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First Generation Sulfonylurea

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141. MI - secondary prevention

. The British Heart Foundation (BHF) estimates that in 2016, 2.3 million people in the UK were living with a diagnosis of CHD and around 1 million people had survived an MI. The commonest cause of MI is an atheromatous plaque rupturing or eroding in a coronary artery; this causes a coronary thrombus to form, which partially or completely obstructs the artery. MIs are divided into 2 types, depending on the ECG changes. ST-segment elevation myocardial infarction (STEMI), which is generally caused by complete (...) antiplatelet therapy. A beta-blocker. A statin. Common concerns that may need to be discussed with a person following an MI include: returning to work and normal activities, driving, sexual activity, erectile dysfunction, air travel, stress, anxiety, and competitive sport. Routine further assessment post-MI that should normally be arranged by secondary care include the following: An assessment of left ventricular function. An assessment of bleeding risk (usually at a first follow-up hospital appointment

2019 NICE Clinical Knowledge Summaries

142. Harm of HPV vaccine: Latest information and examination of epidemiological studies

influenced and distorted by the pharmaceutical industry. "The Informed Prescriber" (TIP: founded in 1986) for professionals and "Med Check, Save Lives" (founded in 2001) targetting general public have provided evidence based rational information which meets the needs of professionals and the general public. This is possible, because they are completely independent: i.e. free from advertisement, funding or any other assistance from industry. The Japanese edition of this bulletin "Med Check - The Informed (...) tumours. Renal, hepatic and gastrointestinal adverse reactions MED CHECK - TIP APRIL 2015 / Vol.1 No.1 · Page 5 Translated as synopsis from Med Chec k TIP 05; 5 (Mar; #58); 7-0. Methadone :Limited use: Useful only in opioid rotation with special precautions Synopsis: Methadone hydrochloride (“methadone”, brand name: Methapain)[1] was first synthesized in Germany in 1937. It was approved in the United States in 1947 as an opioid. Vincent Dole et al. reported in 1964 that it was useful as an alternative

2015 Med Check - The Informed Prescriber

143. Novel glucose lowering agents are associated with a lower risk of cardiovascular and adverse events in type 2 diabetes: A population based analysis. (Abstract)

cotransporter-2 inhibitors (SGLT-2i), dipeptidyl peptidase-4 inhibitor (DPP-4i), glucagon-like peptide 1 agonist (GLP-1a), and sulfonylurea in T2DM patients not controlled on metformin therapy.Retrospective cohort study using the MarketScan database (2011-2015). We selected T2DM individuals who were newly dispensed sulfonylureas, SGLT-2i, DPP-4i, or GLP-1a, as second-line therapy, added to metformin. Cohort entry was defined by date of first prescription of the second-line agent. Time to first non-fatal (...) Novel glucose lowering agents are associated with a lower risk of cardiovascular and adverse events in type 2 diabetes: A population based analysis. Recent randomized control trials have described a protective cardiovascular effect of novel glucose lowering drugs in patients at high cardiovascular risk. Whether these second-line agents have similar effects in the general population is unknown. We aimed to compare the risk of major cardiovascular and adverse events in new users of sodium-glucose

2020 International journal of cardiology

144. Hypertension - not diabetic

during pregnancy, or hypertension caused by other conditions such as renal or hormonal disease. There are separate CKS topics on , , , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary health care. How up-to-date is this topic? How up-to-date is this topic? Changes Changes January 2018 — minor update. Revised SPC for Istin (amlodipine) 5 and 10mg tablets. Drug interactions updated as per (...) . Audit criteria Audit criteria No audit criteria were found during the review of this topic. QOF indicators QOF indicators Table 1. Indicators related to hypertension and blood pressure in the Quality and Outcomes Framework (QOF) of the General Medical Services (GMS) contract. Indicator Points Payment stages Hypertension HYP001 The contractor establishes and maintains a register of patients with established hypertension 6 — HYP006 The percentage of patients with hypertension in whom the last blood

2018 NICE Clinical Knowledge Summaries

145. Balanitis

? From age 1 month onwards (Male). This CKS topic covers the management of balanoposthitis (otherwise known as balanitis) in boys and adult men presenting in primary care. This CKS topic does not cover the specific management of sexually transmitted infections which may cause or be associated with balanoposthitis. There are separate CKS topics on , , , , , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact (...) for recommendation The recommendations on assessment are based on expert opinion in the 2013 European guideline for the management of balanoposthitis [ ], expert opinion in the Royal College of General Practitioners and British Association of Sexual Health and HIV (RCGP/BASHH) publication Sexually transmitted infections in primary care [ ], and expert opinion in a review article on benign male genital skin conditions [ ] and penile inflammatory skin disorders [ ]. The European guideline states a sub-preputial

