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Pharmacologic Therapy, An Issue of Medical Clinics of North America, E-Book

Pharmacologic Therapy, An Issue of Medical Clinics of North America, E-Book

Kim M. O'Connor | Douglas S. Paauw

(2016)

Additional Information

Book Details

Abstract

This issue of Medical Clinics of North America, guest edited by Drs. Douglas Paauw and Kim O'Connor, is devoted to Pharmacologic Therapy. Articles in this issue include: Pharmacologic Therapies for Autoimmune and Rheumatologic Conditions; Pharmacologic Therapies for Ophthalmologic Conditions; Pharmacologic Therapies for Neurologic Conditions; Pharmacologic Therapies for Cardiac Conditions; Pharmacologic Therapies in Men’s Health; Pharmacologic Therapies in Anticoagulation; Pharmacologic Therapies in Women’s Health: Menopause Treatment and Contraception; Pharmacologic Therapies in GI disease; Pharmacologic Therapies in Pulmonology and Allergy; Pharmacologic Therapies for Substance Abuse; Pharmacologic Therapies in Infectious Disease; Pharmacologic Therapies for HIV; Pharmacologic Therapies in Type 2 DM; Pharmacologic Therapies in Musculoskeletal Conditions; and Osteoporosis Treatment.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Pharmacologic Therapy i
Copyright\r ii
CME Accreditation Page iii
PROGRAM OBJECTIVE iii
TARGET AUDIENCE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iii
TO ENROLL iii
METHOD OF PARTICIPATION iv
CME INQUIRIES/SPECIAL NEEDS iv
MEDICAL CLINICS OF NORTH AMERICA\r \r v
FORTHCOMING ISSUES v
September 2016 v
November 2016 v
January 2017 v
RECENT ISSUES v
May 2016 v
March 2016 v
January 2016 v
Contributors vii
CONSULTING EDITORS vii
EDITORS vii
AUTHORS vii
Contents xi
Foreword: Pharmacologic Therapy\r xi
Preface: Pharmacologic Therapies: Updates and Clinical Pearls\r xi
Pharmacologic Therapy of Type 2 Diabetes\r xi
Update in Hypertension Therapy\r xi
Pharmacologic Therapies in Anticoagulation\x0B xi
Pharmacologic Therapies for Rheumatologic and Autoimmune Conditions\r xii
Movement Disorders: A Brief Guide in Medication Management\r xii
Pharmacologic Therapies in Women’s Health: Contraception and Menopause Treatment\r xii
Pharmacologic Therapy in Men’s Health: Hypogonadism, Erectile Dysfunction, and Benign Prostatic Hyperplasia\r xii
Evaluation and Treatment of Osteoporosis\r xiii
Pharmacologic Therapies in Gastrointestinal Diseases\x0B xiii
Pharmacologic Therapies in Pulmonology and Allergy\r xiii
Pharmacologic Therapies in Musculoskeletal Conditions\r xiii
Pharmacotherapy for Substance Use Disorders \r xiv
New Approaches to Antibiotic Use and Review of Recently Approved Antimicrobial Agents\r xiv
Antiretroviral Therapy for Prevention of Human Immunodeficiency Virus Infection\r xiv
Foreword\rPharmacologic Therapy xv
Preface\rPharmacologic Therapies: Updates and Clinical Pearls xvii
Pharmacologic Therapy of Type 2 Diabetes 647
Key points 647
INTRODUCTION 647
Treatment in Context 648
ORAL AGENTS 649
Metformin 649
Sulfonylureas 650
Dipeptidyl-Peptidase 4 Inhibitors 651
Thiazolidinediones 652
Sodium-Glucose Cotransporter 2 Inhibitors 652
