Company: Ther-Rx Pharmacologic class: Estrogen Active ingredient: Estradiol 1.53 mg/spray; transdermal spray. Continue Reading Indication: Moderate-to-severe vasomotor symptoms of menopause. Pharmacology: The addition of exogenous estrogens helps to alleviate the vasomotor symptoms that are associated with declining estrogen levels.Evamist is designed to deliver estradiol to the blood circulation following topical application to the skin of…
Company: Sepracor Pharmacologic class: Corticosteroid Active ingredient: Ciclesonide 50 µg/spray; aqueous nasal spray. Continue Reading Indications: Treatment of seasonal allergic rhinitis in patients ≥6 years old and perennial allergic rhinitis in patients ≥12 years old. Pharmacology: Omnaris is an alcohol-free, hypotonic suspension formulation of the corticosteroid ciclesonide, which is administered as a nasal spray that…
Company: Wyeth Pharmacologic class: Antidepressant (serotonin and norepinephrine reuptake inhibitor [SNRI]) Active ingredient: Desvenlafaxine (as succinate) 50 mg, 100 mg; extended-release tabs. Continue Reading Indication: Major depressive disorder (MDD). Pharmacology: Desvenlafaxine, the major active metabolite of venlafaxine (Effexor XR, also from Wyeth), is a potent and selective SNRI. The increase in the effects of these…
CASE #1 A 30-year-old West African immigrant presented with white lines in his mouth and purple pruritic scaly papules and nodules on his body. The papules and nodules had appeared suddenly on his entire body but not on his face. Blood chemistry was normal. Rapid plasma reagin testing and a hepatitis panel showed no evidence…
A 23-year-old black man complained of a nonpruritic, peripherally growing, annular erythematous eruption that had first appeared on his cheek four weeks ago. The lesion had a slightly raised bright red border with fine trailing scales inside the advancing edge. Tests for fungus were negative. Biopsy of the active border showed discrete parakeratosis, spongiosis, and…
A 60-year-old Caucasian man visited an urgent-care center with acutely tender abscesses on the left jaw and left upper thigh. The physician lanced the pus-filled abscesses to obtain a specimen for culture, then cleaned and packed the area to prevent reinfection of the wound. The cultures were sent to a reference lab for identification and…
With all of the pressures on primary-care clinicians to see more patients while improving the quality of care, we need help in prioritizing the preventive services we provide. Responding to this need, the U.S. Preventive Services Task Force (USPSTF) has identified the most effective preventive measures, and a careful review has prioritized them based on…
The catheterization lab held the key to diagnosis in a patient who noted only mild neck discomfort. Joe, age 67, presented to the emergency department (ED) after a near-syncopal episode that came on while he was eating dinner. He reported nausea, diaphoresis, light-headedness, and generalized weakness. In addition, he noted palpitations and mild left-sided neck…
Clinical and laboratory findings indicated numerous possible maladies. A CT scan eventually led to the correct diagnosis. A 58-year-old truck driver presented to the clinic complaining of nausea and constant epigastric/right upper quadrant (RUQ) pain. The pain initially woke him in the middle of the night and continued for approximately 14 hours. The man tried…
Peppermint has long been known to help soothe stomach discomfort and other digestive upsets, and it is found in many if not most OTC formulations for treating GI problems
