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First Generation Sulfonylurea

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61. General Principles of Poisoning

General Principles of Poisoning General Principles of Poisoning - Injuries; Poisoning - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge (...) , which are unpredictable and not dose-related, and from intolerance, which is a toxic reaction to a usually nontoxic dose of a substance. Poisoning is commonly due to ingestion but can result from injection, inhalation, or exposure of body surfaces (eg, skin, eye, mucous membranes). Many commonly ingested nonfood substances are generally nontoxic (see Table: ); however, almost any substance can be toxic if ingested in excessive amounts. Table Substances Usually Not Dangerous When Ingested* Adhesives

2013 Merck Manual (19th Edition)

62. Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes

-of-rights). Page 3 of 131 1 Recommendations Recommendations 1.1 Ertugliflozin as monotherapy is recommended as an option for treating type 2 diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do not provide adequate glycaemic control, only if: a dipeptidyl peptidase 4 (DPP-4) inhibitor would otherwise be prescribed and a sulfonylurea or pioglitazone is not appropriate. 1.2 Ertugliflozin in a dual-therapy regimen in combination with metformin (...) is recommended as an option for treating type 2 diabetes, only if: a sulfonylurea is contraindicated or not tolerated or the person is at significant risk of hypoglycaemia or its consequences. 1.3 If patients and their clinicians consider ertugliflozin to be 1 of a range of suitable treatments including canagliflozin, dapagliflozin and empagliflozin, the least expensive should be chosen. 1.4 These recommendations are not intended to affect treatment with ertugliflozin that was started in the NHS before

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

63. Dapagliflozin/metformin (type 2 diabetes mellitus) - Benefit assessment according to §35a Social Code Book V (new scientific findings)

2 diabetes mellitus 1 Table 3: Dapagliflozin/metformin – probability and extent of added benefit 4 Table 4: Research question of the benefit assessment of dapagliflozin/metformin in type 2 diabetes mellitus 5 Table 5: Study pool of the company – RCT, direct comparison: dapagliflozin/metformin vs. sulfonylurea + metformin 6 Table 6: Characteristics of the DapaZu study included by the company – RCT, direct comparison: dapagliflozin + metformin vs. glimepiride + metformin 8 Table 7: Characteristics (...) and Efficiency in Health Care (IQWiG) - 1 - 2 Benefit assessment 2.1 Executive summary of the benefit assessment Background In accordance with §35a Social Code Book (SGB) V, the Federal Joint Committee (G-BA) commissioned IQWiG to assess the benefit of the drug combination dapagliflozin/metformin. The company submitted a first dossier on the drug combination on 15 February 2014 to be evaluated for the early benefit assessment. The company now requested a new benefit assessment for a subindication – i.e

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

64. Dapagliflozin (type 2 diabetes mellitus) - Benefit assessment according to §35a Social Code Book V (new scientific findings)

4 Table 4: Research question of the benefit assessment of dapagliflozin in type 2 diabetes mellitus 5 Table 5: Study pool of the company – RCT, direct comparison: dapagliflozin+metformin vs. sulfonylurea + metformin 6 Table 6: Characteristics of the DapaZu study included by the company – RCT, direct comparison: dapagliflozin + metformin vs. glimepiride + metformin 7 Table 7: Characteristics of the intervention – RCT, direct comparison: dapagliflozin + metformin vs. glimepiride + metformin 8 (...) ”) submitted a first dossier of the drug to be evaluated on 15 December 2012 for the early benefit assessment. The company now requested a new benefit assessment for a subindication – i.e. an add-on combination therapy with metformin – because of new scientific findings. The assessment was based on a dossier compiled by the pharmaceutical company. The dossier was sent to IQWiG on 21 December 2017. Research question The aim of this report was to assess the added benefit of dapagliflozin for the treatment

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

65. Heart Disease and Stroke Statistics

–0.92) mortality than those treated at noncertified hospitals, after adjustment for demographic and clinical factors. Hospitals certified between 2009 and 2013 also had lower in-hospital and 30-day mortality than centers certified before 2009. Congenital Cardiovascular Defects and Kawasaki Disease (Chapter 15) Although estimates of birth prevalence/overall prevalence of congenital cardiovascular defects appear relatively stable, a general trend toward improved outcome/survival continues, which has (...) led to an expanding population of adult congenital heart disease patients. Although there remains increased mortality in patients with congenital cardiovascular defects compared with the general population, the standardized mortality ratios after congenital heart disease surgery continue to decrease. In a recent study from the Pediatric Cardiac Care Consortium’s US-based multicenter data registry, which examined 35 998 patients with a median follow-up of 18 years, the overall standardized

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2019 American Heart Association