INJECTABLE AGENTS 654
Glucagon-Like Peptide-1 Receptor Agonists 654
Basal Insulin 655
Prandial Insulin 656
Concentrated Insulins 657
SPECIAL POPULATIONS 657
Renal Dysfunction 657
Elderly Patients 658
Other Pharmacologic Therapies for Reduction of Macrovascular Complication 658
SUMMARY 659
REFERENCES 659
Update in Hypertension Therapy 665
Key points 665
INTRODUCTION 665
CLINICAL QUESTION: WHAT ARE THE APPROPRIATE TARGETS FOR BLOOD PRESSURE CONTROL? 665
CLINICAL BOTTOM LINE 668
CLINICAL QUESTION: WHAT IS THE BEST INITIAL AGENT FOR ESSENTIAL HYPERTENSION? 668
DIABETES 668
SYSTOLIC HEART FAILURE 669
BLACK PATIENTS 669
CHRONIC KIDNEY DISEASE 669
CLINICAL QUESTION: DOUBLE THE DOSE OF ANTIHYPERTENSIVE, OR ADD A SECOND AGENT? 669
Pharmacologic Therapies in Anticoagulation 695
Key points 695
INTRODUCTION 695
CLINICAL APPLICATION 697
Prevention of Stroke in Patients with Atrial Fibrillation 697
Treatment of Deep Vein Thrombosis and Pulmonary Embolism 698
Cancer-Associated Venous Thromboembolism 701
Venous Thromboembolism Prophylaxis 701
Acutely Ill Medical Patients 702
Orthopedic Patients 702
Nonorthopedic Surgical Patients 703
PRACTICAL RECOMMENDATIONS 703
Periprocedural Management of Anticoagulation 703
Switching Between Anticoagulants 703
Choice of Anticoagulant 703
VITAMIN K ANTAGONISTS 705
Pharmacology 705
Dosage 706
Monitoring and Maintenance Dose 707
Adverse Events 708
Reversal of Anticoagulation Effect and Management of Bleeding 709
Contraindications 709
Drug Interactions 709
DIRECT ORAL ANTICOAGULANTS 710
Dabigatran Etexilate 710
Rivaroxaban 710
Apixaban 710
Edoxaban 711
Monitoring Direct Oral Anticoagulants 711
Management of Bleeding Complications 711
Drug-Drug Interactions 712
PARENTERAL ANTICOAGULANTS 712
Pharmacology 712
Dosage 712
Monitoring 713
Adverse Events 713
SUMMARY AND FUTURE DIRECTIONS 714
REFERENCES 714
Pharmacologic Therapies for Rheumatologic and Autoimmune Conditions 719
Key points 719
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS 719
CORTICOSTEROIDS 720
COLCHICINE 721
Urate-lowering Therapy 722
Allopurinol 722
Febuxostat 723
Probenecid 723
Other Agents 724
DISEASE-MODIFYING ANTIRHEUMATIC MEDICATIONS 724
Anchor Disease-modifying Antirheumatic Medications 725
Methotrexate 725
Hydroxychloroquine 726
Other Nonbiologic Disease-modifying Antirheumatic Medications 726
Sulfasalazine 726
Leflunomide 726
Azathioprine 727
Mycophenolate 727
Calcineurin inhibitors 727
Apremilast 727
Biologic Disease-modifying Antirheumatic Medications 727
Vaccination Recommendations 729
REFERENCES 729
Movement Disorders 733
Key points 733
MOVEMENT DISORDERS: PART I 733
Parkinson’s Disease 733
Levodopa 734
Carbidopa 736
Dopamine Agonists 736
Monoamine Oxidase-B Inhibitors 737
Selegiline 737
Rasagiline 738
Catechol O-Methyltransferase Inhibitors 738
Entacapone 738
Tolcapone 738
Amantadine 738
Anticholinergic Agents 739
Nonmotor Symptoms 739
Drooling 739
Constipation 740
Orthostatic hypotension 740
Dementia 740
Hallucinations and psychosis 740
Depression 740
Rapid eye movement sleep behavior disorder 741
MOVEMENT DISORDERS: PART II 741
