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Hepatotoxic Medication

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181. Castration-Resistant Prostate Cancer

Castration-Resistant Prostate Cancer Prostate Cancer: Castration Resistant Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students (...) developed to provide a rational basis for treatment based on currently available published data. [pdf] [pdf] [pdf] Note to the Reader: On July 21, 2014, the FDA issued a recommendation that health care professionals should consider the alcohol content of docetaxel when prescribing or administering the drug to patients. On July 26, 2013, the FDA issued a safety announcement related to the use of ketoconazole in the form of oral tablets. Side effects can include hepatotoxicity, adrenal insufficiency

2018 American Urological Association

182. MASAC Document Regarding Risks of Gene Therapy Trials for Hemophilia

, in at least a subset of clinical trial participants. The mechanisms behind this toxicity are not fully understood, but include an immune response to vector capsid; possible direct cellular toxicity due to stress from catabolizing the AAV capsid; a cellular stress response due to high transgene protein synthesis burden; and/or hepatotoxicity resulting from interaction of vector and co-administered potentially hepatotoxic medications, e.g. efavirenz a component of a HAART regimen for HIV infection(11, 12 (...) ). While the mechanisms are not all understood, these adverse events support the need to counsel patients receiving gene therapy to avoid potentially hepatotoxic therapies such as within HAART, and support the need for more studies to determine the mechanisms of liver toxicity complicating gene therapy. The Medical and Scientific Advisory Council (MASAC) of NHF continues to emphasize the careful consideration of advances in gene therapy to quantify and mitigate the risks to patients and others

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2018 National Hemophilia Foundation

183. Withdrawal of, and alternatives to, valproate-containing medicines in girls and women of childbearing potential who have a psychiatric illness

and multiple Asian countries) suggest that between 14.1% and 35.2% of patients might be prescribed valproate-containing medicines, typically combined with antipsychotic medication. The following paragraphs mention particular medicines in particular indications though in some instances the named drug does not currently (December 2018) have a market authorisation (‘licence’) for that indication. Further guidance on steps to be taken when considering the prescription of a medicine outside the terms of its (...) of valproate-containing medicines, other than risks associated with pregnancy, including hepatotoxicity (family history of liver disease represents a contra- indication), hair loss and thrombocytopenia, and these and other potential problems also need to be considered and discussed with patients when making treatment decisions. 3. Switching patients from valproate-containing preparations to alternative medicines Psychiatrists should consider the possibility of a potential pregnancy when assessing

2019 British Association for Psychopharmacology

184. Cannabis

for Addiction and Mental Health, T oronto, Ontario, Canada; 3 Acute Care Program, Centre for Addiction and Mental Health, T oronto, Ontario, Canada; 4 Departments of Family and Community Medicine, Pharmacology and T oxicology, Psychiatry, Institute of Medical Science, University of T oronto, T oronto, Ontario, Canada; 5 Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, T oronto, Ontario, Canada; 6 Institute for Mental Health Policy Research, Centre for Addiction (...) @ucalgary.ca Keywords: Cannabis; Hepatic disorders; Gastroenterological disorders; Position statement Medical cannabinoid products are widely used in Canada to treat medical symptoms of all kinds, and gastrointestinal (GI) symptoms are among the most commonly cited reasons for use (1). Cannabis is also widely used recreationally (2), and legal- ization of recreational use has occurred in Canada. Currently, cannabis is not an approved therapeutic product in Canada. However, health care practitioners may

2018 Canadian Association of Gastroenterology

185. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

was to compile evidence-based recommendations for the use of laboratory and point-of-care (POC) urine drug tests for relevant over-the-counter medications, prescribed and non-prescribed drugs, and illicit substances in pain management patients. The online version of this executive summary also includes the con- sensus-based expert opinion recommendations in areas where the evidence was limited. The exact process of preparing and publishing the LMPG is shown in Table 1. Briefly, a multidisciplinary LMPG (...) the laboratory tests (screening or definitive) that were com- pared with other clinician tools (e.g., physician interview, medical record review, prescription monitoring programs, screener and opioid assessment for patients with pain). In general, screening tests have adequate clinical sensitivity but may not be highly spe- Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients JANNETTO PJ, BRATANOW N, CLARK WA, HAMILL-RUTH RJ, HAMMETT-STABLER CA, HUESTIS MA, KASSED CA, MCMILLIN

