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Lidocaine Patch

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163. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

-tidal carbon dioxide monitors, and defibrillators with size-appropriate patches/paddles, must have a safety and function check on a regular basis as required by local or state regulation. The use of emergency checklists is recommended, and these should be immediately available at all sedation locations; they can be obtained from . Documentation Documentation prior to sedation shall include, but not be limited to, the following recommendations: Informed consent: The patient record shall document

2019 American Academy of Pediatrics

164. Palliative Care for the Patient with Incurable Cancer or Advanced Disease: Part 2: Pain and Symptom Management

/SC D / IV daily to 8 mg bid (AM & noon) Yes, LCA Yes, LCA $16–124 (G) Inj: 4, 10 mg per mL $6–22 (G) nabilone Cesamet®, G Caps: 0.25, 0.5, 1 mg 1 to 2 mg PO bid No Yes, LCA $100–201 (G) $430–861 scopolamine E Transderm V® Patch: 1.5 mg 1 to 2 F patches applied to skin every 72 hours Yes Yes $44–88 olanzapine Zyprexa®, G Tab: 2.5, 5, 7.5, 10, 15, 20 mg 5 to 10 mg PO q8h prn No Special Authority, LCA $62–124 (G) $118–235 Zyprexa Zydis®, G ODT: 5, 10, 15, 20 mg $63–125 (G) $117–234 Guidelines (...) , but not approved for marketing by Health Canada. F Dose of 2 patches of scopolamine transdermal patch (applied simultaneously) used in practice, but not approved for marketing by Health Canada. BCGuidelines.ca: Palliative Care for the Patient with Incurable Cancer or Advanced Disease 2 Part 2: Pain and Symptom Management – Nausea and Vomiting: Appendix B (2017)Guidelines & Protocols Advisory Committee Part 2: Pain and Symptom Management Pain Management Effective Date: February 22, 2017 Key Recommendations

2017 Clinical Practice Guidelines and Protocols in British Columbia

165. Palliative Care for the Patient with Incurable Cancer or Advanced Disease: Part 1: Approach to Care

) or Lidocaine CSCI Palliative care physician Neuroaxial block Anesthetist Vertebral compression fractures Vertebroplasty Interventional radiologist, neurosurgeon > 50% of the cortex of femur or humerus involved Intramedullary nailing Orthopedic surgeon BCGuidelines.ca: Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 1: Approach to Care: Appendix D (2017) 1Guidelines & Protocols Advisory Committee Appendix E: Cancer Management Flow Sheet Review: Enter Review Date: dd-mm-yy (...) with Incurable Cancer or Advanced Disease Part 1: Approach to Care: Appendix E (2017)Guidelines & Protocols Advisory Committee Appendix F: Typical Home Drug Kit and Subcutaneous Medication List Contents of typical home drug kit * 1 • Atropine 1% drops – 5 mL bottle • Dexamethasone 100 mg/10 mL – 1 vial • DimenhyDRINATE 50 mg/mL – 8 amps • Fentanyl 25 mcg/hr patch – 2 patches • Fentanyl 50 mcg/hr patch – 2 patches • Glycopyrrolate 0.4 mg/2 mL – 5 vials • Haloperidol 5 mg/mL – 4 amps • Hydromorphone 2 mg/mL

2017 Clinical Practice Guidelines and Protocols in British Columbia

166. Management of menopausal symptoms in women with a history of breast cancer

therapy Omega-3 supplementation Phytoestrogens Isoflavones Pharmacological therapies Venlafaxine Paroxetine Escitalopram Desvenlafaxine Clonidine Gabapentin Antidepressants Bupropion Desvenlafaxine Paroxetine Zolpidem Gabapentin Topical lidocaine Ospemifene Hormonal therapies Menopause hormone therapy Vaginal oestrogens Management of menopausal symptoms in women with a history of breast cancer page 8 of 181Tibolone Compounded hormones Testosterone Non-pharmacological therapies Vasomotor symptoms (...) Number Recommendation Grade Related evidence summaries 29 Topical lidocaine treatments to the vulvovaginal area can be considered for women with a history of breast cancer experiencing dyspareunia. C ES27 Management of menopausal symptoms in women with a history of breast cancer page 16 of 181Number Recommendation Grade Related evidence summaries Note: The treatment used in the included study was a 4% lidocaine solution applied to the vulvar vestibule for three minutes, followed by application