Essential Tremors 741
Beta Blockers 741
Primidone 746
Gabapentin 747
Topiramate 747
Other Agents 748
Idiopathic Restless Leg Syndrome 748
Primary Restless Leg Syndrome 749
Intermittent Restless Leg Syndrome: One or Fewer Episodes Weekly 749
Levodopa 749
Clonazepam 749
Daily/Moderate Persistent Restless Leg Syndrome: Two or More Episodes Weekly 749
Dopamine Agonists 749
Ropinirole 751
Pramipexole 751
Gabapentin 751
Pregabalin 751
Refractory Restless Leg Syndrome 751
Carbamazepine 751
Clonidine 751
Amantadine 752
Opioids 752
Secondary Restless Leg Syndrome and Special Populations 752
Iron deficiency 752
Pregnancy 752
End-stage renal disease on hemodialysis 752
Concurrent peripheral neuropathy 754
Periodic limb movements of sleep 754
REFERENCES 754
Pharmacologic Therapies in Women’s Health 763
Key points 763
INTRODUCTION 763
CONTRACEPTION 766
Effectiveness of Different Contraceptive Methods 766
Long-acting Reversible Contraception 766
Other Progestin-only Contraception 772
Combined Hormonal Contraception: Combined Oral Contraception, the Patch, and the Ring 772
Serious risks and contraindications 772
Nonoral combined hormonal contraceptive options: patch and ring 774
Choosing between different combined hormonal contraception options 775
Emergency Contraception 776
Method of action 777
Comparative effectiveness of each method 777
MENOPAUSE 778
Treatment of Menopause Symptoms 779
Treatment of Genitourinary Syndrome of Menopause 781
Contraception During the Menopause Transition 784
SUMMARY 784
REFERENCES 784
Pharmacologic Therapy in Men’s Health 791
Key points 791
INTRODUCTION 791
TESTOSTERONE REPLACEMENT THERAPY IN MALE HYPOGONADISM 792
Benefits, Side Effects, and Risks 792
Testosterone Preparations 792
Injectable preparations 792
Transdermal preparations 796
Other available preparations 796
Monitoring and Dose Adjustment 797
PHARMACOLOGIC TREATMENT OF ERECTILE DYSFUNCTION 797
Erectile Dysfunction 797
Approach to Erectile Dysfunction 797
Oral Phosphodiesterase Inhibitors 798
Other Oral Medications for Erectile Dysfunction 798
Intraurethral and Intrapenile Alprostadil 798
Nonpharmacological Therapy for Erectile Dysfunction 800
PHARMACOLOGIC TREATMENT OF BENIGN PROSTATIC HYPERPLASIA 800
Medical Management 801
Alpha1-Adrenergic Antagonists 801
5-Alpha-Reductase Inhibitors 801
Side effects of 5-alpha-reductase inhibitors 802
Anticholinergic Agents 802
Phosphodiesterase-5-Inhibitors 802
Herbal Therapies 802
REFERENCES 803
Evaluation and Treatment of Osteoporosis 807
Key points 807
INTRODUCTION 807
WHOM TO SCREEN 808
WHOM TO TREAT 809
HOW TO CHOOSE A TREATMENT 810
CALCIUM AND VITAMIN D SUPPLEMENTATION 811
BISPHOSPHONATES 811
SELECTIVE ESTROGEN RECEPTOR MODULATORS 815
TERIPARATIDE 816
DENOSUMAB 817
HORMONE REPLACEMENT THERAPY 818
CALCITONIN 818
STRONTIUM RANELATE 818
MONITORING FOR RESPONSE TO THERAPY 819
GLUCOCORTICOID-INDUCED OSTEOPOROSIS 819
TREATMENT OF OSTEOPOROSIS IN MEN 821
SUMMARY 822
REFERENCES 822
Pharmacologic Therapies in Gastrointestinal Diseases 827
Key points 827
PHARMACOTHERAPY FOR HEPATITIS C VIRUS 827
