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21. Rational Urine Drug Monitoring in Patients Receiving Opioids for Chronic Pain: Consensus Recommendations Full Text available with Trip Pro

Term Close search filter search input Article Navigation Close mobile search navigation Article Navigation January 2018 Article Contents Article Navigation Rational Urine Drug Monitoring in Patients Receiving Opioids for Chronic Pain: Consensus Recommendations Charles E Argoff, MD Department of Neurology, Albany Medical Center, Albany, New York Search for other works by this author on: Daniel P Alford, MD, MPH Department of Medicine, Boston University School of Medicine and Boston Medical Center (...) . Clinicians should also be aware of relevant state mandates, regulations, and guidelines [ ]; descriptions of UDM requirements by state are available from state medical boards and the AAPM website ( ). Question 2: How Should Patients Undergoing UDM Be Stratified for Opioid Misuse Risk? Expert Panel Recommendations To guide UDM frequency, assess and stratify patients who are prescribed opioid therapy for chronic pain with the following strategies: Perform a physical examination and obtain relevant patient

2018 American Academy of Pain Medicine

23. Drug misuse in over 16s: psychosocial interventions

and young people over 16 who have a problem with or are dependent on opioids, stimulants or cannabis. It aims to reduce illicit drug use and improve people's physical and mental health, relationships and employment. NICE has also produced guidelines on drug misuse in over 16s: opioid detoxification. Who is it for? Healthcare professionals Commissioners and providers People who work in specialist residential and community-based treatment settings People who work in prisons and criminal justice settings (...) with additional needs, such as physical, sensory or learning disabilities, and to people who do not speak or read English. If the service user agrees, families and carers should have the opportunity to be involved in decisions about treatment and care. Families and carers should also be given the information and support they need. Drug misuse in over 16s: psychosocial interventions (CG51) © NICE 2018. All rights reserved. Subject to Notice of rights ( conditions#notice

2007 National Institute for Health and Clinical Excellence - Clinical Guidelines

24. Benzodiazepine and Z-Drug Safety

the long-term use of these drugs for insomnia or any mental health indication. There are concerns regarding their safety. Contraindications • Concurrent use of another benzodiazepine, Z-drug, muscle relaxant, or opioid • Active or history of substance use disorder • Pregnancy or risk of pregnancy • Treatment with opioids for chronic pain or agonist therapy for opioid use disorder • Medical and mental health problems that may be aggravated with benzodiazepines, such as fibromyalgia, chronic fatigue (...) of the guideline was approved for publication by the Guideline Oversight Group in January 2019. Team The Benzodiazepine and Z-Drug Safety Guideline development process included representatives from the following specialties: Behavioral Health, Family Medicine, Pharmacy, Residency, and Urgent Care. Clinician lead: Angie Sparks, MD, Medical Director, Clinical Knowledge Development & Support Guideline coordinator: Avra Cohen, MN, RN, Clinical Improvement & Prevention Bridget Albright, PA, Urgent Care Ben

2014 Kaiser Permanente Clinical Guidelines

25. Antiepileptic drug prophylaxis in severe traumatic brain injury

the prophylactic use of antiepileptic drugs (AEDs) in patients with severe traumatic brain injury (TBI). TBI is a common neurologic disorder, accounting for about 1.1 million emergency department visits and one hospitalization per 1,000 people each year in the United States. Among all patients with head trauma who seek medical attention, about 2% develop post-traumatic seizures, although the number varies widely depending primarily on injury severity. About 12% of patients with severe TBI develop post (...) M, Klebs K, Baltzer V. Inhibition or enhancement of kindling evolution by antiepileptics. J Neural Transm . 1988; 72 : 245 –257. Goldstein LB. Prescribing of potentially harmful drugs to patients admitted to hospital after head injury. J Neurol Neurosurg Psychiatry . 1995; 58 : 753 –755. Jennett B. Epilepsy after non-missile head injuries. Chicago, IL: William Heinemann Medical Books, 1975. Temkin NR, Haglund MM, Winn HR. Post-traumatic seizures. In: Youmans JR, ed. Neurological surgery, 4th ed

2003 American Academy of Neurology

26. Antiepileptic drugs guideline for chronic pain

likely to be effective for questionable neuropathic pain conditions with no objective findings of nerve injury. Use of gabapentin for questionable neuropathic pain conditions should be authorized only after consultation and recommendation from a physician specializing in pain therapies, rehabilitation and physical medicine, anesthesiology, or neurology. It is recommended that a physician specializing in pain therapies have a subspecialty certification in pain medicine from the American Board (...) Antiepileptic drugs guideline for chronic pain Medical Treatment Guidelines Washington State Department of Labor and Industries Antiepileptic drugs guideline for chronic pain Purpose and development of the guideline The purpose of this guideline is to provide guidance to treating physicians in the use of Anti-Epileptic Drugs (AEDs) in the management of neuropathic pain. This guideline was developed by the Department of Labor and Industries and the Department of Social and Health Services Health

