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Medicine

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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How do I treat a patient with hemophilia?

This Medical Condition Consult is presented by the JCDA Oasis Team. It is also available through the Oasis Help system Our sincere thanks go to the MDs who developed and reviewed this medical consult.  Hemophilia is a hereditary bleeding disorder caused by low factor VIII coagulant activity (hemophilia A) or low levels of factor IX coagulant activity (hemophilia B). Both forms have an X-linked recessive pattern of inheritance. Men are usually affected. Women are carriers. Hemophilia Severity Classification Mild: No spontaneous bleeding; delayed onset of bleeding after trauma, surgery, or dental extractions (6%–49% of the normal clotting factor). Moderate: Bleeding with minor ...

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Is your patient on barbiturates?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Barbiturates Barbiturates Product Summary Information   Barbiturates are nonselective central nervous system (CNS) depressants, capable of producing all degrees of depression from mild sedation and hypnosis to general anesthesia, deep coma and death. The extent of CNS depression varies with the route of administration, dose and pharmacokinetic characteristics of the particular barbiturate. Patient-specific factors such as age, physical or emotional state and the concomitant use of other drugs will also affect response. Indications Barbiturates have been used parenterally in the management of status epilepticus or acute seizure episodes ...

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How do I manage acute pain?

This post is adapted from the Canadian Pharmacists Association (CPhA) Therapeutic Choices on Neurologic Disorders: Acute Pain Pain is one of the commonest symptoms. It needs to be recognized, assessed for cause and treated appropriately as soon as possible.  The absence of treatment can lead to physiological and psychological adverse effects.  Treatment should be tailored to the level of pain; an analgesic that is effective in one patient may not necessarily be helpful in another with the same type of pain.  The absence of a diagnosis should not delay measures to relieve pain.   Therapeutic Choices. © Canadian Pharmacists Association   Do ...

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Is your patient is on ACE Inhibitors?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: ACE Inhibitors ACE Inhibitors Product Summary Information Drug Administration Dosage Form Strength Benazepril Oral Tablet 5 mg, 10 mg, 20 mg Captopril Oral  Tablet 6.25 mg, 12.5 mg, 25 mg, 50 mg, 100 mg Cilazapril Oral  Tablet 1 mg, 2.5 mg, 5 mg Enalapril Maleate Oral  Tablet 2.5 mg, 5 mg, 10 mg, 20 mg Enalaprilat IV Solution 1.25 mg/mL Fosinopril Oral Tablet 10 mg, 20 mg Lisinopril Oral Tablet 5 mg, 10 mg, 20 mg Perindopril Oral Tablet 2 mg, 4 mg, 8 mg Quinapril Oral Tablet ...

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