Clinical Benefit of Achieving Sustained Virologic Response 827
Direct-acting Antivirals 828
Principles for Patient Selection for Hepatitis C Virus Treatment 828
Pretreatment Evaluation 829
Principles of Regimen Selection 829
Side Effects of Direct-acting Antiviral Regimens in Phase 3 Trials 829
Assessing Hepatitis C Virus Treatment Response 830
Interpretation of Hepatitis C Virus RNA Results 830
Drug Resistance in Direct-acting Antivirals 831
Genotype 1 831
Genotype 2 832
Genotype 3 833
Hepatitis C Virus–Human Immunodeficiency Virus Coinfection 833
Summary 834
PHARMACOTHERAPY FOR IRRITABLE BOWEL SYNDROME 834
Approach to Pharmacotherapy for Irritable Bowel Syndrome 834
Pharmacotherapy in Constipation-predominant Irritable Bowel Syndrome 835
Bulking agents 835
Osmotic laxatives 836
Polyethylene glycol 836
Stimulant laxatives 836
Prosecretory agents 836
Linaclotide 836
Lubiprostone 836
Pharmacotherapy in Diarrhea-predominant Irritable Bowel Syndrome 836
Loperamide 836
Eluxadoline 836
Rifaximin 837
Tricyclic antidepressants and selective serotonin reuptake inhibitors 837
Antispasmodics 837
5-Hydroxytryptamine Receptor Antagonists 837
Alosetron 837
Ondansetron 837
Summary 837
PHARMACOTHERAPY FOR GASTROESOPHAGEAL REFLUX DISEASE AND PEPTIC ULCER DISEASE 838
Medical Management of Gastroesophageal Reflux Disease 838
Proton Pump Inhibitors 838
Which Proton Pump Inhibitor, When to Administer, What Dose, and How Long? 838
Can Proton Pump Inhibitors be Used as On-demand Therapy? 840
Is Maintenance Therapy After the Initial 8 Weeks Necessary? 840
Histamine Receptor Antagonists 840
Antacids 840
Pharmacotherapy for Nonresponders or Partial Responders to Proton Pump Inhibitors 840
Baclofen for Refractory Gastroesophageal Reflux Disease 840
Adverse Effects of Proton Pump Inhibitors 841
Medical Management of Peptic Ulcer Disease 841
Eradication of Helicobacter pylori 841
Treatment of Persistent Helicobacter pylori Infection (Salvage Therapy) 842
Antisecretory Therapy 842
Treatment of Nonsteroidal Antiinflammatory Drug Ulcers 843
Misoprostol Use in Nonsteroidal Antiinflammatory Drug Ulcers 843
Antacids 843
Summary 844
REFERENCES 844
Pharmacologic Therapies in Pulmonology and Allergy 851
Key points 851
RHINITIS 852
H1 Antihistamines 852
Corticosteroids 854
Anticholinergic Agents 855
Decongestants 855
Antileukotriene Agents 856
Environmental Controls 856
Allergen Immunotherapy 856
URTICARIA 856
Acute Urticaria 857
Chronic Urticaria 857
Antihistamines 857
Corticosteroids 857
Other Agents 858
ANGIOEDEMA 858
ASTHMA 859
Rescue Medications 859
Short-acting β2-agonists 859
Maintenance Therapy 862
Inhaled corticosteroids 862
Controller Medications 864
Long-acting β-Agonists 864
Combination inhaled corticosteroids/long-acting β-agonists 864
Leukotriene Antagonists 864
Anticholinergics 864
Omalizumab 864
Mepolizumab 865
SUMMARY 865
REFERENCES 865
Pharmacologic Therapies in Musculoskeletal Conditions 869
Key points 869
INTRODUCTION 869
ACUTE MUSCULOSKELETAL PAIN 870
Oral Nonsteroidal Anti-Inflammatory Drugs 870
Topical Nonsteroidal Anti-Inflammatory Drugs 871
Acetaminophen 873
Tramadol 873
