Expert opinion on pharmacotherapy
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Candida species are the fourth leading cause of nosocomial bloodstream infections in the United States. They are a leading cause of invasive fungal infections and are an emerging problem in hospital medicine. ⋯ New antifungal agents have contributed to significant advances in the treatment of C. albicans. A detailed knowledge of differences in spectrum of activity, toxicity profiles, bioavailability, formulations, and drug interactions of these agents is required. Despite these recent advances, the attributable mortality rates of candidemia and invasive candidiasis remain very high, reminding us of the importance of strategies for the prevention of these infections.
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Expert Opin Pharmacother · Aug 2010
ReviewGabapentin enacarbil (XP13512/GSK1838262) as an alternative treatment to dopaminergic agents for restless legs syndrome.
Gabapentin enacarbil (XP13512/GSK1838262) is being explored as an alternative treatment for restless legs syndrome (RLS), which currently relies heavily on dopaminergic agents; however, these latter medications have the reported complications of augmentation. Gabapentin enacarbil shows promising data that it may be equally to more efficacious and have an improved side effect profile than treatment with dopaminergic agents. ⋯ Based on these findings, gabapentin enacarbil offers a promising alternative treatment for individuals requiring pharmacological intervention for their RLS symptoms.
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Expert Opin Pharmacother · Jun 2010
Meta AnalysisRole of aspirin in the primary prevention of cardiovascular disease in diabetes mellitus: a meta-analysis.
To evaluate the benefits of aspirin in people with diabetes mellitus for the primary prevention of cardiovascular disease. ⋯ Aspirin therapy did not reduce the risk of cardiovascular events. Existing trials were limited by small patient numbers and low cardiovascular event rates. The use of aspirin cannot be routinely recommended for primary prevention of cardiovascular events in diabetes.
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Although trigeminal neuralgia has traditionally been considered the prime neuralgic condition in the face region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. ⋯ Trigeminal neuralgia continues to be best managed using anticonvulsant drugs, the primary ones being carbamazepine and oxcarbazepine; baclofen may be helpful and, of the newly emerging drugs, pregabalin has potential. Glossopharyngeal neuralgia remains managed in the same way as trigeminal neuralgia. Trigeminal neuropathic pain is probably best managed according to guidelines used for the management of neuropathic pain, which include the use of tricyclic antidepressants, gabapentin, pregabalin, duloxetine, venalafaxine and topical lidocaine. Burning mouth syndrome is a neuropathic pain managed initially with topical clonazepam and then with other neuropathic drugs. Patients need to be involved in their management.
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Expert Opin Pharmacother · May 2010
Randomized Controlled Trial Comparative StudyEscitalopram 20 mg versus duloxetine 60 mg for the treatment of chronic low back pain.
Escitalopram has never been demonstrated to be useful in the treatment of chronic low back pain (CLBP), while duloxetine has demonstrated analgesic effect in chronic pain states. The aim of this trial was to examine the efficacy of escitalopram for the treatment of CLBP compared with duloxetine. ⋯ Escitalopram and duloxetine demonstrated efficacy and safety in the management of CLBP, with no significant differences. Results of this study should be replicated in a larger sample of patients.