2005 Washington State Department of Labor and Industries

27. Guidelines for the Clinical and Operational Management of Drug-Resistant Tuberculosis

medicines 230 Importation of drug-resistant tuberculosis medicines 231 Storage and distribution in-country 231 Rational use 231 References 232 Appendices 233 CONTENTS viiAbbreviations 2LI second-line injectable drug AFB acid-fast bacillus Am amikacin Amx/Clv amoxicillin/clavulanate ART antiretroviral therapy ARV antiretroviral (drug) ATS American Thoracic Society AUC24 area under the concentration-time curve from 0 to 24 h BTS British Thoracic Society CD4 cells CD4+T lymphocytes Cf clofazimine Cfx cipro (...) . It was seen following the introduction of widespread anti- microbial use in the late 1940s and early 1950s, and served as a basis for the development of multidrug therapy for TB by Crofton and his colleagues in Edinburgh. When investigators introduced new drugs for treatment of TB as they were developed, they found that the bacterial populations selected by the treatment were resistant to the medications that had previously been used. Whereas the initial appearance of drug resistance is a ‘man-made’ phe

2013 International Union Against TB and Lung Disease

28. Guidelines for the Safe Administration of Injectable Drugs in Anaesthesia

have a significant impact on availability of essential medications when there are interruptions to supply. 5.1.2 If feasible, a designated pharmacist should liaise with a designated (clinical) drug safety officer in the department of anaesthesia or pain medicine over all decisions on relevant drug purchasing and presentation. In the absence of an anaesthesia department an anaesthetist should be nominated/designated to undertake such liaison. 5.1.3 The labelling and packaging of drugs should (...) of controlled medicines should be according to jurisdictional requirements. 5.9 INTRAVENOUS INFUSION OF MEDICATIONS 5.9.1 Wherever practicable infusion pumps and syringe drivers used for the administration of intravenous drugs should be standardised within an institution. Page 7 PS51 2018 5.9.2 When drugs are given by infusion, the patient end of the infusion line should be labelled and precautions taken with one-way valves to avoid any siphoning of the infused drug. Valve design should

2009 Australian and New Zealand College of Anaesthetists

29. 2012 Update to The Society of Thoracic Surgeons Guideline on Use of Antiplatelet Drugs in Patients Having Cardiac and Noncardiac Operations

options of patients exposed to anti- platelet drugs who need urgent operation. A. Search Methods The search methods used to survey the published liter- ature changed in the current guideline version compared with the previously published guideline [1]. In the inter- est of transparency, literature searches were conducted using standardized Medical Subject Heading (MeSH) terms from the National Library of Medicine PUBMED database list of search terms. The following terms com- prised the standard (...) , Charles R. Bridges, MD, ScD, George J. Despotis, MD, PhD, Kanae Jointer, BA, and Ellen R. Clough, PhD Division of Cardiovascular and Thoracic Surgery, University of Kentucky, Lexington, Kentucky (VAF and SPS); Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska (JHO); Division of Cardiothoracic Surgery, Oregon Health and Science University Medical Center, Portland, Oregon (HKS); State University of New York, Stony Brook School of Medicine, Stony

2012 Society of Thoracic Surgeons

30. Treatment of Drug-Susceptible Tuberculosis: Official ATS/CDC/IDSA Clinical Practice Guidelines

completion of intensive-phase therapy is culture-positive) ? Treatment failure ? Relapse ? Drug resistance ? Homelessness ? Current or prior substance abuse ? Use of intermittent dosing ? HIV infection ? Previous nonadherence to therapy ? Children and adolescents ? Mental, emotional or physical disability (ie, cognitive deficits such as dementia; neurological deficits; medically fragile patients; or patients with blindness or severe loss of vision) ? Resident at correctional or long-term care facility (...) , South Africa; 17 University of Sassari, Italy; and 18 Baylor College of Medicine, Houston, Texas The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the Eu- ropeanRespiratorySocietyandtheUSNationalTuberculosisControllersAssociation.RepresentativesfromtheAmericanAcademy ofPediatrics

