The Journal of family practice
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The use of opioids in acute pain may be appropriate in some situations, but there are opportunities to reduce exposure to opioids with equally effective monotherapy and combination therapy over-thecounter (OTC) medications. There are a number of OTC analgesics that are readily accessible and costeffective options to treat pain. ⋯ Nonopioid OTC analgesics, such as NSAIDs and the NSAID/acetaminophen combination, are safe and effective firstline options for managing acute dental pain according to the American Dental Association. The American College of Physicians supports the use of NSAIDs as first-line therapy for the treatment of low back pain.
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Chronic kidney disease (CKD) remains underrecognized by patients and clinicians in the primary care setting, largely due to its asymptomatic presentation in early stages. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have demonstrated kidney-protective effects in clinical trials-including in patients with and without type 2 diabetes (T2D)-and there are several proposed mechanisms for these benefits. Dapagliflozin and canagliflozin are SGLT2 inhibitors with indications for CKD, and only dapagliflozin is indicated for CKD in patients without T2D. Clinically relevant adverse events associated with SGLT-2 inhibitors include volume depletion, diabetic ketoacidosis, and genital mycotic infections.
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Following these guidelines to order fewer tests can improve health care quality and patient experience, while reducing wasteful costs.
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At the end of the activity, participants will be able to:Implement evidence-based methods for cognitive impairment screening in primary care. Identify correct diagnostic criteria for mild cognitive impairment (MCI) and Alzheimer disease (AD) based on current guideline recommendations. Design appropriate and effective treatment plans for patients with MCI and AD and refer to a specialist when necessary. Describe advances in testing and treatment for AD that may impact dementia care.
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New evidence is reshaping the role of low-dose aspirin in primary prevention. More selective decisions are now urged.