Clinical therapeutics
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Clinical therapeutics · Jan 2007
Comparative StudyUse of rapid-acting insulin analogues in the treatment of patients with type 1 and type 2 diabetes mellitus: insulin pump therapy versus multiple daily injections.
Replicating endogenous insulin production is the goal of treatment for diabetes mellitus (DM) and is necessary to minimize the risk of vascular complications. The 2 main methods of achieving this goal are continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDIs) comprising basal and prandial injections. ⋯ CSII with the rapid-acting insulin analogue insulin aspart is a viable choice for patients with type 1 or type 2 DM who want close-to-physiologic insulin treatment.
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Clinical therapeutics · Jan 2007
Influences of attitudes on family physicians' willingness to prescribe long-acting opioid analgesics for patients with chronic nonmalignant pain.
The treatment of moderate to severe chronic nonmalignant pain (CNMP) is a challenge for both the patient and health care provider. Conflicting information exists regarding the appropriate use of long-acting (ie, controlled-release [CR]) opioid analgesics for CNMP, and physicians may be reluctant to prescribe them even when medically appropriate. ⋯ About two thirds of physician respondents were willing to prescribe long-acting opioids for patients with CNMP, and physician attitudes were marginally favorable. Further study should investigate how physicians' attitudes and willingness translate into actual prescribing behavior.
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Clinical therapeutics · Jan 2007
Randomized Controlled Trial Multicenter StudyAnalgesic efficacy of celecoxib in postoperative oral surgery pain: a single-dose, two-center, randomized, double-blind, active- and placebo-controlled study.
Celecoxib 200 mg has been reported to reduce pain following dental extraction but to offer poorer pain relief than active comparators. ⋯ In this postsurgical dental pain study, the onset and magnitude of pain relief with celecoxib 400 mg and ibuprofen 400 mg were found to be comparable. In addition, patients who received celecoxib 400 mg as a single dose had a significantly longer time to use of rescue medication and had higher pain relief scores later in the study than those who received ibuprofen 400 mg. Celecoxib was well tolerated compared with placebo.
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Clinical therapeutics · Jan 2007
Randomized Controlled Trial Multicenter StudyEfficacy of sumatriptan tablets in migraineurs self-described or physician-diagnosed as having sinus headache: a randomized, double-blind, placebo-controlled study.
Many patients and physicians interpret episodic headache in the presence or absence of nasal symptoms as "sinus' headache, while ignoring the possible diagnosis of migraine. ⋯ Sumatriptan 50-mg tablets were effective and generally well tolerated in the treatment of these patients presenting with migraine headaches that were self-described or physician-diagnosed as sinus headaches.
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Clinical therapeutics · Jan 2007
ReviewAdverse drug interactions involving common prescription and over-the-counter analgesic agents.
Eight analgesic preparations with approved indications for acute pain were among the top 200 drugs prescribed in the United States in 2006. In addition, an estimated 36 million Americans use over-the-counter (OTC) analgesics daily. Given this volume of use, it is not surprising that a number of drug interactions involving analgesic drugs have been reported. ⋯ Considering the widespread use of analgesic agents, the overall incidence of serious drug-drug interactions involving these agents has been relatively low. The most serious interactions usually involved other interacting drugs with low therapeutic indices or chronic and/or high-dose use of an analgesic and the interacting drug.