American Family Physician

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STEPS

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STEPS: Tapentadol (Nucynta) for Treatment of Pain - American Family Physician

May 1, 2012 - Tapentadol is a DEA schedule II opioid medication with a safety profile, duration of action, frequency of dosing, and analgesic effect similar to those of other oral narcotics, although it is more expensive. At low doses, immediate-release tapentadol is better tolerated than oxycodone ...

American Family Physician : STEPS

http://www.aafp.org/afp/2012/0501/p910.html

STEPS: Fidaxomicin (Dificid) for Clostridium difficile Infection - American Family ...

Feb 1, 2013 - Fidaxomicin is effective for the treatment of C. difficile infection, but it is much more expensive than traditional therapy. Until it is known that the benefits outweigh the significant cost, metronidazole or oral vancomycin is the preferred treatment for most patients.

American Family Physician : STEPS

http://www.aafp.org/afp/2013/0201/p211.html

STEPS: Tinidazole (Tindamax) for Trichomoniasis and Bacterial Vaginosis - American ...

Jan 15, 2009 - Tinidazole is generally an expensive alternative to metronidazole for the treatment of trichomoniasis and bacterial vaginosis. It offers little, if any, advantage with regard to safety, tolerability, and effectiveness; however, its once-daily dosing and shorter course of therapy may be ...

American Family Physician : STEPS

http://www.aafp.org/afp/2009/0115/p102.html

STEPS: Dutasteride/Tamsulosin (Jalyn) for Benign Prostatic Hyperplasia - American ...

Jun 15, 2012 - Jalyn offers the convenience of taking one medication instead of two. Although monotherapy with dutasteride or tamsulosin is beneficial for many men, the combination drug is slightly better than either component alone at decreasing symptom scores; however, these benefits are of ...

American Family Physician : STEPS

http://www.aafp.org/afp/2012/0615/p1194.html

STEPS: Risperidone (Risperdal) for Management of Autistic Disorder - American Family...

Jun 15, 2009 - Risperidone does not alter the course of autistic disorder, but is effective for controlling irritability and other associated symptoms. Patients taking risperidone should be appropriately monitored for adverse effects, especially abnormal movements.

American Family Physician : STEPS

http://www.aafp.org/afp/2009/0615/p1104.html

STEPS: Dapsone (Aczone) 5% Gel for the Treatment of Acne - American Family Physician

Feb 15, 2010 - Topical dapsone gel will decrease the percentage of lesions in patients with mild to moderate acne, especially inflammatory lesions. Although not directly compared, dapsone gel has lower response rates than currently available topical treatments that are less expensive.

American Family Physician : STEPS

http://www.aafp.org/afp/2010/0215/p451.html

STEPS: Methylnaltrexone (Relistor) for Opioid-Induced Constipation - American Family...

Sep 15, 2010 - Methylnaltrexone can temporarily relieve opioid-induced constipation in patients with advanced illness who have not responded to laxative treatment. However, it must be given by injection, is expensive, and has been studied only for short-term use.

American Family Physician : STEPS

http://www.aafp.org/afp/2010/0915/p678.html

STEPS: Alvimopan (Entereg) for the Treatment of Postoperative Ileus - American ...

Apr 15, 2011 - Use of alvimopan should be restricted to patients at a higher risk of postoperative ileus following abdominal surgeries, such as hospitalized patients undergoing bowel resection with primary anastomosis. It is an expensive option with limited indications; head-to-head studies with ...

American Family Physician : STEPS

http://www.aafp.org/afp/2011/0415/p978.html

STEPS: Milnacipran (Savella) for Fibromyalgia - American Family Physician

Oct 15, 2010 - Milnacipran can decrease the overall pain scores and improve symptoms of fibromyalgia. Safety in patients with severe comorbid medical and psychiatric conditions is unknown because these groups of patients were excluded from the study.

American Family Physician : STEPS

http://www.aafp.org/afp/2010/1015/p901.html

STEPS: Saxagliptin (Onglyza) for Type 2 Diabetes Mellitus - American Family Physician

Jun 15, 2010 - Saxagliptin lowers A1C levels to a lesser extent and is much more expensive than first-line therapy with metformin. Its ability to decrease diabetes-related complications, including mortality, is not known. It is a DPP-4 inhibitor that has a more significant drug interaction profile ...

American Family Physician : STEPS

http://www.aafp.org/afp/2010/0615/p1483.html

STEPS: Febuxostat (Uloric) for Hyperuricemia and Gout - American Family Physician

May 15, 2010 - Febuxostat more effectively lowers serum uric acid to goal levels than does allopurinol; however, this benefit is offset by a slightly higher incidence of adverse effects and treatment discontinuation. Until superiority for patient-oriented outcomes is shown in comparative trials with ...

American Family Physician : STEPS

http://www.aafp.org/afp/2010/0515/p1287.html

STEPS: Sinecatechins (Veregen) for External Genital and Perianal Warts - American ...

Dec 15, 2009 - Sinecatechins offers no clear advantage with regard to safety and tolerability. Indirect comparisons with other treatments suggest that sinecatechins may be more effective, with fewer recurrences of warts following successful treatment, but direct comparisons are lacking.

American Family Physician : STEPS

http://www.aafp.org/afp/2009/1215/p1447.html

STEPS: Adalimumab (Humira) for the Treatment of Rheumatoid Arthritis - American ...

