September 11, 2007 Archives - Clinical Advisor

Print Issue: September 11, 2007

NIH issues new asthma guidelines

NIH issues new asthma guidelinesNew clinical guidelines for treating asthma emphasize helping patients manage their disease and recognize that some children have unique needs. The evidence-based guidelines (sponsored by NIH) are the first update in a decade. They address three age groups—0-4 years, 5-11 years, and 12 or older—instead of two. Earlier versions lumped the…

CLINICAL PEARL- A REMINDER WITH TEETH

Coupling medications with daily oral hygiene helps patients remember daily or twice-daily medication. I have gone so far as to suggest patients tape their pill box to their tube of toothpaste.—Elizabeth Westphal, MD, Marlborough, Mass. (107-23) Contact Us at: Letters@ClinicalAdvisor.com

CLINICAL PEARL- LOOKING BEYOND THE SINUS HEADACHE

Always mindful of the overuse of antibiotics, I am particularly skeptical of a patient’s self-diagnosis of sinus infection when the chief complaint is frontal headache. An assessment of the temporomandibular joints via palpation and joint excursion can often redirect the diagnosis and treatment.—Carolyn Hiscox, MSN, ANP-C, Tiverton, R.I. (107-22)

CLINICAL PEARL- HYPOKALEMIA IN AN ASTHMATIC

Check how often your asthma patient is using his beta agonist, as excessive use can drive potassium into the cells. In that case, asthma management may require increased inhaled steroid or at least the initiation of moderate to more severe approaches.—Patrick Lollis, MD, Easley, S.C. In addition to hypokalemia, increased use of a beta agonist…

CLINICAL PEARL- PRESSURE POINTER

Applying pressure for about 10 seconds with the tip of your finger or knuckle to the area you are about to inject will decrease the discomfort and pain.—Lucky Flores, MD, Hialeah, Fla. (107-20) Contact Us at: Letters@ClinicalAdvisor.com

CLINICAL PEARL- EASIER STREP SWAB TESTING

Easier strep swab testingWhen taking a throat culture for strep infection in a child, have him lie supine with his head tilted back and chin pointed toward the ceiling. This lessens discomfort, lowers anxiety, and facilitates the procedure.—Brian McCambley, MS, PA-C, Danbury, Conn. (107-19)

BEST THERAPY FOR BACTERIAL

My first-line treatment for bacterial vaginosis (BV) is topical clindamycin (Clindesse) (Item 104-10). This one-day, single-dose vaginal gel offers superior patient comfort and efficacy as well as easy compliance. Because the gel adheres to the vaginal environment for several days, there is no need for repeat applications. The cost is fairly comparable with that of…

ANTIVIRALS FOR BELL’S PALSY?

A reader expressed confusion regarding why a patient diagnosed with Bell’s palsy would be given acyclovir (Item 101-15). Bell’s palsy is believed to be caused by a virus; several studies indicate a link to the herpes simplex virus. All patients diagnosed with this condition should be started on a steroid and an antiviral. Valacyclovir is…

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