2017 Cancer Australia

167. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease

; hyperthermia; hypothermia; hypoplastic left heart syndrome; infant, newborn; infusions, intraosseous; intensive care units, neonatal; intensive care units, pediatrics; ischemia; isoproterenol; kidney injury; kidney; lidocaine; medi- cal response team; mitral valve insufficiency/surgery; natriuretic peptide, brain; neonatology; nitric oxide; Norwood procedures; out-of-hospital cardiac arrest; patient transfer; pediatric early warning system; pe- diatrics; pericardial effusion; pericardial tamponade

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2018 American Heart Association

169. Low Back Pain, Adult Acute and Subacute

Management Guideline for detailed recom- mendations on opioid prescribing. Evidence of efficacy of opioids in acute low back pain is insufficient (Chou, 2016). A 2016 AHRQ systematic review found one trial that showed no significant differences between opioids and acetaminophen in days to return to work (Chou, 2016). This same review found two trials that showed buprenorphine patches were associated with greater short-term improvement in pain versus placebo patches for subacute or chronic low back pain (...) , although for some studies, methods for assessing harms were not always well reported and harms data was sparse (Chou, 2015). A comparative systematic review and meta-analysis of 39 RCTs found that for radiculopathy or spinal stenosis, injections with sodium chloride solution or bupivacaine were ineffective. However, lidocaine alone or lidocaine in conjunction with steroids were significantly effective for pain and function with a minimum 12-month follow-up (Manchikanti, 2016). Given these conflicting

2018 Institute for Clinical Systems Improvement

171. CRACKCast E120 – Dermatologic presentations

of the lesions Systemic illness Diagnostic tests Category of rash Infectious Immune Vascular Allergic Malignancy Treatment Core questions [1] List five broad categories of rashes Infectious Allergic Autoimmune Vascular Malignancy-related [2] Describe the primary skin lesion types (table) The primary skin lesions result directly from the disease process. Primary Lesions (For original table, see Rosen’s Table 110.1) Lesion Description Size Macule Flat circumscribed pigmented area <0.5cm in diameter Patch Flat (...) by genus Malassezia. Superficial hypopigmented or hyperpigmented patches occur mainly on the chest and trunk but may extend to the head and limbs. Tinea versicolor may be treated with topical antifungal agents, such as 2.5% selenium sulfide shampoo, imidazole creams, and ketoconazole cream or foam. Systemic therapy may be indicated, such as oral ketoconazole. Tinea Unguium (onychomycosis) Tinea unguium may be caused by dermatophytes, candida, or other fungal species. Paronychia or untreated tinea pedis

2017 CandiEM

172. CRACKCast E071 – Ophthalmology Part B

and oxidizing material needs removal Need eye shielding Need IV ceftazidime Need topical erythromycin 3) List 4 options for treatment of corneal abrasions Mechanical Corneal Abrasions FB sensation, photophobia, decreased VA Pain relief with topical anesthetics diagnose the problem as corneal injury Watch for a positive Seidel’s sign – which suggests a corneal perforation Treatment Full lid eversion and examination! Contact lenses shouldn’t be worn until the abrasion is healed (3-5 days) Eye patches aren’t (...) artery and optic nerve Signs Proptosis Limited EOM Visual loss Increased IOP ***Don’t wait for a CT scan if you are suspicious***** Treatment: Carbonic anhydrase inhibitor Topical beta blockers Mannitol 1-2 g/kg LATERAL CANTHOTOMY The procedure: Ensure the patient has one of the absolute / relative indications for this procedure DIP A CONE Informed consent Don PPE Wash the area with saline 1-3 ml 1% lidocaine with epi. Into the lateral canthus (consider light procedural sedation) Devascularize