2018 NICE Clinical Knowledge Summaries

146. Bites - human and animal

prophylaxis for rabies. There are separate CKS topics on , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary health care. How up-to-date is this topic? How up-to-date is this topic? Changes Changes October 2018 — minor update. Adverse effects updated within prescribing information - metronidazole. February 2018 — minor update. New guidance from Public Health England regarding Rabies: administration (...) 1 December 2017. Changes in product availability Changes in product availability No changes in product availability since 1 December 2017. Goals and outcome measures Goals and outcome measures Goals Goals To support primary healthcare professionals to: Offer immediate first aid. Reduce the risk of infection. Treat any established infection. Achieve satisfactory wound healing with good cosmetic outcome. Prevent tetanus and rabies where appropriate. Appropriately manage a person's risk

2018 NICE Clinical Knowledge Summaries

147. Dyspepsia - proven functional

, and depression, and managing these appropriately. Reviewing and stopping any drugs which may be exacerbating symptoms, if possible and appropriate. Testing for Helicobacter pylori infection should be arranged if the person's status is not known or uncertain. Ideally a carbon-13 urea breath test or stool antigen test should be used — ensuring the person has not taken a proton pump inhibitor (PPI) in the past 2 weeks, or antibiotics in the past 4 weeks. First-line H. pylori eradication therapy should (...) [ ]. This CKS topic covers the management of adults with endoscopically-determined functional (non-ulcer) dyspepsia. There are separate CKS topics on , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare. How up-to-date is this topic? How up-to-date is this topic? Changes Changes October 2018 — minor update. Adverse effects updated within prescribing information - metronidazole. September 2017

2018 NICE Clinical Knowledge Summaries

148. Impetigo

onwards. This CKS topic covers the management of impetigo. This CKS topic does not cover the management of infected wounds and burns, infected eczema, or cellulitis. There are separate CKS topics on , , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary health care. CKS gratefully acknowledges the contribution of the British Association of Dermatologists in the development of this topic. How up (...) include skin trauma or pre-existing skin disease, hot/humid weather, poor hygiene, and crowding. [ ; ; ; ; ; ; ; ; ; ; ; ] Incidence How common is it? Impetigo affects all age groups but is most common in young children. A retrospective study using morbidity data from a sentinel general practice network (Royal College of General Practitioners Weekly Returns Service) found the weekly rates of impetigo in England and Wales to be highest in children aged 0–4 years (84 per 100,000) and children aged 5–14

2018 NICE Clinical Knowledge Summaries

149. Otitis media - acute

serious illness or condition. People who have a high risk of complications. If an antibiotic is required, a 5–7 day course of amoxicillin is recommended first-line. Clarithromycin or erythromycin are alternatives for people who are allergic to penicillin (erythromycin is preferred in pregnant women). The following groups of people should be admitted to hospital for immediate specialist assessment: People with a severe systemic infection. People with suspected complications of AOM, such as meningitis (...) , mastoiditis, intracranial abscess, sinus thrombosis, or facial nerve paralysis. Children younger than 3 months of age with a temperature of 38°C or more. Management of persistent AOM involves: Reassessing the person. Considering the need for paediatric or ENT referral or admission, depending on the clinical situation. Considering a first-line antibiotic (if not already prescribed) or a second-line antibiotic if the initial treatment was ineffective. Measures to prevent recurrent AOM include: In children

2018 NICE Clinical Knowledge Summaries

150. Dyspepsia - proven peptic ulcer

inhibitor (PPI) should be prescribed for 2 months, followed by first-line H. pylori eradication therapy. If there is no associated NSAID use, eradication therapy should be offered. If the test is negative, full-dose PPI therapy should be offered for 4–8 weeks. All people with a proven gastric ulcer should have a repeat endoscopy arranged and H. pylori re-testing (if appropriate) 6–8 weeks after starting treatment. If the test is positive, second-line H. pylori eradication therapy should be offered (...) disease and dyspepsia in adults: investigation and management [ ]. This CKS topic covers the management of people with a confirmed diagnosis of duodenal or gastric ulcer following endoscopy. There are separate CKS topics on , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare. How up-to-date is this topic? How up-to-date is this topic? Changes Changes October 2019 — minor update. Topic

2018 NICE Clinical Knowledge Summaries

151. Dyspepsia - unidentified cause

4 weeks. If the person tests positive for H. pylori infection, first-line eradication therapy should be offered. If symptoms persist or recur, the alternative strategy should be offered. For people with persistent or recurrent symptoms following initial management: Alternative acid suppression therapy with a histamine (H 2 )-receptor antagonist (H 2 RA) may be considered. Long-term acid suppression therapy can be considered if symptoms have previously responded. H. pylori re-testing should (...) symptoms of unknown cause, who have not had an endoscopy. It does not cover the diagnosis or management of upper gastrointestinal malignancy. There are separate CKS topics on , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare. How up-to-date is this topic? How up-to-date is this topic? Changes Changes October 2018 — minor update. Adverse effects updated within prescribing information