66. Type 1 diabetes

that clinicians consider adding either a sulfonylurea, a thiazolidinedione, an SGLT-2 inhibitor, or a DPP-4 inhibitor to metformin to improve glycemic control when a second oral therapy is considered. (Grade: weak (...) peptide- 1 (GLP- 1 ) receptor agonists ( ). Guideline Focus and Target Population Since the publication of the 2012 American College of Physicians (ACP) guideline on the comparative effectiveness and safety of oral medications for the treatment of type 2 diabetes , several new studies (...) for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project Journals Library An error occurred retrieving content to display, please try again 2017 9. ) instrument was used to evaluate the guidelines. Guidance Statement 1 : Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy

2018 Trip Latest and Greatest

67. Sitagliptin

. National Institutes of Health Example: "Heart attack" AND "Los Angeles" Search for studies: Study Record Detail Study to Compare Sitagliptin Versus Sulfonylurea Treatment During (...) Ramadan Fasting in Patients With Type 2 Diabetes (MK-0431-262) This study has been completed. Sponsor: Merck Sharp & Dohme Corp. Information provided by (Responsible Party): Merck Sharp & Dohme Corp. ClinicalTrials.gov Identifier: NCT01340768 First received: March 24, 2011 Last updated: February 4, 2016 Last verified (...) International journal of clinical practice Int. J. Clin. Pract. A comparison of glycaemic effects of sitagliptin and sulfonylureas in elderly patients with type 2 diabetes mellitus. 626-31 10.1111/ijcp.12607 In the USA, 45% of patients with type 2 diabetes mellitus (T2DM) are elderly (≥ 65 years old). In general (...) , use of sulfonylurea increases with patient age as does the associated risk for hypoglycaemia, and the consequences of hypoglycaemia can be more pronounced in elderly patients. Sitagliptin

2018 Trip Latest and Greatest

68. Glipizide

of antidiabetic drugs, sulfonylureas and metformin, may differentially affect macrovascular (...) complications and mortality in diabetic patients. We compared the long-term effects of glipizide and metformin on the major cardiovascular events in type 2 diabetic patients who had a history of coronary artery disease (CAD). This study is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 304 type 2 diabetic patients with CAD, mean age = 63.3 years (range, 36-80 years), were (...) enrolled. Participants were randomly assigned to receive either glipizide (30 mg daily 2013 4. TCF7L2 Genetic Variation Augments Incretin Resistance and Influences Response to a Sulfonylurea and Metformin: The Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH). OBJECTIVE: The rs7903146 T allele in transcription-factor-7-like-2 ( TCF7L2 ) is strongly associated with type 2 diabetes (T2D), but the mechanisms for increased risk remain unclear. We

2018 Trip Latest and Greatest

69. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss. 5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed (...) by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist. 7. All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit. 8. Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit. 9. Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low- density lipoprotein cholesterol

2019 American Heart Association

70. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

to the new Endocrine Practice website. Click to access your account and reset your password if this is your first visit. TheIP ranges for your institution have already been added to your account. You maywish to review this information under the Institutional administration tab inyour User Profile. Not Yet Registered? Benefits of Registration Include: A Unique User Profile that will allow you to manage your current subscriptions (including online access) The ability to create favorites lists down (...) Physician, Birmingham VAMC, Birmingham, Alabama 13 Chairman, Grunberger Diabetes Institute, Clinical Professor, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine, Professor, Internal Medicine, Oakland University William Beaumont School of Medicine, Visiting Professor, Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic, Past President, American Association of Clinical Endocrinologists 14 Medical Director & Principal

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2019 American Association of Clinical Endocrinologists

71. Pharmacological management of glycaemic control in people with type 2 diabetes

intensive treatment with metformin and intensive treatment with chlorpropamide, glibenclamide, or insulin (n=951). 11 R Metformin should be considered as the first-line oral treatment option for people with type 2 diabetes. Pharmacological management of glycaemic control in people with type 2 diabetes 4 • Metformin 1 ++ 1 ++ 1 + 1 ++ 1 ++ 1 ++12 | 5 Sulphonylureas Sulphonylureas increase endogenous release of insulin from pancreatic ß-cells. First-generation agents (acetohexamide, chlorpropamide (...) sustainable forests.Scottish Intercollegiate Guidelines Network Pharmacological management of glycaemic control in people with type 2 diabetes A national clinical guideline November 2017Scottish Intercollegiate Guidelines Network Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB www.sign.ac.uk First published November 2017 ISBN 978 1 909103 61 0 Citation text Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of glycaemic control in people with type 2 diabetes. Edinburgh