2018 American Academy of Pain Medicine

186. Management of Crohn's Disease in Adults

with Crohn’s disease. These guidelines are established for clinical practice with the intent of suggesting preferable approaches to particular medical problems as established by interpretation and collation of scienti? cally valid research, derived from extensive review of published literature. When exercising clinical judgment, health-care providers should incorporate this guideline along with patient’s needs, desires, and their values in order to fully and appropriately care for patients with Crohn’s (...) of Pennsylvania , Philadelphia , Pennsylvania , USA ; 2 Division of Gastroenterology and Hepatology, Mayo Clinic , Rochester , Minnesota , USA ; 3 Department of Medicine, Division of Gastroenterology, University of North Carolina Chapel Hill , Chapel Hill , North Carolina , USA ; 4 Department of Gastroenterology and Hepatology, Cleveland Clinic , Cleveland , Ohio , USA ; 5 Department of Medicine, Division of Gastroenterology, California Paci? c Medical Center , San Francisco , California , USA ; 6 Dr Henry D

2018 American College of Gastroenterology

187. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas

Tumors, Hamburg, Germany 9 Medical Faculty, University Belgrade, Belgrade, Serbia 10 Centre de Pathologie et de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France 11 Departments of Internal Medicine (Section Endocrinology) & Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands 12 Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark Correspondence should be addressed to G Raverot; Email: gerald.raverot@chu-lyon.fr The European (...) Society of Endocrinology has initiated this guideline on the Management of Aggressive Pituitary DOI: Page(s): G1–G24 Volume/Issue: Article Type: Research Article Online Publication Date: Jan 2018 Copyright: © 2018 European Society of Endocrinology 2018 Free access Background Pituitary tumours are common and easily treated by surgery or medical treatment in most cases. However, a small subset of pituitary tumours does not respond to standard medical treatment and presents with multiple local

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2018 European Society of Endocrinology

188. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults

, Department of Internal Medicine I, University Hospital 2 Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany 3 Department of Clinical Epidemiology 4 Department of Clinical Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, the Netherlands 5 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark 6 Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA (...) 7 Endocrine Oncology and Nuclear Medicine, Institut Gustave Roussy, Villejuif, France 8 INSERM UMR 1185, Faculté de Médecine, Le Kremlin-Bicêtre, Université Paris Sud, Paris, France 9 Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Medical Oncology, University of Brescia at ASST Spedali Civili, Brescia, Italy 10 Department of Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands 11 Department of Pathology, University Medical Center

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2018 European Society of Endocrinology

189. Alcoholic Liver Disease

and close monitoring Consider norepinephrine + albumin if progressive HRS-1 Volume expansion with albumin Renal insufficiency Pan-culture, Chest X-Ray Infection Perform doppler abdominal US and if indicated, MRI Rule out HCC/biliary obstruction/Budd-Chiari Mechanical obstruction Use of any potential hepatotoxic substance in the last 3 months Uncertain alcohol intake history Atypical presentation and/or laboratory tests(eg.AST or ALT>400) All negative Review detailed history of medication, supplements (...) ). Owing to various susceptibility factors, individuals with long-term heavy alcohol use remain at risk for advanced liver disease with alcoholic steatohepatitis (ASH), cirrhosis, and hepa- tocellular carcinoma (HCC) ( 3 ). Most patients with ALD present for medical care aft er they have developed jaundice or complica- tions of cirrhosis ( 4 ). Identifi cation of ALD in the primary-care setting at an early stage and subsequent behavioral interventions should thus be encouraged. Compared with the recent