2018 NICE Clinical Knowledge Summaries

152. Sinusitis

, and providing first contact or primary health care. How up-to-date is this topic? How up-to-date is this topic? Changes Changes May to June 2018 — reviewed. A literature search was conducted in May 2018 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of this topic. Sections have been added on prevalence, complications, and antibiotic choice for acute sinusitis, and a prescribing information section is now available. There have been minor (...) medicine use and Antimicrobial stewardship: changing risk-related behaviours in the general population. Review and, if appropriate, optimise current prescribing practice and use implementation techniques to ensure prescribing is in line with NICE antimicrobial prescribing guidelines or Public Health England (PHE) guidance on Managing common infections in primary care , the Department of Health’s guidance Start smart − then focus , local trust antimicrobial guidelines, and the Antimicrobial Stewardship

2018 NICE Clinical Knowledge Summaries

153. Canagliflozin - Benefit assessment according to §35a Social Code Book V

question B) 22 2.4.3 Extent and probability of added benefit (research question B) 22 2.4.4 List of included studies (research question B) 22 2.5 Research question C: canagliflozin plus sulfonylurea 23 2.5.1 Information retrieval and study pool (research question C) 23 2.5.2 Results on added benefit (research question C) 23 2.5.3 Extent and probability of added benefit (research question C) 24 2.5.4 List of included studies (research question C) 24 2.6 Research question D: canagliflozin plus metformin (...) plus sulfonylurea 25 2.6.1 Information retrieval and study pool (research question D) 25 2.6.2 Results on added benefit (research question D) 26 2.6.3 Extent and probability of added benefit (research question D) 26 2.6.4 List of included studies (research question D) 26 2.7 Research question E: canagliflozin plus insulin 27 2.7.1 Information retrieval and study pool (research question E) 27 2.7.2 Results on added benefit (research question E) 27 2.7.3 Extent and probability of added benefit

2014 Institute for Quality and Efficiency in Healthcare (IQWiG)

154. Dapagliflozin/metformin - Benefit assessment according to §35a Social Code Book V

is particularly due to the fact that, both in the intervention arm (dapagliflozin/metformin) and in the control arm (glipizide plus metformin), the treatments were not used in compliance with the approval status. Dapagliflozin was up-titrated from 2.5 mg to 10 mg at 3-week intervals in the first 18 weeks, although the Summary of Product Characteristics (SPC) does not specify titration, but regular daily dosing of 10 mg. The sulfonylurea glipizide was also titrated in the study, which principally (...) 5 2.3 Research question A: dapagliflozin/metformin 7 2.3.1 Information retrieval and study pool 7 2.3.2 Research question A1: dapagliflozin/metformin versus sulfonylureas (glibenclamide, glimepiride) plus metformin 7 2.3.2.1 Results on added benefit 7 2.3.2.2 Extent and probability of added benefit 7 2.3.3 Research question A2: dapagliflozin/metformin versus glipizide plus metformin 8 2.3.3.1 Results on added benefit 9 2.3.3.2 Extent and probability of added benefit 9 2.3.4 List of included

2014 Institute for Quality and Efficiency in Healthcare (IQWiG)

155. Insulin degludec (Type 1 diabetes mellitus) ? Benefit assessment according to §35a Social Code Book V

) “hint”, or (4) none of the first 3 categories applies (i.e., no data available or conclusions 1 to 3 cannot be drawn from the available data), see [1]. The extent of added benefit or harm is graded into 3 categories: (1) major, (2) considerable, (3) minor (in addition, 3 further categories may apply: non-quantifiable extent of added benefit, no added benefit, or less benefit), see [2]. Extract of dossier assessment A14-13 – Benefit assessment acc. to §35a SGB V Version 1.0 Insulin degludec – Type 1 (...) (IQWiG) - I.8 - References for English extract Please see full assessment for full reference list. 1. Institute for Quality and Efficiency in Health Care. General Methods: version 4.1 [online]. 28 November 2013 [accessed: 7 February 2014]. URL: https://www.iqwig.de/download/IQWiG_General_Methods_Version_%204-1.pdf. 2. Institute for Quality and Efficiency in Health Care. Ticagrelor: benefit assessment according to §35a Social Code Book V; extract; commission no. A11-02 [online]. 29 September 2011