Dec 15, 2008 - Adalimumab used alone offers little benefit over the traditional first-line agent, methotrexate. However, it increases remission rates when combined with methotrexate in early aggressive rheumatoid arthritis and when combined with traditional DMARDs in those who have not derived benefit...

American Family Physician : STEPS

http://www.aafp.org/afp/2008/1215/p1406.html

STEPS: Retapamulin (Altabax) 1% Topical ointment for the Treatment of Impetigo - ...

Nov 15, 2007 - Retapamulin is an effective alternative to topical mupirocin in the treatment of limited-area impetigo in patients older than nine months. Although it is more expensive, retapamulin does have a dosing advantage over mupirocin; it only requires a twice-a-day application for five days, ...

American Family Physician : STEPS

http://www.aafp.org/afp/2007/1115/p1537.html

STEPS: Selegiline Transdermal Patch (Emsam) for Major Depressive Disorder - American...

Feb 15, 2008 - Transdermal selegiline is an expensive treatment option for patients with major depressive disorder who have not responded to other antidepressants or who cannot swallow or take oral medications. Based on guidelines from the American Psychiatric Association, MAO inhibitor ...

American Family Physician : STEPS

http://www.aafp.org/afp/2008/0215/p505.html

STEPS: Zoledronic Acid (Reclast) for Osteoporosis - American Family Physician

Aug 15, 2008 - Zoledronic acid, in combination with calcium and vitamin D, will reduce the risk of vertebral fractures, and to a lesser extent, hip fractures in women with osteoporosis. It decreases subsequent fractures and mortality in high-risk patients who have had a hip fracture. Zoledronic acid ...

American Family Physician : STEPS

http://www.aafp.org/afp/2008/0815/p508.html

STEPS: Acamprosate (Campral) for Treatment of Alcoholism - American Family Physician

Aug 15, 2006 - Acamprosate is a safe and well-tolerated treatment for patients with alcoholism and it appears to improve the likelihood that patients will remain abstinent. Most evidence suggests it is as effective as naltrexone but with fewer adverse reactions, and that it may be more effective when ...

American Family Physician : STEPS

http://www.aafp.org/afp/2006/0815/p645.html

STEPS: Conivaptan (Vaprisol) for the Treatment of Hyponatremia - American Family ...

Oct 15, 2008 - In most cases, patients with hyponatremia can be adequately managed with fluid restriction alone. However, acutely symptomatic patients may require treatment, such as hypertonic saline. In these situations, conivaptan is an expensive alternative.

American Family Physician : STEPS

http://www.aafp.org/afp/2008/1015/p984.html

STEPS: Becaplermin (Regranex) for Diabetic Foot Ulcers - American Family Physician

Jul 15, 2008 - Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.

American Family Physician : STEPS

http://www.aafp.org/afp/2008/0715/p255.html

STEPS: Sitagliptin (Januvia) for the Treatment of Patients with Type 2 Diabetes - ...

Sep 15, 2007 - Sitagliptin may be useful as second-line or third-line therapy in patients with a mildly elevated A1C level (less than 9 percent) who do not reach their A1C goal with first-line therapy (metformin). Sitagliptin will decrease postprandial blood glucose and mildly lower fasting blood ...

American Family Physician : STEPS

http://www.aafp.org/afp/2007/0915/p861.html

STEPS: Levonorgestrel/Ethinyl Estradiol (Lybrel) for Continuous Contraception - ...

Jan 15, 2008 - Lybrel appears to be as safe and effective as other combined oral contraceptives; however, at this time, there is little published data about this specific product. Other combined monophasic oral contraceptives, some of which cost less than Lybrel, can be used continuously and have been...

American Family Physician : STEPS

http://www.aafp.org/afp/2008/0115/p222.html

STEPS: Pramipexole (Mirapex) for Restless Legs Syndrome - American Family Physician

Apr 15, 2007 - Although many patients with RLS do not need pharmacologic therapy, pramipexole is one option for treating moderate to severe symptoms. As with other agents used to manage RLS, potentially serious adverse reactions are possible.

American Family Physician : STEPS

http://www.aafp.org/afp/2007/0415/p1239.html

STEPS: Telithromycin (Ketek) for Treatment of Community-Acquired Pneumonia - ...

Dec 15, 2007 - Telithromycin is similar to clarithromycin with regard to dosing, drug interactions, and effectiveness. It has more frequent and severe adverse effects and is more expensive than other macrolides. Telithromycin should only be used in patients with mild to moderate community-acquired ...

American Family Physician : STEPS

http://www.aafp.org/afp/2007/1215/p1857.html

STEPS: Topiramate (Topamax) for Migraine Prevention - American Family Physician

Oct 15, 2005 - Topiramate is more effective than placebo for migraine prevention. Its effectiveness appears to be similar to that of other antiepileptic drugs and beta blockers. Because of the high cost of topiramate and the relative frequency of adverse effects, other approaches to migraine ...

American Family Physician : STEPS

http://www.aafp.org/afp/2005/1015/p1563.html

STEPS: Varenicline (Chantix) for Smoking Cessation - American Family Physician

Jul 15, 2007 - For every nine highly-motivated patients who use varenicline instead of placebo, one will not be smoking one year later. Although the cost of therapy is a limitation (total cost is approximately $360 for a three-month course), the easy dosage titration, lack of drug interactions, and ...

American Family Physician : STEPS

http://www.aafp.org/afp/2007/0715/p279.html

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