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Medication Causes of Dyspepsia

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141. Trastuzumab (Ogivri) - breast cancer or stomach cancer

infusion only. If an alternate route of administration is required, other trastuzumab products offering such an option should be used In order to prevent medication errors it is important to check the vial labels to ensure that the medicinal product being prepared and administered is trastuzumab and not trastuzumab emtansine. 4 Posology Metastatic breast cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight. The recommended maintenance dose at three-weekly intervals (...) as a 30-minute infusion. For instructions on reconstitution of the medicinal product before administration, see section 6.6. 4.3 Contraindications • Hypersensitivity to the active substance, murine proteins, or to any of the excipients listed in section 6.1. • Severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy. 4.4 Special warnings and precautions for use Traceability In order to improve the traceability of biological medicinal products

2019 European Medicines Agency - EPARs

142. Istradefylline (Nourianz) - Parkinson's disease

, including rebound Parkinson’s Disease symptoms, the sponsor summarized any AE occurring up to 40 days after the treatment end date (> 5 plasma elimination half-lives) in Pool 1. Reviewer comment: Variability exists in how TEAEs were defined by study. Presumption of causality by the investigator appears to have played a role in whether AEs were assessed as TEAEs as the investigator had to assess whether an AE worsened in severity after exposure to the study drug. This could cause potential underreporting (...) belonging to narrow SMQs with incidence of at least 1% greater than placebo for Pool 1. The only TEAEs related to laboratory analysis belonged narrow SMQ with incidence of at least 1% greater than placebo was Hyperglycaemia/New Onset Diabetes Mellitus. The following table shows the incidence by dose. Overall, the maximum difference from placebo was low at = 65 13.7 7.4 Fall, dizziness, balance disorder = 65 8.2 9.8 Dyspepsia, N, V, indigestion, epigastric pain, gastritis, duodenitis = 65 5.4 5.6

2019 FDA - Drug Approval Package

143. Treatment of Depression in Children and Adolescents

and harms of pharmacological and nonpharmacological treatments for child and adolescent depressive disorders. Key Messages • Cognitive behavioral therapy (CBT), fluoxetine, escitalopram, and combined fluoxetine plus CBT may reduce depressive symptoms in the short term; clinical significance is unclear. • CBT may improve symptoms and functional status. CBT plus medications may help prevent relapse. • Selective serotonin reuptake inhibitors (SSRIs) as a class may improve response and functional status (...) : Subpopulations 52 Relapse Prevention CBT + Continued Antidepressant Medication Management Versus Continued Medication Management: Subpopulations 53 IPT Versus Wait-List Control: Subpopulations 53 IPT Versus Active Control: Subpopulations 53 Family-Based IPT Versus Active Control: Subpopulations 53 Attachment-Based Family Therapy Versus Wait-List Control: Subpopulations 54 Attachment-Based Family Therapy Versus TAU: Subpopulations 54 Family Therapy Versus Pill Placebo: Subpopulations 54 Family Therapy Versus

2020 Effective Health Care Program (AHRQ)

144. AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia Full Text available with Trip Pro

Western Reserve University, Cleveland, Ohio 10 , 11 , x Reem A. Mustafa Affiliations Department of Internal Medicine, University of Kansas Medical Center, Kansas 12 DOI: | Publication History Published online: December 06, 2019 Expand all Collapse all Article Outline Abbreviations used in this paper: ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ), ( ) See editorial on . Gastric cancer is the third leading cause of cancer death worldwide. x 1 Bray, F., Ferlay, J., Soerjomataram, I. et al. Global cancer (...) Diego, California Division of Gastroenterology and the Moores Cancer Center, University of California San Diego, La Jolla, California 1 , 2 , x Dan Li Affiliations Department of Gastroenterology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California Division of Research, Kaiser Permanente Northern California, Oakland, California 3 , 4 , x Hashem B. El Serag Affiliations Department of Medicine, Baylor College of Medicine, Houston, Texas 5 , x Perica Davitkov Affiliations Veterans

2020 American Gastroenterological Association Institute

145. AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19

in Supplement Table 1 and 2 (Direct Evidence Sources and Indirect Evidence Sources. Table 3: GI Treatment Adverse Effects of Currently Utilized COVID-19 Therapies Medica tion Type Medication Name Gastrointestinal AEs Hepatic AEs Major drug-drug interactions Anti- malarial Chloroquine Nausea, vomiting, abdominal pain, and diarrhea reported; frequency not defined Likelihood score: D (possible rare cause of clinically apparent liver injury) Description: Rare elevations in aminotransferases. Most reactions (...) , particularly in patients undergoing drug therapy for COVID-19 associated with potential hepatotoxicity. We additionally advise that all patients with abnormal LFTs undergo an evaluation to investigate non-COVID-19 causes of liver disease. 3.What are common GI/liver adverse effects of COVID-19 treatments? There are currently no FDA-approved routine treatments for COVID-19. The FDA has issued an emergency use authorization (EUA) for three therapies: choloroquine or hydroxychloroquine, remdesivir

