March 03, 2007 Archives - Page 4 of 8 - Clinical Advisor

Print Issue: March 03, 2007

INSPIRATORY MUSCLE TRAINING REDUCES PULMONARY COMPLICATIONS IN HIGH-RISK CABG PATIENTS

Level 1: Likely reliable evidence Preoperative inspiratory muscle training prevented pneumonia in a randomized trial of 279 patients undergoing coronary artery bypass graft (CABG) surgery who were at high risk for pulmonary complications (JAMA. 2006;296:1851-1857). High risk was defined as forced expiratory volume in one second (FEV1) <80% predicted and ratio of FEV1 to forced…

CAREGIVER SUPPORT DELAYS NURSING-HOME PLACEMENT FOR PATIENTS WITH ALZHEIMER’S DISEASE

Level 2: Mid-level evidence Caregiver support was evaluated in a randomized trial of 406 spouse-caregivers of community-dwelling patients with Alzheimer’s disease (AD) (Neurology. 2006;67:1592-1599). Caregivers were randomized to enhanced counseling and support intervention vs. usual care until the caregiver became too ill to participate or two years after the patient died. Caregivers had to be…

AMOXICILLIN TREATMENT FOR THREE DAYS vs. EIGHT DAYS

Level 2: Mid-level evidence A recent trial involved 121 adults hospitalized for community-acquired pneumonia who were improved after three days of IV amoxicillin (BMJ. 2006;332:1355; full-text available online without charge at: http://bmj.bmjjournals.com, accessed February 7, 2007). Following completion of the IV amoxicillin, patients were randomized to oral amoxicillin 750 mg three times daily for five…

LIDOCAINE AND SUMATRIPTAN EACH REDUCE PAIN IN TRIGEMINAL NEURALGIA

Level 1: Likely reliable evidence Trigeminal neuralgia is typically treated with chronic therapy, but patients occasionally require treatment for acute pain. Now, subcutaneous sumatriptan (Imitrex) and intranasal lidocaine have each been shown in single-dose trials to reduce pain in the short-term. Intranasal lidocaine was evaluated in a randomized crossover trial of 25 patients who had…

Drugs in the pipeline

Cardiovascular Amlodipine besylate + olmesartan medoxomil (from Daiichi Sankyo) calcium channel blocker plus angiotensin receptor blocker combination being reviewed for the treatment of hypertension — NDA submitted Rivaroxaban (from Bayer and Ortho-McNeil) an oral Factor Xa inhibitor being studied for stroke prevention in atrial fibrillation and treatment and long-term secondary prevention of venous thromboembolism —Phase…

Invega- Antipsychotic in extended-release form

Product: Invega Company: Janssen Pharmacologic class: Antipsychotic (benzisoxazole) Active ingredient: Paliperidone 3 mg, 6 mg, 9 mg; extended-release tabs. Indication: Schizophrenia. Pharmacology: Paliperidone is the major active metabolite of risperidone. Although the mechanism of action of this atypical antipsychotic is unknown, the therapeutic effect may be due to a combination of central dopamine type 2…

Tyzeka- Rapid-acting agent for

Companies: Idenix and Novartis Pharmacologic class: Antiviral (nucleoside analog reverse transcriptase inhibitor) Active ingredient: Telbivudine 600 mg; tabs. Indication: Treatment of chronic hepatitis B in patients with evidence of viral replication and either evidence of persistent elevations of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) or histologically active disease. Pharmacology: Telbivudine is a thymidine nucleoside analog that…

Angeliq- Another choice for menopause therapy

Company: Berlex Pharmacologic class: Estrogen + progestin Active ingredients: Estradiol 1 mg, drospirenone 0.5 mg; tabs. Indication: In women with an intact uterus: moderate-to-severe vasomotor symptoms of menopause; moderate-to-severe vulvar and vaginal atrophy associated with menopause. Pharmacology: Angeliq combines the estrogen, estradiol, with the progestin, drospirenone, to treat moderate-to-severe symptoms of menopause. If this product…

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