2017 SIGN

72. Metformin Use in Patients with Historical Contraindications or Precautions

cohort n = 253,690 Sulfonylurea versus metformin MACE or mortality HR 1.18 (95% CI 1.09, 1.28) MACE: HR 1.13 (95% CI 1.03, 1.24) Tzoulaki, 2009 64 Retrospective cohort n = 91,521 Second- generation sulfonylurea versus metformin Rosiglitazone versus metformin Subgroup age ³ 65 years: Mortality: HR 1.35 (95% CI 1.28, 1.42) Myocardial infarction: HR 1.22 (95% CI 1.10, 1.35) CHF: HR 1.18 (95% CI 1.10, 1.26) No difference in mortality or myocardial infarction. Increased CHF (HR 1.32, 95%CI 1.07, 1.63 (...) RCT n = 59 Metformin vs sulfonylurea OR 0.24 (95% CI, 0.01 to 5.17)* Schweizer, 2009 57 RCT n = 322 Metformin + sulfonylurea versus metformin + pioglitazone OR 5.12 (95% CI 0.24 to 107.51)* a OR and 95% CI calculated from data reported. The nested case-control study with low ROB used data from the UK-based General Practice Research Database to compare rates of hypoglycemia in current sulfonylurea users with current metformin users. 59 Overall, 2,025 case subjects with hypoglycemia were compared

2017 Veterans Affairs Evidence-based Synthesis Program Reports

73. CRACKCast E182 – Drug Therapy in the Geriatric Patient

for peptic ulcer disease at full dose for >8 weeks NSAID’s in patients with moderate to severe hypertension Long-term use of opioids Aspirin without adequate cardiovascular risk Warfarin and NSAID used together Beta blocker in patients with COPD Prolonged use of first-generation antihistamines NSAID use in patients with chronic renal failure This post was formatted and copyedited by Dillan Radomske ( ) (Visited 640 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He (...) in older patients Drug Adverse Event ACE Inhibitors/ARB’s Hyperkalemia Benzos and Sedative-Hypnotics Fractures, Falls CCB’s Hypotension Digoxin Toxicity Lithium Toxicity Phenytoin Toxicity Sulfonylureas Hypoglycemia Theophylline Toxicity Warfarin Bleeding [5] What are the top 10 STOPP criteria? REMEMBER: STOPP (Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions) are newer criteria to identify potentially inappropriate medications in the elderly, including drug–drug and drug

2018 CandiEM

74. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association

are generally younger at the time of their first MI. , Dyslipidemia Dyslipidemia is likely an important factor contributing to the increased CVD risk observed in South Asian populations. The typical lipoprotein pattern seen in individuals of South Asian descent who are living in Western societies is characterized by hypertriglyceridemia and low levels of HDL cholesterol (HDL-C). Although levels of low-density lipoprotein (LDL) cholesterol (LDL-C) may not appear elevated, this population has a high incidence (...) of expertise on South Asians and CVD. A general framework outlined by the committee chairs was used to conduct a comprehensive literature review to summarize existing evidence, to indicate gaps in current knowledge, and to formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and US Census data as secondary resources. Inductive methods and descriptive studies

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2018 American Heart Association

75. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

Beaumont School of Medicine, Visiting Professor, Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic, Past President, American Association of Clinical Endocrinologists, President Elect, American College of Endocrinology; 14 Medical Director & Principal Investigator, Metabolic Institute of America, Chair, AACE Diabetes Scientific Committee, Tarzana, California; 15 Professor of Medicine, University of Washington School of Medicine, Seattle, Washington; 16 Professor (...) - tions-centric model that incorporates 3 disease stages: Stage 0 (elevated BMI with no obesity complications), Stage 1 (1 or 2 mild to moderate obesity complications), and Stage 3 (>2 mild to moderate obesity complications, or =1 severe complications) (41,42). The patients who will benefit most from medical and surgical intervention have obesity- related complications that can be classified into 2 general categories: insulin resistance/cardiometabolic disease and biomechanical consequences of excess

2018 American Association of Clinical Endocrinologists

76. Insulin Degludec (Tresiba, Novo Nordisk A/S) for the Treatment of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks

. The VA/DOD recommends considering the risk of hypoglycemia when setting HbA1c goals for any patient. Diet and exercise modification should be the first-line therapy in all patients with type 2 DM. Insulin should be considered for all patients with severe hyperglycemia. Metformin or a sulfonylurea should be used as a first-line pharmacological agents, and patients unable to tolerate either should attempt monotherapy with a TZD, AG inhibitor, meglitinide, DPP-4 inhibitor, or GLP-1 agonist. The VA/DOD (...) , Endocrinology and Metabolism Division and Director of Diabetes Center for High Risk Populations, San Francisco General Hospital; Professor of Clinical Medicine, UCSF Manuel Quiñones, MD Internal Medicine and Diabetology, Healthcare Partners - Anaheim Tony Van Goor, MD, MMM, CPE, FACP Senior Director, Medical Affairs, Medical Director for Policy and Technology Assessment, Blue Shield of California The roundtable discussion was facilitated by Jed Weissberg, MD, Senior Fellow at ICER. The main themes

