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Medicine

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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Could Botulinum Toxin A be a treatment for trigeminal neuralgia and temporomandibular joint dysfunction?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Botulinum Toxin A for the treatment of trigeminal neuralgia and temporomandibular joint dysfunction: a review of the clinical effectiveness Full Report (PDF) CONTEXT Temporomandibular joint dysfunction (TMD) is a musculoskeletal and rheumatologic disorder of the temporomandibular joint, which may result in jaw deformities, malocclusion, inflammation, and compression of the bilaminar tissue, with pain and dysfunction being the most prominent clinical features. Trigeminal neuralgia (TN) is a disorder caused by proximal compression of trigeminal nerve root, which may bring about electric shock-like pain ...

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How safe are benzodiazepines?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: High dose and watchful dosing of benzodiazepines: a review of the safety and guidelines Full Report (PDF)   Key Findings No “watchful dose” for benzodiazepines was identified. Benzodiazepines may be used in higher than 10 mg diazepam-equivalent doses in some circumstances, but data were limited. Context   Benzodiazepines are compounds that enhance the activity of gamma-aminobutyric acid (GABA)-A receptors by increasing the affinity of the receptors for GABA. Therefore, benzodiazepines are prescribed as anxiolytic medications. In Canada, the labeled indications include, the treatment of anxiety disorders, panic disorder, ...

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How Do I manage a patient with asthma?

  This medical Condition Consult is presented by the JCDA Oasis Team Asthma is a chronic inflammatory respiratory disease associated with increased airway hyper-responsiveness. Patients are sensitive to a variety of stimuli (e.g., cold air, salicylates, NSAIDs, cholinergic drugs, beta-adrenergic blocking drugs). No information available to require special precautions.   Prescribe the following with caution, due to likely adverse reactions: 1. NSAIDs, ASA-containing medications: Samter triad syndrome, an association of ASA sensitivity, ASA-induced asthma, nasal polyposis or sinusitis. 2. Barbiturates, narcotics: may precipitate an asthma attack.   Sulfite preservatives A coughing reflex and prolonged supine positioning. Consider semisupine chair position. ...

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Is inadequate osseointegration a concern in radiation-treated patients, if implants are treatment planned?

This question was submitted by a general dentist: Is inadequate osseointegration a concern in patients who have received radiation therapy for a head and neck malignancy if implants are treatment planned? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question Yes, however … As with most questions related to this patient population, the answer is: “it depends.” Careful examination is a vital step in determining which restorative/prosthodontic approach best suits the individual. Examination also mandates a thorough review of their cancer diagnosis as well as the constituents and sequence ...

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What are the risk factors for osteoradionecrosis (ORN), in a xerostomic radiation-treated patient, if extractions are required?

This question was submitted to us by a general dentist: If extractions are required, what are the risk factors for osteoradionecrosis (ORN) in a xerostomic patient with rampant decay two years after the successful treatment of their head and neck cancer (radiation, chemotherapy and surgery)? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question:  With the numerous comorbidities associated with head and neck radiation (oral mucositis, radiodermatitis, dysgeusia, dysphagia/odynophagia, trismus, and xerostomia), arises a critical issue with tooth extraction is the altered biology of the maxilla and mandible due ...

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