2020 American Gastroenterological Association Institute

146. AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19 Full Text available with Trip Pro

, Cleveland, Ohio Joseph D. Feuerstein Affiliations Division of Gastroenterology and Center for Inflammatory Bowel Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts Joseph K. Lim Affiliations Yale Liver Center and Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut; and Yngve Falck-Ytter Affiliations Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio (...) co-first authorship. Osama Altayar Footnotes ∗ Authors share co-first authorship. Affiliations Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri Shazia M. Siddique Affiliations Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania Perica Davitkov Affiliations Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine

2020 American Gastroenterological Association Institute

147. BTS Guideline for Long Term Macrolide Use

is being derived from therapy. If there is no benefit, treatment should be stopped. ? Even if benefit is seen, consideration should be given to stopping treatment for a period each year, for example, over the summer. Such a drug holiday may help with reducing the development of resistance while maintaining efficacy because the vicious cycle has been broken. See quick reference guide in online supplementary file 1. Chronic obstructive pulmonary disease Recommendations ? Long- term macrolide therapy (...) , previous low serum potassium measurements, a slow pulse rate, a family history of sudden death or known prolonged QT interval. Patients with such a history should not receive low- dose macrolide therapy without careful consideration and counselling of the increased risk of adverse cardiac effects. ? Prior to initiating low- dose macrolide therapy, a drug history looking for agents that might prolong the QTc interval should be sought (see online supplementary appendices 3 and 4). Patients taking

2020 British Thoracic Society

148. Abdominal and pelvic imaging

, hepatobiliary scintigraphy is ionizing, less widely available, and takes longer to perform, hence best used as an add-on test following nondiagnostic ultrasound. Choledocholithiasis Advanced imaging is considered medically necessary for diagnosis and management following nondiagnostic ultrasound. IMAGING STUDY - MRI/MRCP abdomen Rationale Choledocholithiasis is a common cause of biliary obstruction. Ultrasound has high diagnostic accuracy for acute cholecystitis and is non-ionizing, widely available (...) Includes chronic hepatitis, cirrhosis, glycogen storage diseases, hemochromatosis, and Wilson’s disease. Advanced imaging is considered medically necessary in ANY of the following scenarios: ? Evaluation of suspected liver disease based on clinical findings or abnormal liver function tests when ultrasound is nondiagnostic and further evaluation is required ? Suspected hepatocellular carcinoma in persons with known cirrhosis ? Evaluation for iron overload in hemochromatosis when chelation therapy

2020 AIM Specialty Health

149. Upper airway cough syndrome

of a sensory neuropathic process and not relate to rate or quantity of nasal discharge. Most common cause of chronic cough in adults. No pathognomonic findings exist; diagnosis should be determined by considering a combination of criteria, including the history, physical exam, imaging, and, ultimately, the response to therapy. Trial of empirical therapy with a first-generation antihistamine plus a decongestant is both diagnostic and therapeutic. Non-pharmacological therapies also form part of the treatment (...) on a speaker's bureau for AstraZeneca and Novartis, and has received educational grants from AstraZeneca, GSK, Bionorica, PGT Healthcare, and Vernalis Therapeutics, for supporting the Ninth London International Cough Symposium held in London in 2016. Consultant Respiratory Physician Respiratory Medicine Royal Brompton Hospital London UK Disclosures JHH has received advisory board fees from Menlo Pharmaceuticals, and speaking and travel fees from TEVA and Boehringer Ingelheim. Peer reviewers Professor

2018 BMJ Best Practice

150. Upper airway cough syndrome

of a sensory neuropathic process and not relate to rate or quantity of nasal discharge. Most common cause of chronic cough in adults. No pathognomonic findings exist; diagnosis should be determined by considering a combination of criteria, including the history, physical exam, imaging, and, ultimately, the response to therapy. Trial of empirical therapy with a first-generation antihistamine plus a decongestant is both diagnostic and therapeutic. Non-pharmacological therapies also form part of the treatment (...) on a speaker's bureau for AstraZeneca and Novartis, and has received educational grants from AstraZeneca, GSK, Bionorica, PGT Healthcare, and Vernalis Therapeutics, for supporting the Ninth London International Cough Symposium held in London in 2016. Consultant Respiratory Physician Respiratory Medicine Royal Brompton Hospital London UK Disclosures JHH has received advisory board fees from Menlo Pharmaceuticals, and speaking and travel fees from TEVA and Boehringer Ingelheim. Peer reviewers Professor

