Home » Supporting Your Practice » Medicine (page 20)

Medicine

What are the drug therapies for patients with bipolar disorders?

This summary is based on the guidelines published by the Canadian Medical Association (CMA): Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013 (February 2013) Access the article (PDF) The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications. The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, ...

Read More »

Refresher: Why use Analgesics?

This summary is based on the Clinical Info provided by the Canadian Pharmacists Association: Drugs in Dentistry (December 2012) By Dr. Dan Haas, DDS, PhD, FRCDC Consider the following points in the use of analgesics: Eliminate the source of pain, if possible. Individualize regimens. Optimize dose and frequency before switching. Maximize the nonopioid before adding the opioid. Consider a loading dose and/or a preoperative dose for nonsteroidal anti-inflammatory drugs (NSAIDs). Avoid chronic use of any analgesic. Reduce the dose in older individuals. Be aware of the contraindications and cautions for NSAIDs, including ASA (see also individual product monographs and CPhA monographs as ...

Read More »

Managing a patient with HIV

This summary is an adaptation of the e-Therapeutics Evaluation published by the Canadian Pharmacists Association (CPhA): Infectious Diseases: HIV Infection Investigations Clinical History Risk behaviours, social support and need for counselling Establish date of infection, if possible, based on a review of past sexual contacts, period of needle sharing, receipt of blood or blood products, availability of a previous negative test or a history of possible seroconversion illness (e.g., mononucleosis-like or severe flu-like illness) shortly after a high-risk exposure General indicators: anorexia, weight loss, fatigue or malaise, lymphadenopathy Symptoms of opportunistic infections, e.g., fever, night sweats, cough, dyspnea, diarrhea, headache ...

Read More »

What are some of the clinical approaches to oral mucosal disorders?

This summary is based on the Preface article published in the Dental Clinics of North America: Clinical Approaches to Oral Mucosal Disorders (October 2013) Dr. P. Sollicito, DMD, FDS, RCSEd Dr. Eric Stoopler, DMD, FDS, RCSEd Oral health and disease are intimately related to general health status. Clinicians understand that the oral cavity does not exist in isolation, but as an integral component of the human body. The oral cavity and peri-oral region consist of various tissues that are not unlike other organ systems, including mucous membranes, nerves, ligaments, and bone. The oral cavity is perhaps more intricate than other areas because, in addition ...

Read More »

What are the Canadian Expert Consensus Recommendations for the Management of Anaphylaxis?

This summary is based on the Position Paper provided by the Canadian Medical Association (CMA): management of anaphylaxis in primary care: Canadian expert consensus recommendations. The article was retrieved from the CMA Infobase: Clinical Practice Guidelines Database (CPGs) Access the article here (PDF) Context  Anaphylaxis is often managed inadequately. The authors  used findings from a systematic review of gaps in anaphylaxis management to develop evidence-based recommendations for gaps rated as clinically important by a panel of Canadian allergy experts. Key Messages Thirty unique physician gaps from the systematic review were categorized according to gaps of knowledge and anaphylaxis practice behaviors. The panel rated diagnosis of anaphylaxis, and ...

Read More »

From the trenches: How to “dodge the bullet” and make the right diagnosis?

This case was submitted by Dr. Ron Kellen  This situation occurred about 20 years ago. My office was in a plaza, on the second floor, requiring 26 steps to access it, with no elevator. At about 2 PM on a weekday, a 60-year-old male patient presented in our office as an emergency case with a terrible toothache. He pointed to his broken 35. On his medical questionnaire, he indicated that he had a little bit of high blood pressure and that he sometimes would get out of breath. He was taking medication once a day for blood pressure, but he ...

Read More »

Diabetes and periodontal diseases: what does the consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases say?

This is the summary of the report issued by the Joint European Federation of Periodontology and the American Academy of Periodontology Workshop on Periodontitis and Systemic Diseases: Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases (April 2013) Context Diabetes and periodontitis are complex chronic diseases with an established bidirectional relationship. There is long-established evidence that hyperglycemia in diabetes is associated with adverse periodontal outcomes. However, given the ubiquity of periodontal diseases and the emerging global diabetes epidemic, the complications of which contribute to significant morbidity and premature mortality, it is timely to review ...

Read More »

Managing severe Alzheimer disease: what are the evidence-based guidelines?

This summary is based on the guidelines published by the Canadian Medical Association (CMA): Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease. The article was retrieved from the CMA Infobase: Clinical Practice Guidelines Database (CPGs) Access the article here (PDF) Context The management of severe Alzheimer disease often presents difficult choices for clinicians and families. The disease is characterized by a need for full-time care and assistance with basic activities of daily living. The authors outline an evidence-based approach for these choices based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. The authors developed evidence-based guidelines using systematic literature searches, ...

Read More »