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161. Constipation in older adults: Stepwise approach to keep things moving

) Anticholinergic drugs: antipsychotic drugs, benztropine, oxybutynin Anti-Parkinson drugs: amantadine, bromocriptine, pramipexole Anticonvulsant drugs: gabapentin, phenytoin, pregabalin Antidepressant drugs: tricyclic antidepressants, paroxetine Antidiarrheal drugs: diphenoxylate, loperamide Antiemetic drugs: dimenhydrinate, ondansetron, prochlorperazine, promethazine, scopolamine Antihistamine drugs: diphenhydramine, hydroxyzine Antihypertensive drugs: α-adrenergic agonists (eg, clonidine), β-blockers

2016 RxFiles

163. Antiemetics (Full text)

of diphenhydramine as an adjunctive drug. There was no new evidence regarding lorazepam or diphenhydramine as adjuncts to antiemetics. Clinical interpretation. Diphenhydramine was incorporated into antiemetic regimens primarily to prevent the adverse effects from dopaminergic blockade—for example, akasthisia—that were anticipated with the use of high-dose metoclopramide before the introduction of selective 5-HT 3 receptor antagonists. With high doses of metoclopramide rarely used for the prevention (...) of antineoplastic agent-induced nausea and vomiting, the rationale for the inclusion of diphenhydramine no longer exists. CLINICAL QUESTION 7. What is the role of cannabinoids in the prevention or treatment of nausea and vomiting induced by antineoplastic agents or radiation? Recommendation 7. Evidence remains insufficient for a recommendation regarding medical marijuana for the prevention of nausea and vomiting in patients with cancer who receive chemotherapy or radiation therapy. Evidence is also insufficient

2017 American Society of Clinical Oncology Guidelines PubMed

166. Atopic Dermatitis - Guidelines for Prescribing Topical Corticosteroids (Full text)

TriCeram Lubriderm Spectro Jel soapless cleanser Uremol EpiCeram Moisturel Lowila soap Urisec Others Petrolatum Cetaphil Gentle Cleanser Lac-Hydrin -- OTC corticosteroids – hydrocortisone 0.5 %, clobetasone butyrate 0.05% - see description of topical corticosteroids below Itch in atopic dermatitis is not histamine-related and therefore does not respond well to non-sedating antihistamines. Potent sedating antihistamines such as diphenhydramine or chlorpheniramine may provide some relief, possibly

2017 medSask PubMed

167. Oral Aphthous Ulcer - Guidelines for Prescribing Triamcinolone Dental Paste

and should be used only up to 4 times a day. Combination products which contain local anaesthetics in a vehicle that forms a protective coating over sore. Examples: Orabase with benzocaine®, Kanka®, Zilactin-B ® – also caution about sensitivity reactions and maximum frequency of application four times a day. Supplementing with vitamin B12, ( level 2 [mid-level] evidence ), vitamin B6, folic acid and/or zinc might be associated with symptom improvement. Milk of magnesia and diphenhydramine allergy liquid

2017 medSask

168. Delirium in Adult Cancer Patients: ESMO Clinical Practice Guidelines

anticholinergic activity, e.g. tricyclic antidepressants, diphenhydramine, promethazine, trihexyphenidyl, hyoscine butylbromide Other psychoactive: antipsychotics, antidepressants, levodopa, lithium Anti-infectives: cipro?oxacin, acyclovir, ganciclovir Histamine H2 blockers Omeprazole Immunomodulators: interferon, interleukins, ciclosporin Medication polypharmacy Otherstatusorpredisposingcomorbidities[5,39] Age> 70 years Pre-existing cognitive impairment, e.g. dementia History of delirium Hearing impairment

2018 European Society for Medical Oncology

170. Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial

). Our objective was to determine if IV lidocaine provides significant pain relief and overall improvement in quality of life in the longer term (for up to four weeks).This single site randomized double-blind, crossover trial compared IV lidocaine infusion (5 mg·kg-1) with active placebo infusion containing diphenhydramine (50 mg) in patients with chronic neuropathic pain of peripheral nerve origin of at least six months duration. The primary outcome was average pain intensity reduction from IV

2019 EvidenceUpdates

171. Intravenous Fluid for the Treatment of Emergency Department Patients With Migraine Headache: A Randomized Controlled Trial

(fluid group) or saline solution at 10 mL/hour for 1 hour (control group). All patients received intravenous prochlorperazine and diphenhydramine at the start of fluid administration. Participants and outcome assessors were blinded; nurses administering the intervention were not. Outcomes were assessed at 60 and 120 minutes, and 48 hours. The primary outcome was the difference in the verbal pain rating (on a scale of 0 to 10) between 0 and 60 minutes. Key secondary outcomes included additional

