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Medication Causes of Dyspepsia

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101. Adalimumab (Hyrimoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Papulosquamous Skin Diseases, Hidradenitis Suppurativa, Ankylosing Spondylitis, Uveitis

5.1 and 5.2). 4 Crohn’s disease Hyrimoz is indicated for treatment of moderately to severely active Crohn’s disease in adult patients who have not responded despite a full and adequate course of therapy with a corticosteroid and / or an immunosuppressant; or who are intolerant to or have medical contraindications for such therapies. Paediatric Crohn's disease Hyrimoz is indicated for the treatment of moderately to severely active Crohn's disease in paediatric patients (from 6 years of age) who (...) to or have medical contraindications for such therapies. Uveitis Hyrimoz is indicated for the treatment of non-infectious intermediate, posterior and panuveitis in adult patients who have had an inadequate response to corticosteroids, in patients in need of corticosteroid-sparing, or in whom corticosteroid treatment is inappropriate. Paediatric uveitis Hyrimoz is indicated for the treatment of paediatric chronic non-infectious anterior uveitis in patients from 2 years of age who have had an inadequate

2018 European Medicines Agency - EPARs

102. Sodium zirconium cyclosilicate (Lokelma) - Hyperkalemia

with S-K levels between 3.5 and 4.5 mmol/L but, more importantly, S-K levels between 4.5 and 5.0 mmol/L, which is within the normal range, were associated with a 2-fold increased risk of mortality compared with S-K between 3.5 and 4.5 mmol/L. 2.1.2. Epidemiology Hyperkalemia develops when there is insufficient elimination, excessive intake, or shift of potassium from the intracellular space. Insufficient elimination, which is the most common cause of hyperkalaemia, can be hormonal (as in aldosterone (...) deficiency), pharmacologic (e.g. treatment with angiotensin-converting enzyme inhibitors [ACEs], angiotensin-receptor blockers [ARBs], mineralocorticoid receptor antagonists) or, most commonly, due to reduced kidney function. Often, the cause is multifactorial (e.g. reduced kidney function combined with drug treatment such as ACEs or ARBs). Increased extracellular potassium levels result in depolarization of the membrane potential of cells. This depolarization opens some voltage gated sodium EMA/93250

2018 European Medicines Agency - EPARs

103. Rucaparib camsylate - Ovarian Neoplasms

2.10. Product information 157 2.10.1. User consultation 157 2.10.2. Additional monitoring 158 3. Benefit-Risk Balance 158 3.1. Therapeutic Context 158 3.1.1. Disease or condition 158 3.1.2. Available therapies and unmet medical need 158 3.2. Favourable effects 158 3.3. Uncertainties and limitations about favourable effects 159 3.4. Unfavourable effects 159 3.5. Uncertainties and limitations about unfavourable effects 160 3.6. Effects Table 160 3.7. Benefit-risk assessment and discussion 161 3.7.1 (...) acid DSB double-strand breaks DSC differential scanning calorimetry DVS dynamic vapour sorption EC European Commission ECG(s) electrocardiogram(s) ECOG Eastern Cooperative Oncology Group EMA European Medicines Agency EOC epithelial ovarian cancer ESMO European Society for Medical Oncology EU European Union EU-RMP European Union Risk Management Plan FDA Food and Drug Administration FeSSIF Fed state simulated intestinal fluid Assessment report EMA/CHMP/238139/2018 Page 5/167 FFPE formalin-fixed

2018 European Medicines Agency - EPARs

104. Glibenclamide (Amglidia) - Diabetes Mellitus

4/60 3.1.1. Disease or condition 49 3.1.2. Available therapies and unmet medical need 49 3.1.3. Main clinical studies 50 3.2. Favourable effects 51 3.3. Uncertainties and limitations about favourable effects 52 3.4. Unfavourable effects 52 3.5. Uncertainties and limitations about unfavourable effects 52 3.6. Effects Table 53 3.7. Benefit-risk assessment and discussion 56 3.7.1. Importance of favourable and unfavourable effects 56 3.8. Balance of benefits and risks 57 3.9. Additional (...) in the short term for patients with diabetes caused by KCNJ11 mutations and is probably more effective than insulin therapy. This pharmacogenetic response to sulphonylureas may result from the closing of mutant KATP channels, thereby increasing insulin secretion in response to incretins and glucose metabolism." The conclusion of the second article (Babenko et al. NEJM, 2006) was that "Dominant mutations in ABCC8 accounted for 12 percent of cases of neonatal diabetes in the study group. Diabetes results