2017 CandiEM

174. Comprehensive Postabortion Care

anaesthesia and/or conscious sedation supplemented by verbal reassurance are sufficient. • The need for pain management increases with gestational age and narcotic analgesia may be required. • Prophylactic NSAIDs may reduce the need for narcotic analgesia during MVA. • Prophylactic paracetamol (oral or rectal) is ineffective in reducing pain during both surgical and medical abortion. Local anaesthesia, such as lidocaine, will alleviate discomfort from mechanical cervical dilatation and uterine evacuation (...) SECOND TRIMESTER IMMEDIATE POST-SEPTIC ABORTION COC 1 1 1 CIC 1 1 1 Patch & vaginal ring 1 1 1 POP 1 1 1 DMPA, NET-EN 1 1 1 LNG/ENG implants 1 1 1 Copper-bearing IUD 1 2 4 LNG-releasing IUD 1 2 4 Condom 1 1 1 Spermicide 1 1 1 Diaphragm 1 1 1 CIC, combined injectable contraceptive; COC, combined oral contraceptive; DMPA/NET-EN, progestogen-only injectables: depot medroxyprogesterone acetate/norethisterone enantate; IUD, intrauterine device; LNG/ENG, progestogen-only implants: levonorgestrel

2016 Royal College of Obstetricians and Gynaecologists

175. Chronic pain disorder medical treatment guideline.

as the first application (Design: Meta-analysis of randomized clinical trials ). Good Evidence Low dose capsaicin (0.075%) applied 4 times per day will decrease pain up to 50% (Design: Meta-analysis of randomized trials ). Some Evidence In patients who are being treated with capsaicin 8% patches, two methods of pre-treatment are equally effective in controlling application pain and in enabling patients to tolerate the patch: topical 4% lidocaine cream applied to the area for one hour before placement (...) for up to 12 hours to the lower extremities of patients with post-herpetic neuralgia and diabetic painful neuropathy, is non-inferior to pregabalin for the same indications. The topical lidocaine is associated with significantly fewer drug-related adverse events over 4 weeks of observation (Design: Non-inferiority randomized trial ). Some Evidence A 5% lidocaine patch may be used as a secondary option for patients with focal neuropathic pain (Design: Randomized crossover trial ). The 8% sprays

2017 National Guideline Clearinghouse (partial archive)

176. Chronic and refractory pain: a systematic review of pharmacologic management in oncology.

Not Established Once-daily fentanyl patch Low-dose methadone Acetaminophen Caffeine Corticosteroids Flurbiprofen Herbal medicine Topical anesthetic (lidocaine patch) Memantine Omega-3 fatty acids Pregabalin Tanezumab Effectiveness Unlikely Calcitonin Refractory Pain Recommended for Practice Intraspinal analgesia Benefits Balanced with Harms Ketamine Effectiveness Not Established Systemic administration of anesthetic agents Intrathecal dexmedetomidine Dimethyl sulfoxide and sodium bicarbonate KRN5500 (...) , herbal medicine, low-dose methadone, memantine, omega 3 fatty acids, once daily fentanyl patch, pregabalin, tanezumab, topical anesthetics (lidocaine patch); for refractory pain: systemic anesthetics, dimethyl sulfoxide and sodium bicarbonate, intrathecal dexmedetomidine, KRN5500, opioid switching or rotation, pregabalin and antidepressant combination, ziconotide. Pain intensity/relief Quality of life Side effects of pharmacologic agents Searches of Electronic Databases A thorough search of PubMed

2017 National Guideline Clearinghouse (partial archive)

178. Management of Type 2 Diabetes Mellitus

(SNRIs) are useful in treating patients with co-morbid depression. Selective Serotonin Reuptake Inhibitors (SSRIs) and trazodone are not as effective in treating painful PDN. Lidocaine 5% patches have been proven to relieve PDN pain and improve quality of life ratings. No side effects were found with the regimen of up to 3 patches worn 12 hours overnight and removed. Other agents. Among other agents, including carbamazepine (200 – 600 mg/day) and valproate (500 mg/day) have been shown to decrease PDN

2017 University of Michigan Health System

179. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians

NSAID versus another showed no differences in pain relief in patients with chronic low back pain ( ). There were no data on COX-2–selective NSAIDs. Opioids Moderate-quality evidence showed that strong opioids (tapentadol, morphine, hydromorphone, and oxymorphone) were associated with a small short-term improvement in pain scores (about 1 point on a pain scale of 0 to 10) and function compared with placebo ( ). Low-quality evidence showed that buprenorphine patches improved short-term pain more than (...) a small effect on short-term pain and function. Low-quality evidence showed that buprenorphine (patch or sublingual) resulted in a small improvement in pain. Opioids should be the last treatment option

2017 American College of Physicians

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