2014 Institute for Quality and Efficiency in Healthcare (IQWiG)

156. Canagliflozin/metformin - Benefit assessment according to §35a Social Code Book V (dossier assessment)

characteristics and the risk of bias at study level for both studies at first. However, in the further discussion it pointed out that these were placebo-controlled studies, which were not relevant for the assessment of the added benefit of canagliflozin/metformin plus sulfonylurea. Further information on the inclusion criteria for studies in this benefit assessment and the methods of information retrieval can be found in Module 4B, Sections 4.2.2 and 4.2.3 of the dossier, and in Section 2.7.3 of the full (...) , from the company’s point of view, sulfonylureas are unsuitable. The G-BA decides on the added benefit. Extract of dossier assessment A14-27 Version 1.0 Canagliflozin/metformin – Benefit assessment acc. to §35a SGB V 13 November 2014 Institute for Quality and Efficiency in Health Care (IQWiG) - 14 - References for English extract Please see full dossier assessment for full reference list. 1. Institute for Quality and Efficiency in Health Care. General Methods: version 4.1 [online]. 28 November 2013

2014 Institute for Quality and Efficiency in Healthcare (IQWiG)

157. Exercise for type 2 diabetes

Exercise for type 2 diabetes RACGP - Exercise: type 2 diabetes Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship Fellowship International graduates FRACGP (...) exams RACGP offer courses and events to further develop the knowledge you need to develop your GP career Re-entry to general practice Supervisors and examiners Mental Health (GPMHSC) Research Discover a world of educational opportunities to support your lifelong learning Courses and events QI&CPD Online learning Conferences Become a provider with the QI&CPD Program and be recognised for the quality education and training you offer GPs Curriculum for Australian General Practice Programs for educators

2014 Handbook of Non-Drug interventions (HANDI)

158. Obeticholic acid for treatment of nonalcoholic steatohepatitis

or liver transplantation. All patients with NASH have a higher cardiovascular mortality compared to the general population, which was based on published ©Institute for Clinical and Economic Review, 2016 Page 23 Draft Evidence Report - OCA for the treatment of NASH Return to Table of Contents studies 53 and incorporated into the model. Background mortality risk was based on patients’ age and sex and estimated from US life tables. 54 Transplant patients have higher risk of mortality for the first year (...) Obeticholic acid for treatment of nonalcoholic steatohepatitis ©Institute for Clinical and Economic Review, 2016 Obeticholic Acid for the Treatment of Nonalcoholic Steatohepatitis: Comparative Clinical Effectiveness and Value Evidence Report June 23, 2016 Institute for Clinical and Economic Review ©Institute for Clinical and Economic Review, 2016 Page i Draft Evidence Report - OCA for the treatment of NASH AUTHORS ICER Staff Massachusetts General Hospital, Institute for Technology Assessment

2016 California Technology Assessment Forum

159. Cutaneous Lupus Erythematosus (CLE), Treatment

, University of Szeged, Szeged, Hungary 5 Department of Medical and Surgical Critical Care Section of Dermatology, University of Florence, Italy 6 Evidence-Based Medicine Frankfurt, Institute for General Practice, Goethe-University Frankfurt, Germany 7 Department of Dermatology and Allergology, Hôpital Tenon, Paris, France 8 Department of Dermatology, Venerology and Allergology, University Hospital of Schleswig-Holstein, Campus Kiel, Germany 9 Department of Dermatology, Inselspital Bern - University (...) by a European subcommittee, guided by the European Dermatology Forum (EDF) and supported by the European Academy of Dermatology and Venereology (EADV). In total, 16 European participants were included in this project and agreed on all recommendations. Topical corticosteroids remain the mainstay of treatment for localized CLE, and further topical agents, such as calcineurin inhibitors, are listed as alternative first- line or second-line topical therapeutic option. Antimalarials are recommended as first-line

2016 European Dermatology Forum

160. Pharmacological Management of Obesity

to the generous providing of disk space by the Internet Archive, multi-terabyte datasets can be made available, as well as in use by the , providing a path back to lost websites and work. Our collection has grown to the point of having sub-collections for the type of data we acquire. If you are seeking to browse the contents of these collections, the Wayback Machine is the best first stop. Otherwise, you are free to dig into the stacks to see what you may find. The Archive Team Panic Downloads are full (...) suggests adding at least one of the following: metformin, pramlintide, or GLP-1 agonists to mitigate associated weight gain due to insulin. The first-line insulin for this type of patient should be basal insulin. This is preferable to using either insulin alone or insulin with sulfonylurea. The Task Force also suggests that the insulin therapy strategy be considered a preferential trial of basal insulin prior to premixed insulins or combination insulin therapy. ( 2|+++O ) The Task Force recommends

2016 National Guideline Clearinghouse (partial archive)

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