2016 American Thoracic Society

31. Drugs That May Cause or Exacerbate Heart Failure Full Text available with Trip Pro

Antifungal Medications Several cases of new-onset dilated cardiomyopathy with subsequent HF with amphotericin B and its liposomal formulation have been reported. In each case, HF symptoms and echocardiographic findings normalized on discontinuation of therapy, which occurred within 10 days to 6 months of drug discontinuation. Anticancer Medications Anthracyclines The anthracyclines are a highly used class of cytotoxic agents that target proliferating cells via a diverse mechanism that includes DNA (...) . Hospitalization for HF is the largest segment of those costs. It is likely that the prevention of drug-drug interactions and direct myocardial toxicity would reduce hospital admissions, thus both reducing costs and improving quality of life. Patients with HF often have a high medication burden consisting of multiple medications and complex dosing regimens. On average, HF patients take 6.8 prescription medications per day, resulting in 10.1 doses a day. This estimate does not include over-the-counter (OTC

2016 American Heart Association

32. American Heart Association Principles on the Accessibility and Affordability of Drugs and Biologics: A Presidential Advisory From the American Heart Association Full Text available with Trip Pro

, payers, and patient groups that they are unsustainable and threaten the affordability of and accessibility to much-needed therapies for patients. Two trends related to drugs/biologics and generic drugs/biosimilars underlie this overall increase in spending. First, the market entry prices of innovator pharmaceutical products, or brand drugs and biologics, are at levels that some assessments consider unaffordable to the healthcare system. Second, prices for some established generic drugs (...) pharmaceutical products, or brand drugs and biologics, are at levels that some assessments consider unaffordable to the healthcare system. The approval of 2 proprotein convertase subtilisin/kexin type 9 inhibitors for hypercholesterolemia, alirocumab and evolocumab, and another drug for heart failure, sacubitril/valsartan, has focused attention on the price of specialty therapies for cardiovascular disease, although innovator drugs for other disease states such as cancer have similar price tags. Second

2017 American Heart Association

33. Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury

- ologists must always consider the possibility of DILI in patients with unexplained acute and chronic liver injury, as well as when prescribing certain gastrointestinal medications (e.g., azathio- prine, anti-tumor necrosis factor agents, sulfonamides) ( 7,8 ). Many herbal and dietary supplements (HDS) can cause DILI, and thus they must be considered as a cause for DILI. For the purposes of this guideline, the term DILI will refer to idiosyn- cratic liver injury from HDS, as well as prescription drugs (...) , USA ; 4 Einstein Health Care Network , Philadelphia , Pennsylvania , USA ; 5 University of Texas at Southwestern Medical Center , Dallas , Texas , USA ; 6 University of Michigan , Ann Arbor , Michigan , USA . Correspondence: Naga P. Chalasani, MD, FACG , Indiana University School of Medicine , Indianapolis , Indiana 46202 , USA . E-mail: Received 21 October 2013; accepted 10 April 2014 The American Journal of GASTROENTEROLOGY VOLUME 104 | XXX 2014 2 Chalasani et

2014 American College of Gastroenterology

34. Neuropathic pain - drug treatment

, spinal cord injury, and multiple sclerosis. In many cases, it is not possible to completely cure the underlying disease or lesion or to reverse the neurological changes. Consequently, neuropathic pain is usually persistent in these cases. The general principles for prescribing drug treatment for neuropathic pain include considering: Contraindications and potential adverse effects, especially for people with comorbid conditions. Interactions with other medications. Comorbid conditions that may benefit (...) guideline referenced above. Previous changes Previous changes August 2012 — minor update. Minor typographical error corrected. May to September 2010 — topic updated. The evidence base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence. January 2009 — minor update. Drug safety advice from the MHRA (Medicines and Healthcare products Regulatory Agency) that all antiepileptic drug treatment (including carbamazepine and gabapentin

2019 NICE Clinical Knowledge Summaries

35. Benzodiazepine and z-drug withdrawal

on the advice of your GP, or your pharmacist, you will be able to raise a 'statutory defence' and the police may not prosecute you. It may be helpful to keep evidence with you while you are driving, that you are taking a benzodiazepine in accordance with medical advice. Suitable evidence may include: your medication box with the pharmacy label on, or the other half of your prescription with the list of medicines prescribed by your doctor. The DVLA provides no advice for people taking z-drugs. For more (...) relaxation techniques (such as progressive muscular relaxation and controlled breathing techniques), or CBT if symptoms are severe or protracted. For more information, see the CKS topic on . Adjunct drug therapy should not be routinely prescribed, but may be considered. Propranolol: for severe, physical symptoms of anxiety (such as palpitations, tremor, and sweating) only if other measures fail. Antidepressants: only if depression or panic disorder coexist or emerge during drug withdrawal. Do