Opioids 873
Mixed Opioid and Nonopioid Medications 874
NECK AND BACK PAIN 874
Skeletal Muscle Relaxants 875
Antispasmodics 875
Antispasticity medications 875
Benzodiazepines 876
Oral Corticosteroids 877
Antidepressants 877
VERTEBRAL COMPRESSION FRACTURES 877
NEUROPATHIC PAIN 879
Antidepressants 879
Anticonvulsants 880
Topical Medications 880
Lidocaine 880
Capsaicin 880
OSTEOARTHRITIS 881
Nutraceuticals: Glucosamine and Chondroitin 881
Injectable Medications 882
Corticosteroids 882
Local anesthetics 883
Hyaluronic acid 883
TENDINOPATHY 884
Topical Glyceryl Trinitrate 884
Injectable Corticosteroids 884
SUMMARY 884
REFERENCES 885
Pharmacotherapy for Substance Use Disorders 891
Key points 891
INTRODUCTION 891
Screening 891
Diagnosis 892
Treatment Principles 892
TOBACCO USE DISORDERS 893
Pharmacology of Nicotine 893
Epidemiology of Tobacco Use 893
First-line Agents 893
Nicotine replacement therapy 893
Varenicline 893
Bupropion 895
Second-line Agents 895
Nortriptyline 895
Combination Therapy 895
Special Circumstances 895
Pregnancy and lactation 895
Older adults 896
Relapsed smokers 896
ALCOHOL USE DISORDERS 896
Pharmacology of Alcohol 896
Epidemiology of Alcohol Use 896
Detoxification 896
Maintenance Therapy: First-line Agents 897
Naltrexone 897
Acamprosate 898
Maintenance Therapy: Second-line Agents 898
Disulfiram 898
Other agents 899
Combination Therapy 899
Special Circumstances 899
Pregnancy and lactation 899
Older adults 900
OPIOID USE DISORDERS 900
Pharmacology of Opioids 900
Epidemiology of Opioid Use 900
Detoxification Versus Maintenance 900
First-line Agents 902
Methadone 902
Buprenorphine 903
Second-line Agents 904
Naltrexone 904
Other agents 904
Special Circumstances 905
Pregnancy and lactation 905
Older adults 905
OTHER SUBSTANCE USE DISORDERS 906
SUMMARY 906
REFERENCES 906
New Approaches to Antibiotic Use and Review of Recently Approved Antimicrobial Agents 911
Key points 911
INTRODUCTION 912
WHITE HOUSE STEWARDSHIP INITIATIVE 912
THE DIMINISHED ROLE OF ANTIBIOTICS IN SKIN AND SOFT TISSUE ABSCESSES 912
SHORT-COURSE THERAPY FOR COMPLICATED INTRAABDOMINAL INFECTION 914
GUIDELINE-CONCORDANT ANTIBIOTIC PRESCRIBING 914
NOVEL ANTIMICROBIALS 915
DALBAVANCIN AND ORITAVANCIN 915
Clinical Efficacy 916
Place in Therapy 918
CEFTAROLINE 918
Clinical Efficacy 918
Place in Therapy 919
CEFTOLOZANE-TAZOBACTAM 919
Clinical Efficacy 919
Place in Therapy 920
CEFTAZIDIME-AVIBACTAM 921
Spectrum of Activity 921
Clinical Efficacy 921
Place in Therapy 922
SUMMARY 922
REFERENCES 923
Antiretroviral Therapy for Prevention of Human Immunodeficiency Virus Infection 927
Key points 927
INTRODUCTION 927
ANTIRETROVIRAL THERAPY FOR PREVENTION 928
TREATMENT AS PREVENTION 928
WHEN TO START HUMAN IMMUNODEFICIENCY VIRUS TREATMENT 928
COMMONLY USED ANTIRETROVIRAL DRUGS 929
TREATMENT INITIATION AND LABORATORY MONITORING 929
PREVENTION OF MOTHER-TO-CHILD TRANSMISSION 934
OCCUPATIONAL AND NONOCCUPATIONAL POSTEXPOSURE PROPHYLAXIS 934
PRE-EXPOSURE PROPHYLAXIS 937
ANTIRETROVIRAL THERAPY SIDE EFFECTS AND DRUG INTERACTIONS 939
FUTURE DIRECTIONS AND SUMMARY 943
REFERENCES 946
Index 951