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Pharmacology

Does Your Patient Need Penicillin?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Penicillin G/Penicillin V Product Summary Table Pharmacology Penicillins G and V, known as the natural penicillins, are bactericidal against susceptible organisms. Penicillins interfere with the synthesis of cell wall mucopeptides, resulting in the formation of defective cell walls that will lyse and eventually result in death of the organism. The spectra of activity of penicillins G and V are similar: Penicillin G is more active against gram-negative organisms (e.g., Neisseria) and some anaerobes than is penicillin V. Penicillin G can be given parenterally, enabling the attainment of high serum ...

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What are NSAIDs?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Click here to view the Product Summary Table (web image) Click here to download the Product Summary Table (PDF) Indications and Clinical Use As anti-inflammatory, analgesic and antipyretic agents, NSAIDs provide symptomatic relief but do not cure the underlying disease. No NSAID has been proven superior for symptom relief. The choice of drug depends on individual risk factors, such as NSAID toxicity, individual patient response, compliance potential, dosage forms, cost and available evidence. For compliance, drugs with a long half-life or available in dosage ...

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Brief: When should you use anti-infective drugs?

This Summary is an adaptation of the Clinical Info on Medical Emergencies provided by the Canadian Pharmacists Association (CPhA) Consider the following when prescribing antibiotics: Use only when there is an indication. Use only when the risk-benefit ratio is favourable. They are not a substitute for establishing adequate drainage. Choose an effective agent with the narrowest spectrum of activity. Prescribe a therapeutic dose and consider a loading dose. Prescribe at an appropriate frequency and for an appropriate duration. Choose the drug with the fewest side effects. Consider laboratory culture and sensitivity tests to target specific bacteria with antibiotics identified as ...

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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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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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