ITEMS IN AFP WITH KEYWORD:
Oct 1, 2020 Issue
Alcohol Use Disorder: Pharmacologic Treatment Options [FPIN's Clinical Inquiries]
Acamprosate and naltrexone should be used as first-line agents for treatment of alcohol use disorder and are effective for reducing relapse rates. Agent selection should be based on comorbid conditions and adherence to the dosing regimen.
Vaginal, oral, and sublingual misoprostol in single doses of 600 to 800 mcg are equally effective for promoting completed abortion in patients with an incomplete first-trimester spontaneous abortion.
Acetaminophen is no better than placebo for relief of hip or knee pain due to osteoarthritis. Although acetaminophen does provide some pain relief, the effect is small and not clinically significant.
Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.
May 1, 2020 Issue
Megestrol for Palliative Care in Patients with Cancer [FPIN's Clinical Inquiries]
Megestrol may be considered as a component of palliative care nutritional support in patients with cancer.
The available evidence that treatment-resistant depression (depression that is unresponsive to two different treatments of adequate dose and length) responds well to augmentation treatment (i.e., adding psychotherapy, lithium, or aripiprazole [Abilify] to current treatment) is weak.
Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.
The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily due to increased cancer-related mortality.
Polypharmacy, commonly defined as the use of at least five medications, can have negative consequences for both the patient and health care system. Physicians should identify and prioritize medications to discontinue and discuss potential deprescribing with patients. A specific follow-up plan should be developed, including reviewing the patient’s medication list at every visit.
Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.