2018 BMJ Best Practice

151. Assessment of nausea and vomiting in children

:1456-68. http://www.ncbi.nlm.nih.gov/pubmed/27144632?tool=bestpractice.com Vomiting is usually preceded by nausea; the only exceptions are rumination syndrome, in which oral regurgitation is not preceded by nausea, and possibly gastro-oesophageal reflux disease. Nausea is not always followed by vomiting, as in conditions such as chronic functional nausea, postural nausea, and functional dyspepsia. Aetiology There are various established mechanisms that are known to cause nausea and vomiting (...) or central nervous system infection Metabolic or endocrine abnormalities such as diabetic ketoacidosis, adrenal insufficiency, and protein or carbohydrate metabolism disorders Urological/gynaecological or renal causes such as gonadal torsion Renal causes such as haemolytic uraemic syndrome and nephrolithiasis Psychiatric causes such as eating disorders, rumination, or factitious disorder Environmental causes such as toxic ingestions and adverse effects associated with the use of medications or illicit

2018 BMJ Best Practice

152. Assessment of nausea and vomiting in children

:1456-68. http://www.ncbi.nlm.nih.gov/pubmed/27144632?tool=bestpractice.com Vomiting is usually preceded by nausea; the only exceptions are rumination syndrome, in which oral regurgitation is not preceded by nausea, and possibly gastro-oesophageal reflux disease. Nausea is not always followed by vomiting, as in conditions such as chronic functional nausea, postural nausea, and functional dyspepsia. Aetiology There are various established mechanisms that are known to cause nausea and vomiting (...) or central nervous system infection Metabolic or endocrine abnormalities such as diabetic ketoacidosis, adrenal insufficiency, and protein or carbohydrate metabolism disorders Urological/gynaecological or renal causes such as gonadal torsion Renal causes such as haemolytic uraemic syndrome and nephrolithiasis Psychiatric causes such as eating disorders, rumination, or factitious disorder Environmental causes such as toxic ingestions and adverse effects associated with the use of medications or illicit

2018 BMJ Best Practice

153. Gastritis

Gastritis Gastritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Gastritis Last reviewed: February 2019 Last updated: October 2018 Summary Helicobacter pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol are the most common causes. Other causes include stress (secondary to mucosal ischaemia) and autoimmune gastritis. Rare forms include phlegmonous gastritis (a rare bacterial (...) B12 upper GI contrast series blood/fluid cultures parietal cell antibodies intrinsic factor antibodies H pylori culture/polymerase chain reaction (PCR) Treatment algorithm INITIAL ACUTE Contributors Authors Professor of Medicine Rosalind Franklin University Medical School North Chicago, Illinois Adjunct Professor of Pediatric Gastroenterology University of Miami Miller Medical School Miami, Florida Associate Director for Research Internal Medicine Residency Advocate Lutheran General Hospital Park

2018 BMJ Best Practice

154. Gastritis

Gastritis Gastritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Gastritis Last reviewed: February 2019 Last updated: October 2018 Summary Helicobacter pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol are the most common causes. Other causes include stress (secondary to mucosal ischaemia) and autoimmune gastritis. Rare forms include phlegmonous gastritis (a rare bacterial (...) B12 upper GI contrast series blood/fluid cultures parietal cell antibodies intrinsic factor antibodies H pylori culture/polymerase chain reaction (PCR) Treatment algorithm INITIAL ACUTE Contributors Authors Professor of Medicine Rosalind Franklin University Medical School North Chicago, Illinois Adjunct Professor of Pediatric Gastroenterology University of Miami Miller Medical School Miami, Florida Associate Director for Research Internal Medicine Residency Advocate Lutheran General Hospital Park

2018 BMJ Best Practice

155. Ascariasis

for ascariasis. CP declares that she has no competing interests. Peer reviewers Director Stanford Health Promotion Network Stanford School of Medicine Palo Alto CA Disclosures YM declares that he has no competing interests. Associate Professor Department of Medical Parasitology and Mycology School of Public Health Tehran University of Medical Sciences Iran Disclosures MBR declares that he has no competing interests. Use of this content is subject to our Services Legal © BMJ Publishing Group 2018 ISSN 2515 (...) asymptomatic, ascariasis can cause gastrointestinal and hepatobiliary obstruction, and can contribute to cognitive and growth delay in children. Seltzer E, Barry M, Crompton DWT. Ascariasis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical infectious diseases: principles, pathogens and practice. 2nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2006:1257-1264. Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367

