime, helpful to try “test dose” in advance



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