2018 European Medicines Agency - EPARs

105. Dolutegravir sodium rilpivirine hydrochloride (Juluca) - HIV Infections

. Conclusions on the clinical efficacy 75 2.6. Clinical safety 75 2.6.1. Discussion on clinical safety 98 2.6.2. Conclusions on the clinical safety 100 2.7. Risk Management Plan 100 2.8. Pharmacovigilance 103 2.9. Product information 103 2.9.1. User consultation 103 Assessment report EMA/243517/2018 Page 3/109 3. Benefit-Risk Balance 103 3.1. Therapeutic Context 103 3.1.1. Disease or condition 103 3.1.2. Available therapies and unmet medical need 104 3.1.3. Main clinical studies 104 3.2. Favourable effects (...) and that the mean duration of use of the ART- regimen at screening was almost 4 years. Moreover, relevant comorbidities, such as CHB-infection and co-medications were excluded. Self-reported adherence to study medications was – with intake of 98% of the doses- unusually high. It is not clear, if outside a study setting and in a less stringently selected population the regimen’s efficacy would be the same. Study 201674 and Study 201676 The data indicate a difference in the relevant PK parameters of RPV

2018 European Medicines Agency - EPARs

106. Deprescribing proton pump inhibitors

in conjunction with patients. D eprescribing is the planned and supervised process of dose reduction or stopping of medication that might be caus- ing harm or might no longer be providing benefit. 1 The goal of deprescribing is to reduce medication burden and harm while maintaining or improving quality of life. However, deprescribing can be difficult, especially when medications do not appear to be causing overt harm. 2 In an effort to provide evidence-based recom- mendations and tools to aid clinicians (...) Association • RxFiles PPI—proton pump inhibitor.Vol 63: may • mai 2017 | Canadian Family Physician • Le Médecin de famille canadien 363 Deprescribing proton pump inhibitors | Clinical Practice Guidelines caused by the PPI) and negative (such as recurrence of upper GI symptoms) patient-specific effects of PPI depre- scribing, particularly over the longer term, would be help- ful. Evaluating cost-effectiveness and long-term medical resource use is also important. Next steps The deprescribing team

2017 CPG Infobase

107. Management of Acute Myocardial Infarction in patients presenting with ST-segment elevation

. The two chairmen contributed equally to the document: Borja Ibanez, Director Clinical Research, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain; Department of Cardiology, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; and CIBERCV, Spain. Tel: +34 91 453.12.00 (ext: 4302), Fax: +34 91 453.12.45, E-mail: bibanez@cnic.es or bibanez@fjd.es. Stefan James, Professor of Cardiology, Department of Medical Sciences (...) Carlos III (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain; Department of Cardiology, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; and CIBERCV, Spain. Tel: +34 91 453.12.00 (ext: 4302), Fax: +34 91 453.12.45, E-mail: bibanez@cnic.es or bibanez@fjd.es. Stefan James, Professor of Cardiology, Department of Medical Sciences, Scientific Director UCR, Uppsala University and Sr. Interventional Cardiologist, Department of Cardiology Uppsala University Hospital UCR Uppsala Clinical

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2017 European Society of Cardiology

108. Asthma

— minor update. The range of dry powder inhaler devices included as prescriptions has been updated. Issued in February 2011. December 2010 — minor update. The Flixotide Diskhaler ® (fluticasone) range has been discontinued. The prescription has been removed. Issued in December 2010. October 2010 — minor update. Information on fitness to drive from the Driver and Vehicle Licensing Agency's guidance for medical practitioners, At a glance guide to the current medical standards of fitness to drive has (...) . British Medical Journal. [ ] BMJ (2018) Improving the global diagnosis and management of asthma in children . British Medical Journal. [ ] Busse, W., et al. (2018) Combined analysis of asthma safety trails of long-acting ß 2 -agonists. The New England Journal of Medicine. [ ] NIHR (2018) Increasing inhaled steroids for short periods reduces asthma exacerbations. National Institute for Health Research [ ] Connett, G., Connett, L., and Thomas, M. (2019) Determining the reasons for poorly controlled

2017 Prodigy

109. Antiocoagulation - oral

of a bleeding complication in secondary care consists of stopping treatment and general haemostatic measures, such as mechanical compression and surgical haemostasis with bleeding control procedures, fluid replacement and haemodynamic support, blood products (packed red cells or fresh frozen plasma, depending on associated anaemia or coagulopathy), or platelets. People taking oral anticoagulants should be advised: To seek immediate medical advice if spontaneous bleeding occurs and does not stop, or recurs (...) . This includes bruising, bleeding gums, nosebleeds, prolonged bleeding from cuts, blood in the urine or stools, haemoptysis, subconjunctival haemorrhage, and vaginal bleeding in a postmenopausal woman. To seek medical advice if they get sudden severe back pain (which may indicate spontaneous retroperitoneal bleeding). Not to take over-the-counter medicines such as nonsteroidal anti-inflammatory drugs. What to do if there has been a missed dose or if a double dose has been taken. The duration of treatment