2018 American College of Gastroenterology

190. BHIVA guidelines on the management of HIV in pregnancy and postpartum

of labour. Please also see section 9.1.3 for HIGH-RISK neonatal management. 2D 6.4.4 In preterm labour, if the infant is unlikely to be able to absorb oral medications consider the addition of double-dose tenofovir DF to the woman’s treatment described in recommendation 6.7.3 to further load the infant. 2C 6.4.5 Women presenting in labour/with spontaneous rupture of the membranes (SROM)/requiring delivery without a documented HIV result must be advised to have an urgent HIV test. A reactive/positive (...) be repeated at 2 and 4 weeks after commencing ART to detect evidence of hepatotoxicity or immune reconstitution inflammatory syndrome (IRIS) and then monitored regularly throughout pregnancy and postpartum. 1C 7.1.3 Because there is no evidence of any adverse effect on maternal or neonatal health if women become pregnant while taking ART dually active against HBV, treatment should be continued. 1C 7.1.4 Tenofovir DF and emtricitabine or lamivudine should form the backbone of an antiretroviral regimen

2019 British HIV Association

193. Non-alcoholic Fatty Liver Disease, Diagnosis and Management

) Because this guidance document is lengthy, to make it easier for the reader, a list of all guidance statements and recommendations are pro- videdinatabularformasSupportingTableS1. De?nitions Forde?ningNAFLD,theremustbe(1)evidence of hepatic steatosis (HS), either by imaging or histology, and (2) lack of secondary causes of hepatic fat accumu- lation such as signi?cant alcohol consumption, long- term use of a steatogenic medication, or monogenic hereditary disorders (Table 1). In the majority (...) . For de?ning “advanced” ?brosis, this guidance document will be referring speci?cally to stages 3 or 4, that is, bridging ?brosisorcirrhosis. TABLE 1. Common Causes of Secondary HS Macrovesicular steatosis - Excessive alcohol consumption - Hepatitis C (genotype 3) -WD - Lipodystrophy - Starvation - Parenteral nutrition - Abetalipoproteinemia - Medications (e.g., mipomersen, lomitapide, amiodarone, methotrexate, tamoxifen, corticosteroids) Microvesicular steatosis - Reye’s syndrome - Medications

2018 American Association for the Study of Liver Diseases

194. Poisoning

Specific treatments • Opiates: Naloxone may be considered if opiate poisoning is likely. • Salicylate or Tricyclics: Alkalinisation with bicarbonate (1mmol/kg boluses) should be considered. 2.2.1 Paracetamol: • Attain history of timing and dose taken. Serum level, at least 4 hours post ingestion, with AST/ALT, U+E, creat, blood gas, lactate, clotting. • If hepatotoxic dose ingested (>75mg/kg) consider activated charcoal. • Discuss management algorithms for acute, staggered and repeated supratherapeutic (...) ingestions and modified release formulations with medical toxicologist (toxbase). • If presenting at 4-8 hours the level should be plotted on graph below and treatment started with N-acetylcysteine (NAC) if the level is above the line. • Start NAC empirically if: • Patients present >8 hours after ingestion, serum paracetamol levels are not available within an 8 hour time window, uncertainty over timing of overdose, patients are unconscious or have a suspected overdose. • Specific antidotes (N

2018 Children's Acute Transport Service

195. Anticoagulants in non-valvular atrial fibrillation

95 9.2.3 Patient selection 95 9.2.4 Definition of clinical variables and medications 97 9.2.5 Statistical analysis 100 9.3 RESULTS 101 9.3.1 Prescription of oral anticoagulants in general practice in the general population and validation of proxies for the CHA2DS2-VASc and CHADS2 scores (part 1) 101 4 Anticoagulants in non-valvular atrial fibrillation KCE Report 279 9.3.2 Trends in prescriptions of OACs in general practice in people with atrial fibrillation (part 2)107 9.4 CONCLUSIONS 125 9.4.1 (...) ) 79 Table 21 – Overview of Belgian studies 88 Table 22 – Total and monitoring costs: Belgian studies 88 Table 23 – Incremental outcomes: Belgian studies 89 Table 24 – Incremental Cost-effectiveness Ratios (ICERs): Belgian studies 90 Table 25 – Definition of oral anticoagulants, based on the ATC code 97 Table 26 – Definition of medications recorded (=2 prescriptions in a year) 97 Table 27 – Definition of variables used in CHA2DS2-Vasc and CHADS2 scores 98 Table 28 – Definition of clinical