2019 NICE Clinical Knowledge Summaries

36. Use of Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes in Preclinical Cancer Drug Cardiotoxicity Testing: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

, as well as structural abnormalities, making it possible to deliver novel drugs free from cardiac liabilities and guide personalized therapy. This article briefly reviews the challenges of cardio-oncology, the strengths and limitations of using human induced pluripotent stem cell–derived cardiomyocytes to represent clinical findings in the nonclinical research space, and future directions for their further use. In the United States and Europe, cancer is the second leading cause of death and morbidity (...) the safety and efficacy of currently available and future therapies. The focus of this scientific statement is the utility and potential promise of human induced pluripotent stem cell (hiPSC)–derived cardiomyocytes (hiPSC-CMs) in preclinical testing of drug-induced cardiotoxicity. Although there is overlap, it is useful to consider cardiotoxicity in 3 categories: electrophysiological abnormalities, contractile dysfunction, and structural toxicity. Although touching on all 3 categories, this review

2019 American Heart Association

37. Drug misuse prevention: targeted interventions

and the Psychoactive Substances Act 2016, as well as new psychoactive substances (often described as 'legal highs'), solvents, volatile substances, image- and performance-enhancing drugs, prescription-only medicines and over-the-counter medicines. Drug misuse Drug misuse Dependence on, or regular excessive consumption of, psychoactive substances, leading to physical, mental or social problems. This term does not include occasional or experimental drug use in adults. Groups at risk Groups at risk Groups at risk (...) , including illegal drugs, 'legal highs' and prescription-only medicines. It aims to prevent or delay harmful use of drugs in children, young people and adults who are most likely to start using drugs or who are already experimenting or using drugs occasionally. This guideline does not cover broader activities, both population-level (universal) and targeted, that aim to build people's skills, resilience and ability to make positive decisions about their health and which address the wider determinants

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

38. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection

not so identified.xiii Definition of key terms Serodiscordant couples are couples in which one partner is living with HIV and the other is HIV-negative. A couple refers to two people in an ongoing sexual relationship; each of these people is referred to as a partner in the relationship. How individuals define their relationships will vary according to their cultural and social context. Antiretroviral therapy ARV (antiretroviral) drugs refer to the medicines used to treat HIV. ART (antiretroviral (...) ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTIONCONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION 2016 RECOMMENDATIONS FOR A PUBLIC HEALTH APPROACH SECOND EDITIONWHO Library Cataloguing-in-Publication Data Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach – 2nd ed. 1.HIV Infections – drug therapy. 2.HIV Infections – prevention

2016 World Health Organisation HIV Guidelines

39. Recommendations for the control of multi-drug resistant gram-negatives - carbapenem resistant enterobacteriaceae

• mechanical ventilation • a higher severity of illness • admission to the intensive care unit • an indwelling medical device, such as a central venous catheter, urinary catheter, biliary catheter or wound drainage • an organ or stem-cell transplant People who come into contact with CRE organisms may spread or become infected with multi-drug resistant bacteria. The increased frequency of international travel for work, leisure and migration, potentially contributes to the spread of CRE from country (...) , ‘micro-alerting’ may facilitate these processes. Micro-alerting refers to application of a tag or flag to a patient’s medical record (soft or hard copy) that alerts a facility of a patients status with regard to prior colonisation or infection with multi-drug resistant organisms, including CRE. • All staff should receive education and training regarding CRE (see clinician information sheet), including the proper use of and rationale for, contact precautions. • The Australian Guidelines

2014 Clinical Practice Guidelines Portal

40. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users

drugs inject opioids. A number of different opioid agonists are used for opioid substitution therapy, the most common being methadone and buprenorphine, both of which are listed as essential medicines by WHO (37). Other preparations, including pharmaceutical heroin (diamorphine) and slow-release morphine preparations, also are used in a limited number of countries. OST for non-injecting opioid-dependent people is also considered in the indicators presented here. Transition to injecting among (...) symptomatic relief to reduce the discomfort of withdrawal; opioid withdrawal can be managed with opioid substitution therapy in diminishing doses (39). In a number of countries drug users are apprehended and confined to detention centres, ostensibly for the purpose of drug treatment and rehabilitation, but without trial or clinical assessment of dependence, and the duration of detention is rarely determined by clinical treatment outcomes. Typically, in these centres there is no medical supervision of drug

2013 World Health Organisation HIV Guidelines


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