2017 Prodigy

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

Management Nausea and Vomiting Effective Date: February 22, 2017 Key Recommendations • Select anti-nausea medication based on the etiology of the nausea and vomiting. Assessment 1. Nausea and vomiting are common, but can be controlled with antiemetics. 2. Identify and discontinue medications that may be the cause. 3. Further assessment may include lab tests and imaging to investigate (e.g., GI tract disturbance, electrolyte/calcium imbalance, intracranial disease, and sepsis). 4. Good symptom control may (...) . Pharmacological: match treatment to cause (e.g., if opioid-induced, metoclopramide (sometimes IV or SC initially) and domperidone are most effective). Most drugs are covered by the BC Palliative Care Drug Plan, exc ept olanzapine and ondansetron (refer to Appendix B – Medications Used in Palliative Care for Nausea and Vomiting). 3. Consider pre-emptive use of anti-nauseates in opioid-naive patients. BCGuidelines.ca: Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain

2017 Clinical Practice Guidelines and Protocols in British Columbia

111. The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline

, symptoms and signs of peptic ulcer disease, or dyspepsia). Children with chronic abdominal pain or anorexia should have other common causes of their symptoms considered in addition to H. pylori infection. Treat all those with a positive test (see the full guidelines for details, tables 1.5 and 9.1). STIs: Offer an STI screen to people with a risk factor for acquiring an STI or on request. Universal post-arrival screening for STIs for people from refugee-like backgrounds is not supported by current (...) The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline | The Medical Journal of Australia mja-search search Use the for more specific terms. Title contains Body contains Date

2017 MJA Clinical Guidelines

112. CRACKCast Episode 149 – Aspirin and Nonsteroidal Agents

warrants IV glucose supplementation. NSAIDs: Most NSAID overdoses are asymptomatic or cause only minor symptoms. Ibuprofen, along with other propionic acid derivatives, has been associated with sporadic cases of aseptic meningitis. The management of NSAID overdose is supportive, and there is no specific antidote. Hemodialysis is reserved for patients with massive overdose and pH <7.1. Patients who have ingested a pyrazolone or fenamate require observation for possible seizures until 8 hours after (...) ingestion. Rosen’s In Perspective Aspirin, or acetylsalicylic acid, is widely consumed for its analgesic, anti-inflammatory, and antiplatelet effects… however salicylate toxicity is not a benign condition and causes a complex set of life-threatening metabolic derangements with significant morbidity and mortality. 20-30 people die every year from ASA overdoses. The very young and very old are at particular risk! It’s not just ASA that we worry about: other potential sources of salicylate toxicity include

2018 CandiEM

113. Erectile Dysfunction

Erectile Dysfunction Erectile Dysfunction (ED) 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 Exams/LLL/Certifications Exam (...) is the cornerstone of the treatment and management of ED, a model that relies on the concepts of autonomy and respect for persons in the clinical encounter. It is also a process in which the patient and the clinician together determine the best course of therapy based on a discussion of the risks, benefits and desired outcome. Using this approach, all men should be informed of all treatment options that are not medically contraindicated to determine the appropriate treatment. Although many men may choose

2018 American Urological Association

114. Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion

with lifestyle modi?cations, substituting alternative medications in place of those that can exacerbate ED, and moving on to PDE5i in patients who have organic causes of ED such as spinal cord injuries, radical pelvic surgery, severe atherosclerosis, or those who fail lifestyle therapy or desire rapid improvement in their ED. Typically,thesemenmaybestartedonaPDE5itrial,with appropriate counseling about risk of priapism (de?ned as an erection lasting longer than 4 hours). Contraindications for PDE5i use (...) include use of nitrates and inadequate cardiac reserve for sexual activity requiring clearance by a cardiolo- gist.Further,thesemedicationsshouldbeusedwithcautionin menonanalphablocker astheycancauseanunsafedropin bloodpressure.SideeffectsofPDE5iagentsincludeheadache, facial?ushing,muscleaches,nasalcongestion,abluetingein vision, dizziness, dyspepsia, and priapism. Typical doses of PDE5iaresildena?l50–100mg,tadala?l5–20mg,vardena?l 10–20 mg, and avana?l50–200 mg. All of these drugs are expensive, $10