2017 Belgian Health Care Knowledge Centre

196. Acute lymphoblastic leukemia

Acute lymphoblastic leukemia CLINICAL PRACTICE GUIDELINE LYHE-005 Version 1 Page 1 of 70 Acute Lymphoblastic Leukemia Effective Date: July, 2016 The recommendations contained in this guideline are a consensus of the Alberta Provincial Hematology Tumour Team and are a synthesis of currently accepted approaches to management, derived from a review of relevant scientific literature. Clinicians applying these guidelines should, in consultation with the patient, use independent medical judgment (...) assessment using either flow cytometry or PCR. 3. Treatment: 3.1. Eligible adults under age 60 with Ph/BCR-ABL negative ALL should be treated with a pediatric-based protocol. 3.1.1. In Alberta the standard regimen is the modified Dana Farber Cancer Institute (DFCI) protocol. 3.1.2. Patients with co-morbidities may be treated with a ‘less toxic’ regimen. 3.2. Medically fit adults above age 60 with Ph/BCR-ABL negative ALL should be treated with curative intent. CLINICAL PRACTICE GUIDELINE LYHE-005 Version

2016 CPG Infobase

197. Analgesia and Anesthesia for the Breastfeeding Mother

Analgesia and Anesthesia for the Breastfeeding Mother ABM Protocol ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017 Sarah Reece-Stremtan, 1 Matilde Campos, 2 Lauren Kokajko, 1 and The Academy of Breastfeeding Medicine A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols, free from commercial interest or in?uence, for managing common medical problems that may impact breastfeeding success. These protocols (...) serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Background T hereislittlerigorousinformationinthescienti?c literature about anesthesia or procedural sedation in breastfeeding mothers. Recommendations in this area typi- cally focus on pharmacologic properties of anesthetic agents, limited

2017 Academy of Breastfeeding Medicine

198. Guideline for the management of adults with Systemic Lupus Erythematosus

Article Navigation Close mobile search navigation Article navigation January 2018 Article Contents Article Navigation The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults Caroline Gordon Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham,Rheumatology Department, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust,Rheumatology Department, University (...) Hospitals Birmingham NHS Foundation Trust, Birmingham, Search for other works by this author on: Maame-Boatemaa Amissah-Arthur Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Search for other works by this author on: Mary Gayed Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham,Rheumatology Department, University Hospitals Birmingham NHS

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2017 British Society for Rheumatology

199. British Association of Dermatologists guidelines for the management of pemphigus vulgaris

in medical dermatology. One of the dermatologists is also an oral medi- cine specialist. The draft document was circulated to the BAD membership, the British Dermatological Nursing Group, the Primary Care Dermatological Society, the Pemphigus Vulgaris Network and PEM Friends (U.K.) for comments, which were actively considered by the GDG, and peer reviewed by the Clinical Standards Unit of the BAD (made up of the T&G Sub- committee) prior to publication. 3.0 Methodology This set of guidelines has been

2017 British Association of Dermatologists

200. Guidelines on the management of abnormal liver blood tests

), together with a full blood count if not already performed within the previous 12 months. (level 2b, grade B) ? Research Recommendation 1: Further evidence is required to establish the cost-effectiveness of case finding for non-alcoholic fatty liver disease (NAFLD) in high-risk groups before it can be recommended. (level 5, grade D) ? Recommendation 2: Abnormal liver blood test results should only be interpreted after review of the previous results, past medical history and current medical condition (...) is estimated at just under 10%. 40 Primary sclerosing cholangitis-inflamma- tory bowel disease is associated with increased complications relating to liver disease, as well as increased colorectal cancer risk. 41 Periodic monitoring of liver blood tests is therefore common practice, with a low clinical threshold for investiga- tion of cholestatic liver blood tests by MRI. In the absence of currently approved medical therapy ongoing efforts clinically table 2 Liver aetiology table for patients with non

2017 British Society of Gastroenterology

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