January 10, 2007 Archives - Page 3 of 6 - Clinical Advisor

Print Issue: January 10, 2007

HUMAN PAPILLOMAVIRUS VACCINE CONCERNS

I currently test for human papillomavirus (HPV) DNA as a marker for HPV infection. With the advent of the HPV vaccine, how will clinicians be able to distinguish between an active HPV infection and immunity? Will HPV tests for antibodies and antigens be available similar to those for hepatitis B?—Karin Greer, MS, MPH, PA-C, East…

ELEVATED TRIGLYCERIDES

A patient with CAD has high triglycerides (300-500 mg/dL), and therefore his LDL is reported as “unable to calculate.” If he fails lifestyle modification, should he start a fibrate (or niacin) for the high triglycerides, or would it be better to start a statin? The statin might lower triglycerides enough to calculate the LDL, not…

TRACING THE CAUSE OF BAD BREATH

I am treating a patient for persistent bad breath. GI workup, including Helicobacter pylori testing and esophagogastroduodenoscopy, is negative. A dental evaluation was normal. His father also has bad breath. Is this condition hereditary? Where do I go from here?—Helen Song, RNP, Woodland Hills, Calif. As noted, even a methodical exploration of sinuses, teeth, gums,…

Fentora- New opioid relieves the pain of cancer

Company: Cephalon Pharmacologic class: Opioid analgesic Active ingredient: Fentanyl (as citrate) 100 µg, 200 µg, 400 µg, 600 µg, 800 µg; buccal tablets.Continue Reading Indication: Management of breakthrough pain in patients with cancer who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Opioid-tolerant patients are those taking…

Verdeso- Spray-on corticosteroid for eczema

Product: Verdeso Company: Connetics Pharmacologic class: Topical corticosteroid (low potency) Continue Reading Active ingredient: Desonide 0.05%; topical foam. Indication: Mild-to-moderate atopic dermatitis in patients older than 3 months of age. Pharmacology: Desonide, like other topical corticosteroids, has anti-inflammatory, antipruritic, and vasoconstrictive actions. Verdeso is a petroleum-based emulsion formulation of desonide that is dispensed as an…

Januvia- New way to combat type 2 diabetes

Product: Januvia Company: Merck Pharmacologic class: Antidiabetic (dipeptidylpeptidase-4 inhibitor) Continue Reading Active ingredient: Sitagliptin (as phosphate) 25 mg, 50 mg, 100 mg; tabs. Indication: Adjunct to diet and exercise in type 2 diabetes, as monotherapy or in combination with either metformin or a thiazolidinedione. Pharmacology: Incretins, such as glucagonlike peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide,…

Drug choice for diabetic hypertensives: two options

For patients with both type 2 diabetes and hypertension, should you choose an ACE inhibitor or an angiotensin-receptor blocker (ARB) for BP control? Two new studies weigh in with different answers. One was a double-blind, randomized, prospective trial of 1,204 diabetic hypertensive patients in Italy. At the end of the 3.6-year study, those receiving the…

PRENATAL STEROIDS REDUCE SEVERITY OF NEONATAL LUNG DISEASE BUT INCREASE RATE OF CESAREAN DELIVERY

Level 1: Likely reliable evidence The efficacy of weekly prenatal corticosteroids was evaluated in a randomized trial of 982 women at risk of preterm birth before 32 weeks’ gestation (Lancet. 2006;367:1913-1919). Women were treated with one corticosteroid course and randomized to betamethasone sodium phosphate 7.8 mg plus betamethasone acetate 6 mg (Celestone Chronodose) or to…

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