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What is the clinical effectiveness and safety of buspirone versus benzodiazepines, serotonin reuptake inhibitors, or serotonin-norepinephrine reuptake inhibitors for the treatment of anxiety?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Use of Buspirone for the treatment of anxiety: A review of the clinical effectiveness, safety, and cost effectiveness Full Report (PDF) Context   Generalized Anxiety Disorder (GAD) is a chronic anxiety disorder characterized by excessive, pervasive and uncontrollable worry. In the general population, GAD has a lifetime prevalence of 6%. Diagnosed twice as often in women than men, GAD typically presents as somatic illness, pain, fatigue, depression and/or sleep disturbances. Pharmacological treatments for GAD include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, anticonvulsants, benzodiazepines ...

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How do you manage a patient who’s had a stroke?

This Medical Condition is presented by the JCDA Oasis Team and is available on Oasis Help Definition Stroke (cerebrovascular accident) is a serious and often fatal neurologic event characterized by the rapid appearance (usually over minutes) of a focal deficit of brain function. Pathophysiology: Of patients presenting with a stroke, 85% will have sustained a cerebral infarction due to inadequate blood flow to part of the brain, and the remainder will have had an intracerebral hemorrhage. If a stroke is not fatal, the survivor is often debilitated in motor function and/or speech. Warning signs: Four events are associated with a stroke: ...

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Is Your Patient Taking Calcium Channel Blockers?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Calcium Channel Blockers Indications Angina Arrhythmias Hypertension Migraine prophylaxis: Verapamil Muscle cramps: Diltiazem  Product Summary Pharmacology This monograph focuses on the calcium channel blockers (CCBs) affecting the cardiovascular system. CCBs (also referred to as slow channel blockers, calcium entry blockers or calcium antagonists) are a chemically and pharmacologically heterogeneous group of drugs, but physiologically they all share the ability to selectively antagonize the calcium ion movements that are responsible for the excitation-contraction coupling in the cardiovascular system. There are two main classes of CCBs: Dihydropyridines (amlodipine, felodipine, nifedipine and ...

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What is the current state of second- and third-line therapy for patients with type 2 diabetes?

This summary is based on comprehensive Optimal Therapy Reports on the topic prepared by Canadian Agency for Drugs and Technologies in Health (CADTH): Second- and Third-Line Therapy for Patients with Type 2 Diabetes Report Summary (PDF) Full Report (PDF) The Canadian Agency for Drugs and Technologies in Health (CADTH) has released a series of Optimal Therapy Reports on the prescribing and use of second-line therapy for patients with type 2 diabetes inadequately controlled on metformin, and a therapeutic review of third-line therapy for patients with type 2 diabetes inadequately controlled with metformin and a sulfonylurea combination therapy. CADTH has also released intervention tools to support the uptake ...

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Is your patient on benzodiazepines?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Benzodiazepines Benzodiazepines Product Summary Information   Indications   Contraindications Patients with known hypersensitivity to this class of drugs or to any component of the product in question. Patients with myasthenia gravis and acute angle-closure glaucoma, but they may be used in patients receiving appropriate therapy for open-angle glaucoma. Warnings Not recommended for use in patients with a major depressive disorder or psychosis in which anxiety is not a prominent feature. Should be used with extreme caution in patients with severe pulmonary insufficiency or sleep apnea, especially the elderly ...

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Is your patient undergoing treatment with biphosphonates?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Biphosphonates Product Summary Pharmacology Bisphosphonates (previously called diphosphonates) are stable analogues of pyrophosphate. After binding to bone surfaces, they slow the formation of hydroxyapatite crystals and delay their aggregation into large clusters. They also interfere with the resorptive action and promote apoptosis (programmed cell death) of osteoclasts, resulting in decreased depth and rate of formation of new bone remodeling units. Lifelong accumulation of remodeling deficits begins shortly after bone growth stops and is thought to be the underlying mechanism of age-related bone loss. By inhibiting this process, bisphosphonates ...

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How to improve patient safety?

This summary of evidence is based on the Annals of Internal Medicine Supplement (Ann Intern Med. 2013;158:365-368) and on the report by the Agency for Healthcare Research and Quality: Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices Annals of Internal Medicine Supplement Full Report (PDF) Structured Abstract Study Objective To review important patient safety practices for evidence of effectiveness, implementation, and adoption. Data Sources Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders. Results From an initial list of over 100 patient safety practices, ...

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How can you deliver effective oral hygiene instruction to children with autism?

This question was submitted by a general dentist: “How can we deliver effective oral hygiene instruction to children with autism?” Dr. John O’Keefe, Director of Knowledge Networks at CDA interviewed Dr. Clive Friedman,  past President of the International Association for Disability and Oral Health (IADH) and current member of IADH Education Committee Understanding your patient is crucial The key to success in treating an autistic child is to follow an approach based on understanding the patient, not only in terms of their diagnosed condition, but also of their psychosocial environment. It is important to understand where a child fits on ...

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