https://yk-health.org/index.php?action=history&feed=atom&title=YKHC_Low-Risk_Endoscopy_CriteriaYKHC Low-Risk Endoscopy Criteria - Revision history2026-04-18T17:30:58ZRevision history for this page on the wikiMediaWiki 1.39.5https://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3184&oldid=prevAndyS at 05:14, 15 March 20192019-03-15T05:14:03Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 05:14, 15 March 2019</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Aspirin'''<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Aspirin'''<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy<ins style="font-weight: bold; text-decoration: none;">.</ins>''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Drugs in this class include: clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** Drugs in this class include: clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid).</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** Thienopyridines, either as a single agent or in combination with aspirin (<del style="font-weight: bold; text-decoration: none;">Dual Antiplatelet Therapy[</del>DAPT<del style="font-weight: bold; text-decoration: none;">]</del>), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding (which can occur up to 2 weeks post-polypectomy) may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** Thienopyridines, either as a single agent or in combination with aspirin (<ins style="font-weight: bold; text-decoration: none;">dual anti-platelet therapy, a.k.a. '''</ins>DAPT<ins style="font-weight: bold; text-decoration: none;">'''</ins>), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding (which can occur up to 2 weeks post-polypectomy) may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** DAPT is frequently used only for limited duration (i.e. 3-12 months) after an event (such as thromboembolic CVA) or procedure (such as coronary stent placement). Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** DAPT is frequently used only for limited duration (i.e. 3-12 months) after an event (such as thromboembolic CVA) or procedure (such as coronary stent placement). Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Warfarin'''<ref name="Feagins"/></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Warfarin'''<ref name="Feagins"/></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>** Warfarin presents a substantial risk of post-polypectomy bleeding, whether stopped, bridged, or continued. If polypectomy is expected, these patients <del style="font-weight: bold; text-decoration: none;">must </del>be referred to Anchorage.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>** Warfarin presents a substantial risk of post-polypectomy bleeding, whether stopped, bridged, or continued. If polypectomy is expected, these patients <ins style="font-weight: bold; text-decoration: none;">should </ins>be referred to Anchorage.</div></td></tr>
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</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3183&oldid=prevAndyS: /* MEDICATIONS */2019-03-15T04:55:58Z<p><span dir="auto"><span class="autocomment">MEDICATIONS</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 04:55, 15 March 2019</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>** If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*'''Warfarin'''<ref name="Feagins"/></ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">** Warfarin presents a substantial risk of post-polypectomy bleeding, whether stopped, bridged, or continued. If polypectomy is expected, these patients must be referred to Anchorage.</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
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<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"><br /><br /></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"><br /><br /></ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">==References==</ins></div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3182&oldid=prevAndyS at 03:56, 15 March 20192019-03-15T03:56:28Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 03:56, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l95">Line 95:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Aspirin'''<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Aspirin'''<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>Drugs in this class include: clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>Drugs in this class include: clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid).</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding (which can occur up to 2 weeks post-polypectomy) may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding (which can occur up to 2 weeks post-polypectomy) may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>DAPT is frequently used only for limited duration (i.e. 3-12 months) after an event (such as thromboembolic CVA) or procedure (such as coronary stent placement). Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>DAPT is frequently used only for limited duration (i.e. 3-12 months) after an event (such as thromboembolic CVA) or procedure (such as coronary stent placement). Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">:- </del>If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">* </ins>If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3181&oldid=prevAndyS: /* MEDICATIONS */2019-03-15T03:37:10Z<p><span dir="auto"><span class="autocomment">MEDICATIONS</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 03:37, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l98">Line 98:</td>
<td colspan="2" class="diff-lineno">Line 98:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*'''Thienopyridines'''<ref name="Feagins"/></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*:- Drugs in this class include: clopidogrel (Plavix), prasugrel (Effient), and ticlopidine (Ticlid).</ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. <del style="font-weight: bold; text-decoration: none;">6</del>-12 months) after <del style="font-weight: bold; text-decoration: none;">the indicating </del>event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding <ins style="font-weight: bold; text-decoration: none;">(which can occur up to 2 weeks post-polypectomy) </ins>may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. <ins style="font-weight: bold; text-decoration: none;">3</ins>-12 months) after <ins style="font-weight: bold; text-decoration: none;">an </ins>event <ins style="font-weight: bold; text-decoration: none;">(such as thromboembolic CVA) </ins>or procedure <ins style="font-weight: bold; text-decoration: none;">(such as coronary stent placement)</ins>. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on a thienopyridine or DAPT.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3180&oldid=prevAndyS at 01:31, 15 March 20192019-03-15T01:31:44Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:31, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l100">Line 100:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes than those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on DAPT.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on <ins style="font-weight: bold; text-decoration: none;">a thienopyridine or </ins>DAPT.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3179&oldid=prevAndyS at 01:28, 15 March 20192019-03-15T01:28:23Z<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:28, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l94">Line 94:</td>
