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Lidocaine Patch

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161. 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

163. 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)

164. 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)

167. 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

169. 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

170. 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

174. 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

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

in pain, although it does not appear to speed overall healing. Lesions can be numbed with topical lidocaine prior to treatment and patients should rinse with water for several minutes after the procedure. Ibuprofen or acetaminophen may ease pain. Topical pastes which form a protective layer over lesion. Topical formulations containing local anaesthetics such as benzocaine or lidocaine which numb painful sores. Example: Orajel® - Topical local anaesthetics may be associated with sensitivity reactions (...) FOR TREATMENT OF ORAL APHTHOUS ULCERS Anesthetic Protectant Form Anbesol Anbesol Ex Strength Anbesol Max Strength Benzocaine 10% Benzocaine 20% Benzocaine 20% Gel, Gel Liquid Canker Care + Canker Cover Patch Canker-X Menthol 0.5% Menthol 2.5 mg Aloe vera Polyvinyl pyrrolidone Sodium hyaluronate Gel Cold Sore Lotion Camphor 4% Menthol 2% Benzoin 10% Liquid Fletcher’s Sore Mouth Medicine Potassium alum 1.28% Potassium chlorate 2.5% Liquid Kank-A Benzocaine 20% Liquid Orabase Gelatin 13.3% Pectin 13.3% Sod

2017 medSask

176. Neuropathic pain in adults: pharmacological management in non-specialist settings

Consider capsaicin cream [4] for people with localised neuropathic pain who wish to avoid, or who cannot tolerate, oral treatments. T T r reatments that should not be used eatments that should not be used 1.1.12 Do not start the following to treat neuropathic pain in non-specialist settings, unless advised by a specialist to do so: cannabis sativa extract capsaicin patch lacosamide lamotrigine levetiracetam morphine oxcarbazepine topiramate tramadol (this is referring to long-term use; see (...) -and- conditions#notice-of-rights). Page 16 of 33Lamotrigine Levetiracetam Oxcarbazepine Phenytoin Pregabalin Valproate T opiramate Buprenorphine Co-codamol Co-dydramol Dihydrocodeine Fentanyl Morphine Oxycodone Oxycodone with naloxone T apentadol Tramadol Cannabis sativa extract Flecainide 5-HT 1 -receptor agonists T opical capsaicin T opical lidocaine Neuropathic pain in adults: pharmacological management in non-specialist settings (CG173) © NICE 2019. All rights reserved. Subject to Notice of rights (https

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

177. 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

179. Comprehensive abortion care

Paper No. 2 • The need for pain management increases with gestational age and narcotic analgesia may be required. • Prophylactic NSAIDs at the time of initiation of misoprostol for second-trimester medical abortion may reduce the need for narcotic analgesia. • Prophylactic paracetamol (oral or rectal) is ineffective in reducing pain after surgical abortion. Local anaesthesia, such as lidocaine, can be used to alleviate discomfort from mechanical cervical dilatation and uterine evacuation during (...) method of contraception, the woman’s medical eligibility for a method should be veri?ed. Post-abortion medical eligibility recommendations for hormonal contraceptives, intrauterine devices and barrier contraceptive methods POST-ABORTION CONDITION FIRST TRIMESTER 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

2015 Royal College of Obstetricians and Gynaecologists

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