Use Cases

• A 72-year-old man presents to the emergency department (ED) with rhinorrhea, lightheadedness, and cough with purulent sputum. As part of the evaluation, an ECG is ordered that reveals a prolonged QT interval which the patient states have been present on prior ECGs. The ED physician diagnoses acute bronchitis and begins to prescribe azithromycin but pauses to check DynaMedex and queries Watson. The physician uses the voice to text feature on DynaMedex app to ask Watson "What are the contraindications to azithromycin" and discovers it can prolong QT interval and result in torsade de pointes. The ED physician looks up acute bronchitis in DynaMedex and queries Watson again, asking, "Are there alternative treatments" and discovers that antibiotic therapy is not recommended in uncomplicated acute bronchitis. The patient is told to use over-the-counter guaifenesin, hydrate, and see his personal physician if not better in two weeks.


• A 44-year-old man previously prescribed apixaban for a deep vein thrombosis two months earlier presents to the emergency department (ED) with acute shortness of breath and pleuritic chest pain. A pulmonary embolism (PE) is suspected, and a computerized tomogram pulmonary angiogram (CTPA) is performed, confirming the presence of a PE. The patient swears compliance with apixaban and the ED physician closely examines the patient's drug list for agents that might interact with apixaban but does not find any. He next searches DynaMedex to explore what might have affected metabolism and discovers that CYP3A4 and p-glycoprotein inducers can decrease exposure to apixaban resulting in blood clots; one such agent listed was St. John's wart, an over-the-counter agent used by many for depression. Upon further questioning, the patient confirms he had begun to take this about two weeks prior. He was educated about this interaction and told to stop the St. John's wort.


• A 70-year-old Black male presents to his primary care physician's office complaining of fatigue and lightheadedness. His pulse is irregularly irregular, and an ECG confirms the presence of atrial fibrillation. The physician uses DynaMedex to calculate his CHA2DS-VASc score, which is 1. She reads in DynaMedex topic on Thromboembolic Prophylaxis in Atrial Fibrillation that the decision to anticoagulate a male with this degree of stroke risk is controversial. She next uses DynaMedex HAS-BLED calculator to assess his risk of bleeding should anticoagulation be initiated, which calculates to 2. After using DynaMed Decisions with the patient, a 3% chance of stroke in the next 5 years is determined, and the patient wishes to begin anticoagulation. The MD explains the modifiable risk factors to reduce the risk of bleeding, including avoiding nonsteroidal medication use and reducing alcohol consumption from the current 10 drinks a week to less than 8 per week. Apixaban is selected, and a check on "ask Watson" reveals that consumption of grapefruit juice can interact with this agent, and he is told not to ingest this from now on.

Available in These Countries

• This solution is offered worldwide.

Supported Devices

• Desktop
• Tablet
• SmartPhone

Version Details

Compatible with PowerChart