2018 Society for Assisted Reproductive Technology

115. Erectile Dysfunction

treatment options that are not medically contraindicated to determine the appropriate treatment. Although many men may choose to begin with the least invasive option, the Panel notes that it is valid for men to begin with any type of treatment, regardless of invasiveness or reversibility. Men also may choose to forego treatment. In each scenario, the clinician’s role is to ensure that the man and his partner have a full understanding of the benefits and risks/burdens of the various management strategies (...) ) Copyright © 2018 American Urological Association Education and Research, Inc.® Guideline Statements: Evaluation and Diagnosis: 1. Men presenting with symptoms of ED should undergo a thorough medical, sexual, and psychosocial history; a physical examination; and selective laboratory testing. (Clinical Principle) 2. For the man with ED, validated questionnaires are recommended to assess the severity of ED, to measure treat- ment effectiveness, and to guide future management. (Expert Opinion) 3. Men should

2018 American Urological Association

116. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

events cause one or multiple symptoms is often difficult (1,12). This is particularly true in nonverbal infants in whom defining trouble- some is problematic. Reported symptoms of infant GERD vary widely and may include excessive crying, back arching, regurgi- tation and irritability. Many of these symptoms, however, occur in all babies with or without GERD, making a definitive diagnosis challenging. Therefore, the degree of concern of parents is often the factor driving the need for a diagnosis (...) to be a prominent phenomenon in children who have other underlying medical conditions such as prematurity, neurologic impairment, and pulmonary problems, including cystic fibrosis. The present guideline was not intended Original studies, n = 16 - Massage therapy, n=1 - Feeding modifications, n=14 - Positioning therapy, n =1 Systematic reviews, n = 2 Records identified through database searching (n = 3068) Additional records identified through other sources (n = 11) Records screened Records after duplicates

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

117. Deprescribing Proton Pump Inhibitors

drug”, spawning multiple imita- tors. Eventually this included (as patent extensions) the single enantiomers esomeprazole and dexlansoprazole. Prescription PPIs are approved for peptic ulcer disease (PUD), gastro- esophageal reflux (GERD), and non-ulcer dyspepsia. About 1 in 12 British Columbians receives a prescription in any year. 1 Over the counter omeprazole and esomeprazole are also approved for heartburn occurring on >2 days/week, achieving full acid suppressant effect in 1-4 days. 2 Most (...) people taking PPIs have not been endoscoped, so that “GERD” often refers to reflux or heartburn. Our previous reviews 3-9 of randomized clinical trial (RCT) evidence on PPIs concluded: • Over 8-12 weeks, PPIs are effective for GERD 3 and PUD 4 . • Patients treated effectively do not require chronic acid suppressive medications. 4 • Long-term PPIs are appropriate in relapsing severe erosive esophagitis. 3 • No PPI demonstrated superiority for GERD or symptoms related to PUD. 9 • No long-term RCTs

2018 Therapeutics Letter

118. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

, Connecticut Search for other works by this author on: Karen C Carroll Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Search for other works by this author on: Kimberle C Chapin Department of Pathology, Rhode Island Hospital, Providence Search for other works by this author on: Peter H Gilligan Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill Search for other works by this author on: Mark D Gonzalez Department of Pathology (...) , Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Robert C Jerris Department of Pathology, Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Sue C Kehl Medical College of Wisconsin, Milwaukee Search for other works by this author on: Robin Patel Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: Bobbi S Pritt Division of Clinical

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2018 Infectious Diseases Society of America

119. Core IM: 5 pearls on proton pump inhibitors

antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30) How should you educate patients to take PPIs to get the maximize benefit? (16:48) How do you manage ongoing symptoms in patients on PPIs? (21:41) Many thanks to Dr. Peter Stanich from the Division of Gastroenterology, Hepatology and Nutrition at The Ohio State University Medical Center for peer-reviewing this podcast! Subscribe to CORE IM on any podcast app! Follow us on Facebook || Twitter (...) you had someone in mind when you developed the pearls for this podcast. C: I do – thanks Shreya! My patient was a 74 year old man who had seen several providers in clinic. He had multiple medical problems including, CKD, osteoporosis, some early cognitive impairment, and a problem list with its own table of contents–you know what I mean. Anyway, he had been on omeprazole 20mg for years and years, but from the past bunch of notes, I didn’t even know he had reflux. Turns out he hadn’t had symptoms

2018 Clinical Correlations

120. 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

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