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1522

Pharmacology Mnemonic: Partial Seizures: Phenytoin, Carbamazepine, Lamotrigine, Topiramate

Simple and complex partial seizures can be treated with medical drugs.  
YouTube
over 5 years ago
Www.bmj
1
31

A man with a palpable abdominal mass and night sweats

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  
bmj.com
over 5 years ago
Www.bmj
1
21

Dermatitis herpetiformis

A 28 year old woman presented with a raised, red and intensely itchy rash on the extensor surface of her elbows and buttocks, in groups of small blisters. There was no history of trauma, atopy, or recent illness. She had no gastrointestinal symptoms or change in bowel habit and had not lost weight. No major medical or surgical history was noted and she was not taking drugs on a regular basis. Owing to the appearance and location of the rash, together with pruritus, dermatitis herpetiformis was suspected.  
bmj.com
over 5 years ago
Www.bmj
1
29

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
13

What is an “n-of-1” trial?

Researchers assessed the effectiveness of “n-of-1” trials for the short term choice of drugs for osteoarthritis. The efficacy of sustained release paracetamol was compared with celecoxib in the management of symptoms associated with osteoarthritis. A series of double blind randomised n-of-1 controlled trials using a double dummy design was performed. The intervention was sustained release paracetamol (two 665 mg tablets, three times a day), or celecoxib (200 mg daily, or 200 mg twice a day for those who were already using this dose). Each treatment regimen was taken for two weeks, administered for three treatment cycles. The primary outcome measures included pain, stiffness, and functional limitation scores; preferred treatment; and adverse effects.1  
bmj.com
over 5 years ago
Www.bmj
1
20

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
2
35

Ketamine helps a third of patients with treatment resistant depression, finds small UK study

A course of ketamine delivered intravenously could potentially be used to treat severe depression in patients who do not respond to other drugs, a UK study has found.  
bmj.com
over 5 years ago
Www.bmj
1
18

Anticoagulation in atrial fibrillation

Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin’s shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment.  
bmj.com
over 5 years ago
Www.bmj
1
30

Incretin based drugs and risk of acute pancreatitis in patients with type 2 diabetes: cohort study | The BMJ

Objectives To determine whether the use of incretin based drugs, compared with sulfonylureas, is associated with an increased risk of acute pancreatitis. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
over 5 years ago
Www.bmj
1
26

The safety of incretin based drugs | The BMJ

Important concerns have been raised about the impact of incretin based drugs on the risk of acute pancreatitis in patients with type 2 diabetes. Two linked papers by Li and colleagues (doi:10.1136/bmj.g2366) and Faillie and colleagues (doi:10.1136/bmj.g2780) could help us decide whether patients and clinicians should consider these concerns when choosing an antihyperglycemic drug. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
over 5 years ago
Www.bmj
1
54

Incretin based drugs and risk of acute pancreatitis in patients with type 2 diabetes: cohort study

Objectives To determine whether the use of incretin based drugs, compared with sulfonylureas, is associated with an increased risk of acute pancreatitis.  
bmj.com
over 5 years ago
Www.bmj
1
20

The safety of incretin based drugs

Important concerns have been raised about the impact of incretin based drugs on the risk of acute pancreatitis in patients with type 2 diabetes. Two linked papers by Li and colleagues (doi:10.1136/bmj.g2366) and Faillie and colleagues (doi:10.1136/bmj.g2780) could help us decide whether patients and clinicians should consider these concerns when choosing an antihyperglycemic drug.1 2  
bmj.com
over 5 years ago
Www.bmj
1
20

Dermatitis herpetiformis

A 28 year old woman presented with a raised, red and intensely itchy rash on the extensor surface of her elbows and buttocks, in groups of small blisters. There was no history of trauma, atopy, or recent illness. She had no gastrointestinal symptoms or change in bowel habit and had not lost weight. No major medical or surgical history was noted and she was not taking drugs on a regular basis. Owing to the appearance and location of the rash, together with pruritus, dermatitis herpetiformis was suspected.  
bmj.com
over 5 years ago
Www.bmj
1
26

Dermatitis herpetiformis

A 28 year old woman presented with a raised, red and intensely itchy rash on the extensor surface of her elbows and buttocks, in groups of small blisters. There was no history of trauma, atopy, or recent illness. She had no gastrointestinal symptoms or change in bowel habit and had not lost weight. No major medical or surgical history was noted and she was not taking drugs on a regular basis. Owing to the appearance and location of the rash, together with pruritus, dermatitis herpetiformis was suspected.  
bmj.com
over 5 years ago
Www.bmj
1
22

Multisystem failure: the story of anti-influenza drugs

Last year the Cochrane team, with the help of the BMJ’s open data campaign, finally got access to full clinical study reports on neuraminidase inhibitors. Tom Jefferson and Peter Doshi explain what the new systematic review found and how a series of failures meant that decisions about these drugs were made without the full evidence  
www.bmj.com
over 5 years ago
Preview
1
14

The missing data that cost $20bn

Marketing is what you do when your product is no good, said Edward Land, scientist and inventor of the Polaroid instant camera. The same notion filled Tom Jefferson’s head when he began to reappraise his initial conclusions about neuraminidase inhibitors and the risk of influenza complications and hospital admissions (doi:10.1136/bmj.g2227). Keiji Hayashi, a Japanese researcher, alerted him to the existence of unpublished trials, trials that were not included in his Cochrane review of 2006. From trusting the literature, researchers, and companies, Jefferson moved to a position of deep scepticism. Many trials were unpublished, data weren’t shared, and decisions on purchasing, stockpiling, and using the drugs were based on a slim and skewed representation of the total evidence base.  
bmj.com
over 5 years ago
Www.bmj
1
46

Drugs for neuropathic pain

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working.  
bmj.com
over 5 years ago
Www.bmj
1
37

Monoclonal antibodies: magic bullets with a hefty price tag

Sales of monoclonal antibodies are projected to reach more than $160bn in the US alone over the next few years so is it any wonder that drug companies fiercely protect their profits? Allen Shaughnessy considers why these unique and complex drugs are so eyewateringly expensive  
www.bmj.com
over 5 years ago
Www.bmj
1
13

Multisystem failure: the story of anti-influenza drugs

Last year the Cochrane team, with the help of the BMJ’s open data campaign, finally got access to full clinical study reports on neuraminidase inhibitors. Tom Jefferson and Peter Doshi explain what the new systematic review found and how a series of failures meant that decisions about these drugs were made without the full evidence  
bmj.com
over 5 years ago