2018 BMJ Best Practice

156. Assessment of chronic abdominal pain

of Medicine Chief of Clinical Gastroenterology and Hepatology University of Texas Medical Branch Galveston TX Disclosures NS declares that he has no competing interests. Gastroenterologist Dartmouth-Hitchcock Nashua Nashua NH Disclosures SN declares that he has no competing interests. Use of this content is subject to our Services Legal © BMJ Publishing Group 2018 ISSN 2515-9615 Help us improve Thank you × Your feedback has been submitted successfully. (...) , and gynaecological tracts. The aetiology of chronic abdominal pain is so wide that only the more common causes can be covered here. A clear relationship with an anatomical structure or underlying process may not always be present. Classification Chronic abdominal pain is divided into organic and functional aetiologies. Organic aetiologies have a clear anatomical, physiological, or metabolic cause. Chronic abdominal pain without clear source, in spite of a thorough diagnostic evaluation, is usually termed

2018 BMJ Best Practice

157. Assessment of nausea and vomiting, adults

Assessment of nausea and vomiting, adults Assessment of nausea and vomiting, adults - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of nausea and vomiting, adults Last reviewed: February 2019 Last updated: June 2018 Summary Nausea and vomiting are extremely common symptoms and may be caused by a vast array of medical conditions. Koch KL. Nausea and vomiting. In: Wolfe MM, Davis GL, Farraye FA, et al, eds (...) and disorders that originate in peripheral organ systems, such as the GI tract, stimulate vagal or spinal afferent nerves that connect with the vagal sensory (tractus solitarius) and vagal efferent motor nuclei. Ultimately, cortical centres where nausea is perceived and the efferent pathways that mediate vomiting are stimulated. Tumours, infections, and drugs in the periphery may cause local dysfunction in a variety of organ systems that is sensed as nausea, and severe nausea eventually evokes vomiting

2018 BMJ Best Practice

158. Peptic ulcer disease

Peptic ulcer disease Peptic ulcer disease - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Peptic ulcer disease Last reviewed: February 2019 Last updated: February 2019 Summary Peptic ulcers usually present as chronic, upper abdominal pain related to eating a meal (dyspepsia). Use of non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection are the most common causes. There may be some (...) epigastric tenderness, but often there are no other signs on physical examination. Endoscopy is diagnostic and may show an ulcer in the stomach or proximal duodenum. H pylori infection should be sought. In the absence of 'alarm' (red flag) symptoms or signs, testing for and treating H pylori and/or empirical acid inhibition therapy is appropriate. The most common complication is gastroduodenal bleeding. Perforation is a less frequent but potentially life-threatening complication. Either of these may

2018 BMJ Best Practice

159. Early breast cancer (preventing recurrence and improving survival): adjuvant bisphosphonates

. Clodronate costs around £1780 per year and ibandronic acid costs around £80 per year (costs taken from Drugs and pharmaceutical electronic market information and the Drug T ariff; excluding VAT). These costs do not include any local procurement discounts or other costs incurred, such as dilution and administration, standard supportive therapy (such as calcium and vitamin D), or any costs associated with attendance for day case treatment. Depending on the bisphosphonate used, additional costs that need (...) (27%) and ibandronic acid (16%). There is little or no evidence to support the use of risedronate, alendronic acid or pamidronate for preventing recurrence and improving survival in people with early breast cancer. Although serious adverse effects are rare, they should be discussed with women considering adjuvant bisphosphonate therapy and measures should be taken to reduce the risk of them occurring (see the MHRA guidance). Oral bisphosphonates such as clodronate are more likely to cause

2017 National Institute for Health and Clinical Excellence - Advice

160. Obese, overweight with risk factors: liraglutide (Saxenda)

of 3.0 mg daily (MIMS, May 2017, excluding VAT). Orlistat 120 mg 3 times a day costs £18.05 for 30 days' supply (Drug T ariff, May 2017, excluding VAT). The manufacturer has reported that they will only promote the use of liraglutide (Saxenda) on private prescription, so they anticipate that use on the NHS will be limited. This evidence summary does not contain recommendations from NICE on whether the medicine should be prescribed within the NHS or by private prescription. Obese, overweight with risk (...) or more with associated risk factors, such as type 2 diabetes. Orlistat therapy should be continued beyond 3 months only if the person has lost at least 5% of their initial body weight since starting drug treatment. Rates of weight loss may be slower in people with type 2 diabetes, so less strict goals than those for people without diabetes may be appropriate. A NICE interactive flowchart on obesity brings together all related NICE guidance and associated products on this topic in a set of interactive

2017 National Institute for Health and Clinical Excellence - Advice

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