2017 California Technology Assessment Forum

77. Nine different drug classes reviewed for type 2 diabetes

does current guidance say on this issue? The NICE guideline for treating type 2 diabetes in adults, last updated in July 2016, recommends metformin (standard release) as initial drug treatment. If metformin is not appropriate, initial treatment should be with a dipeptidyl peptidase-4 (DPP-4) inhibitor, a sulfonylurea or pioglitazone (a thiazolidinedione). Individual needs and preferences should be taken into account. If single drug treatment is ineffective, the first intensification step is dual (...) Nine different drug classes reviewed for type 2 diabetes Nine different drug classes reviewed for type 2 diabetes Discover Portal Discover Portal Nine different drug classes reviewed for type 2 diabetes Published on 17 January 2017 doi: Metformin worked best at keeping blood sugar levels under control and remains a good first choice as single therapy. Overall, the nine classes of blood sugar-lowering drugs had similar effect on risk of death from cardiovascular causes and overall mortality

2019 NIHR Dissemination Centre

78. CRACKCast E126 – Diabetes Mellitus and Disorders of Glucose Homeostasis

fluid requirements and administer NS – use the worksheet or estimate using 4-2-1- rule ******Wait 1-2 hrs before starting IV insulin***** Insulin given in the first 1–2 h of DKA repair is thought to increase mortality. This insulin rate fully inhibits ketogenesis and gluconeogenesis and should be maintained if possible. Replace: Calculate and start a piggyback insulin drip at 0.05–0.1 units/kg BW/h: No insulin boluses When you start insulin, you should be adding potassium to the IV fluids! (could (...) add it to the maintenance fluid) Replace lost electrolytes Reassess: Add dextrose to keep serum glucose between 10-15 mmol/L Keep [K+] >4.0 mmol/L; Correct Mg. Notes: Bicarbonate is not generally recommended Q1 hr glucose checks Q2-3 hrs electrolyes and creatinine checks. Watch for cerebral edema Here’s a breakdown for adults: Remember, we’re typically looking for the triad of: Hyperglycemia, acidosis, and ketosis However, various states can knock one of these things out of the triad (e.g. severe

2017 CandiEM

79. Sex Effects in High-impact Conditions for Women Veterans - Depression, Diabetes, and Chronic Pain

. Center Directors are recognized leaders in the field of evidence synthesis with close ties to the AHRQ Evidence-based Practice Centers. The ESP is governed by a Steering Committee comprised of participants from VHA Policy, Program, and Operations Offices, VISN leadership, field-based investigators, and others as designated appropriate by QUERI/HSR&D. The ESP Centers generate evidence syntheses on important clinical practice topics. These reports help: · Develop clinical policies informed by evidence (...) in older adults More adverse effects on sexual dysfunction Paroxetine Depressive symptoms Antidepressants overall, quality improvement, self-help a Combined antidepressant and psychotherapy for dysthymia Adverse effects overall Antidepressants Diabetes Fracture risk Lower for sulfonylureas (compared with thiazolidinediones) Glycemic control Linagliptin a , vildagliptin a Weight loss Bariatric surgery Chronic pain b Greater improvement in CLBP Quality improvement CLBP Antidepressants a Findings are from

2016 Veterans Affairs Evidence-based Synthesis Program Reports

80. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for Management of Dyslipidemia and Prevention of Cardiovascular Disease

School of Medicine, Professor, Internal Medicine, Oakland University William Beaumont School of Medicine, Visiting Professor, Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic, Immediate Past President of the American Association of Clinical Endocrinologists, Chancellor of the American College of Endocrinology; 11 Clinical Assistant Professor of Medicine, University of California San Diego, San Diego, California, Immediate Past-President of the California (...) to individuals with diabe- tes, familial hypercholesterolemia, women, and youth with dyslipidemia. Both clinical and cost-effectiveness data are provided to support treatment decisions. (Endocr Pract. 2017:Suppl2;23:1-87) I. INTRODUCTION In 2016, approximately 660,000 U.S. residents will have a new coronary event (defined as a first hospitalized myocardial infarction [MI] or atherosclerotic cardiovascu- lar disease [ASCVD] death), and approximately 305,000 will have a recurrent event. The estimated annual

2017 American Association of Clinical Endocrinologists

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