<td colspan="2" class="diff-lineno">Line 94:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">'''</ins>Aspirin<ins style="font-weight: bold; text-decoration: none;">'''</ins><ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Thienopyridines<ref name="Feagins"/></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">'''</ins>Thienopyridines<ins style="font-weight: bold; text-decoration: none;">'''</ins><ref name="Feagins"/></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes <ins style="font-weight: bold; text-decoration: none;">than </ins>those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on DAPT.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on DAPT.</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3178&oldid=prevAndyS at 01:26, 15 March 20192019-03-15T01:26:39Z<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<col class="diff-marker" />
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:26, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l100">Line 100:</td>
<td colspan="2" class="diff-lineno">Line 100:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*:- If there is strong rationale that colonoscopy will not involve polypectomy, then colonoscopy referral can be placed while on DAPT.</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*:- If the colonoscopy indication is truly urgent and the risk of thienopyridine discontinuation is unacceptably high, then the patient should be referred to Anchorage.</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Opioid Replacement Therapy===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* _</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3177&oldid=prevAndyS: /* MEDICATIONS */2019-03-15T01:20:02Z<p><span dir="auto"><span class="autocomment">MEDICATIONS</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:20, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l94">Line 94:</td>
<td colspan="2" class="diff-lineno">Line 94:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin<ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</del><ref name="Feagins">Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''</ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Thienopyridines</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Thienopyridines<ins style="font-weight: bold; text-decoration: none;"><ref name="Feagins"/></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- Thienopyridines, either as a single agent or in combination with aspirin (Dual Antiplatelet Therapy[DAPT]), present a meaningful risk of a post-polypectomy bleed (approximately 2.4%). Additionally, the fact that many of our patients will return to a village means that delayed post-polypectomy bleeding may have worse outcomes those in the published literature (due to lack of easy access to intervention and/or transfusion).</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- DAPT is frequently used only for limited duration (i.e. 6-12 months) after the indicating event or procedure. Therefore serious consideration should be given to the urgency of the indication and the possibility of postponing the referral until the DAPT period is complete.</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3176&oldid=prevAndyS at 01:19, 15 March 20192019-03-15T01:19:16Z<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<col class="diff-content" />
<col class="diff-marker" />
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<tr class="diff-title" lang="en">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:19, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l95">Line 95:</td>
<td colspan="2" class="diff-lineno">Line 95:</td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating (and documenting) a medication management plan. The referral order comment section should specify where to find the plan.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''<ref>Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''<ref <ins style="font-weight: bold; text-decoration: none;">name="Feagins"</ins>>Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Thienopyridines</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Thienopyridines</div></td></tr>
</table>AndyShttps://yk-health.org/index.php?title=YKHC_Low-Risk_Endoscopy_Criteria&diff=3175&oldid=prevAndyS: /* MEDICATIONS */2019-03-15T01:10:30Z<p><span dir="auto"><span class="autocomment">MEDICATIONS</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 01:10, 15 March 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l93">Line 93:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Endoscopy with simple biopsy is considered low risk for bleeding, therefore antiplatelets/anticoagulants usually do not require adjustment/cessation for EGD.<br /><br /></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>Endoscopy with simple biopsy is considered low risk for bleeding, therefore antiplatelets/anticoagulants usually do not require adjustment/cessation for EGD.<br /><br /></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>However, polypectomy is considered high risk for bleeding, therefore colonoscopy may require antiplatelet/anticoagulant adjustment or cessation.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating a medication management plan.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Antiplatelet/anticoagulant management is a decision best made by the referring physician (possibly in consultation with a managing specialist and/or the anticipated endoscopist). Patients on antiplatelets/anticoagulants should not be referred prior to formulating <ins style="font-weight: bold; text-decoration: none;">(and documenting) </ins>a medication management <ins style="font-weight: bold; text-decoration: none;">plan. The referral order comment section should specify where to find the </ins>plan.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Aspirin</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''<ref>Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*:- ''Aspirin and NSAIDs can be continued safely during colonoscopy with polypectomy''<ref>Feagins LA. Colonoscopy, Polypectomy, and the Risk of Bleeding. Med Clin North Am. 2019 Jan;103(1):125-135. doi: 10.1016/j.mcna.2018.08.003</ref></div></td></tr>
</table>AndyS