International journal of clinical practice
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Int. J. Clin. Pract. · Oct 2010
ReviewTopical diclofenac epolamine patch 1.3% for treatment of acute pain caused by soft tissue injury.
Acute pain caused by musculoskeletal disorders is very common and has a significant negative impact on quality-of-life and societal costs. Many types of acute pain have been managed with traditional oral non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclooxygenase-2 inhibitors (coxibs). Data from prospective, randomised controlled clinical trials and postmarketing surveillance indicate that use of oral traditional NSAIDs and coxibs is associated with an elevated risk of developing gastrointestinal, renovascular and/or cardiovascular adverse events (AEs). ⋯ Several topical formulations of diclofenac have been developed. A topical patch containing diclofenac epolamine 1.3% (DETP, FLECTOR(®) Patch), approved for use in Europe in 1993, has recently been approved for use in the United States and is indicated for the treatment of acute pain caused by minor strains, sprains and contusions. In this article, we review the available clinical trial data for this product in the treatment of pain caused by soft tissue injury.
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Int. J. Clin. Pract. · May 2010
ReviewA practical guide to male hypogonadism in the primary care setting.
There is a high prevalence of hypogonadism in the older adult male population and the proportion of older men in the population is projected to rise in the future. As hypogonadism increases with age and is significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome, the physician is increasingly likely to have to treat hypogonadism in the clinic. The main symptoms of hypogonadism are reduced libido/erectile dysfunction, reduced muscle mass and strength, increased adiposity, osteoporosis/low bone mass, depressed mood and fatigue. ⋯ Restoration of testosterone levels to the normal range improves libido, sexual function, and mood; reduces fat body mass; increases lean body mass; and improves bone mineral density. Testosterone treatment is contraindicated in subjects with prostate cancer or benign prostate hyperplasia and risks of treatment are perceived to be high by many physicians. These risks, however, are often exaggerated and should not outweigh the benefits of testosterone treatment.
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Int. J. Clin. Pract. · May 2010
ReviewIbandronate does not increase risk of atrial fibrillation in analysis of pivotal clinical trials.
To determine the incidence of adverse events or serious adverse events of atrial fibrillation in the pivotal trials of ibandronate and to assess whether increasing dose or duration of exposure had any effect on the incidence of atrial fibrillation. ⋯ In this pooled analysis of all four ibandronate pivotal trials, including analysis by ACE, all studied ibandronate regimens, including the licensed doses of 150 mg monthly oral and 3 mg quarterly i.v., were not associated with an increased incidence of atrial fibrillation.
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Int. J. Clin. Pract. · Mar 2010
ReviewCounterfeit phosphodiesterase type 5 inhibitors pose significant safety risks.
Counterfeit drugs are inherently dangerous and a growing problem; counterfeiters are becoming increasingly sophisticated. Growth of the counterfeit medication market is attributable in part to phosphodiesterase type 5 inhibitor (PDE5i) medications for erectile dysfunction (ED). Millions of counterfeit PDE5is are seized yearly and account for the bulk of all counterfeit pharmaceutical product seizures. ⋯ Globally, increased obstacles for counterfeiters are necessary to combat pharmaceutical counterfeiting, including fines and penalties. The worldwide nature of the counterfeit problem requires proper coordination between countries to ensure adequate enforcement. Locally, physicians who treat ED need to inform patients of the dangers of ordering PDE5is via the Internet.