2019 EvidenceUpdates

172. Management of Infusion Reactions to Systemic Anticancer Therapy: ESMO Clinical Practice Guidelines

frequent: bronchospasm, hypertension and hypoxia. Premedication 1h before every infu- sion: i.v. corticosteroid [(methyl)- prednisolone 100mg, or equivalent], oral antipyretics (para- cetamol 650–1000mg) and oral or i.v. antihistamine (diphenhydramine 25–50mg or equivalent). Following the second infusion, the dose of i.v. corticosteroid may be reduced [(methyl)prednisolone 60mg]. Post-infusion medication: oral corticosteroid [20mg (methyl)pred- nisolone or equivalent] on each of the 2 days following (...) : oral paracetamol 1g, oral or i.v. antihist- amine (e.g. diphenhydramine 50mg or cetirizine 10mg), i.v. corti- costeroid (prednisolone: in previ- ously untreated or relapsed CLL 50mg and in refractory CLL 100mg). If the patient does not experience an IR in the ?rst and second infusion, corticosteroid may be reduced or omitted. Before ninth infusion (?rst monthly infusion), full dose of premedication agents. If no IR, prednisolone may be reduced to 50mg. [IV, B] Grade 1/2: stop or slow the infusion

2017 European Society for Medical Oncology

173. Intravenous (IV) iron for severe iron deficiency

, the MCV to 95 fL. • Chronic lower GI bleed and limited iron absorption: a 14 y/o boy with severe ulcerative colitis had daily bloody stools. Concurrent celiac disease limited iron absorption from a vegetarian diet. His Hb was 44 g/L, (MCV) 58 fL and plasma ferritin < 1 mcg/L. A test dose of iron dex- tran caused wheezing, back and abdominal pain, but after 25 mg IV diphenhydramine, he tolerated iron sucrose 600 mg. Seven weeks later, 100 90 80 70 60 50 40 30 20 10 _ _ _ _ _ _ _ _ _ _ IronThe (...) Non-allergic toxicity includes local reactions to the infusate, delayed muscle and joint pains, transient hypotension, and fever. These are generally self-limited. Nothing is known about long-term toxicity. Increased risk of infection after IV iron is not established. Does premedication or IM injection improve safety? Premedication is not required, and is not known to pre- vent dangerous hypersensitivity. IV diphenhydramine 25 mg predictably causes sedation. 24 IM iron injection is not safer

2016 Therapeutics Letter

174. SCAI Expert Consensus Statement: 2016 Best Practices in the Cardiac Catheterization Laboratory

contrast allergy, although none have been subject to randomized con- trolled trials. Each CCL should have a protocol for pre- venting contrast reactions. One regimen is prednisone 50 mg orally at 13, 7, and 1 hr prior to the procedure, or alternatively prednisone 60 mg orally the night before and the morning of the procedure. 50 mg of diphenhydramine orally is given 1 hr before the proce- dure in both regimens [29,33]. Many CCLs administer H2 blockers, although there are minimal data to sup- port

2016 Society for Cardiovascular Angiography and Interventions

176. CRACKCast E003 – Pain Management

allergies to amides, diphenhydramine may be used as a local nerve block 50 mg/ml diluted to 5-10 ml Check out Rob Orman’s podcast on Chronic pain: Check out my rounds talk on Kids in pain that we can post on our website. This post was copyedited and uploaded by Rob Carey (@_Robcarey). (Visited 3,734 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance

2016 CandiEM

177. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians

. Most studies have examined newer medications, whereas commonly used older and generic medications, such as diphenhydramine and trazodone, have not been studied. Low-quality evidence showed that both eszopiclone and zolpidem improved global outcomes in the general population, and low- to moderate-quality evidence showed that eszopiclone, zolpidem, and doxepin improved sleep outcomes, such as sleep onset latency, total sleep time, and wake after sleep onset. Moderate-quality evidence showed

2016 American College of Physicians

179. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention (Full text)

, and placebo showed no significant differences in the number of days to cough resolution ( ). Although macrolides (azithromycin) are frequently prescribed for patients with a cough, one study showed that patients with acute bronchitis treated with a macrolide had significantly more adverse events than those receiving placebo ( ). Patients may benefit from symptomatic relief with cough suppressants (dextromethorphan or codeine), expectorants (guaifenesin), first-generation antihistamines (diphenhydramine

2016 American College of Physicians PubMed

180. Insect Bites - Guidelines for Prescribing Topical Hydrocortisone

or excessive redness or swelling. Any antihistamine will do, but cetirizine has a quicker onset of action (15 – 30 minutes) than loratadine (1 – 3 hours). Diphenhydramine or chlorpheniramine at bedtime may help induce sleep and help to break the itch-scratch-itch cycle, but be aware that sedation may persist into the following day. Ibuprofen or naproxen may help lessen inflammation and swelling as well as pain . Acetaminophen may help lessen pain. 0.5% or 1 % (if > 2 years of age) hydrocortisone may

2016 medSask

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