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Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Vaccine Adverse Events: Separating Myth from Reality - American Family Physician

Jun 15, 2017 - Vaccines are one of the most successful medical advances in modern times. Most vaccine-preventable illnesses are unfamiliar to modern parents. Because of this, parents are increasingly questioning the necessity of immunizing their children, especially because no vaccine is completely ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p786.html

Common Herbal Dietary Supplement—Drug Interactions - American Family Physician

Jul 15, 2017 - Nearly 25% of U.S. adults report concurrently taking a prescription medication with a dietary supplement. Some supplements, such as St. John’s wort and goldenseal, are known to cause clinically important drug interactions and should be avoided by most patients receiving any ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p101.html

Clinically Relevant Drug-Drug Interactions in Primary Care - American Family Physician

May 1, 2019 - Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p558.html

Hip Fracture: Diagnosis, Treatment, and Secondary Prevention - American Family Physician

Jun 15, 2014 - Hip fractures cause significant morbidity and are associated with increased mortality. Women experience 80% of hip fractures, and the average age of persons who have a hip fracture is 80 years. Most hip fractures are associated with a fall, although other risk factors include decreased ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p945.html

HIV-Associated Complications: A Systems-Based Approach - American Family Physician

Aug 1, 2017 - Persons with human immunodeficiency virus (HIV) infection often develop complications related directly to the infection, as well as to treatment. Aging, lifestyle factors, and comorbidities increase the risk of developing chronic conditions such as diabetes mellitus and chronic kidney ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p161.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Adverse Effects of Antipsychotic Medications - American Family Physician

Mar 1, 2010 - The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects. There is more variability among specific antipsychotic medications than there is between the ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0301/p617.html

The Effect of Cytochrome P450 Metabolism on Drug Response, Interactions, and Adverse ...

Aug 1, 2007 - Cytochrome P450 enzymes are essential for the metabolism of many medications. Although this class has more than 50 enzymes, six of them metabolize 90 percent of drugs, with the two most significant enzymes being CYP3A4 and CYP2D6. Genetic variability (polymorphism) in these enzymes may ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0801/p391.html

Managing Adverse Effects of Hormonal Contraceptives - American Family Physician

Dec 15, 2010 - Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only...

American Family Physician : Article

https://www.aafp.org/afp/2010/1215/p1499.html

Drug-Induced Nephrotoxicity - American Family Physician

Sep 15, 2008 - Drugs are a common source of acute kidney injury. Compared with 30 years ago, the average patient today is older, has more comorbidities, and is exposed to more diagnostic and therapeutic procedures with the potential to harm kidney function. Drugs shown to cause nephrotoxicity exert ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0915/p743.html

Complications of Adjustable Gastric Banding Surgery for Obesity - American Family ...

May 15, 2014 - Laparoscopic adjustable gastric banding procedures have a favorable risk-benefit profile and are increasingly important as part of the overall management of obesity. These procedures are effective at inducing weight loss and improving comorbid conditions, including diabetes mellitus, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p813.html

Cesarean Delivery: Counseling Issues and Complication Management - American Family ...

Feb 1, 2015 - Nearly one-third of all deliveries in the United States are cesarean deliveries. Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Interventions that decrease the chance of a cesarean delivery ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0201/p178.html

First Trimester Bleeding - American Family Physician

Jun 1, 2009 - Vaginal bleeding in the first trimester occurs in about one fourth of pregnancies. About one half of those who bleed will miscarry. Guarded reassurance and watchful waiting are appropriate if fetal heart sounds are detected, if the patient is medically stable, and if there is no adnexal...

American Family Physician : Article

https://www.aafp.org/afp/2009/0601/p985.html

Considerations for Safe Use of Statins: Liver Enzyme Abnormalities and Muscle Toxicitiy...

Mar 15, 2011 - Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p711.html

Diabetic Foot Infection - American Family Physician

Jul 1, 2008 - Foot infections are common in patients with diabetes and are associated with high morbidity and risk of lower extremity amputation. Diabetic foot infections are classified as mild, moderate, or severe. Gram-positive bacteria, such as Staphylococcus aureus and beta-hemolytic ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p71.html

Antidepressant Discontinuation Syndrome - American Family Physician

Aug 1, 2006 - Antidepressant discontinuation syndrome occurs in approximately 20 percent of patients after abrupt discontinuation of an antidepressant medication that was taken for at least six weeks. Typical symptoms of antidepressant discontinuation syndrome include flu-like symptoms, insomnia, ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0801/p449.html

Office Management of Early Pregnancy Loss - American Family Physician

Jul 1, 2011 - The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p75.html

Reducing Adverse Effects of Proton Pump Inhibitors - American Family Physician

Jul 1, 2012 - Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p66.html

Appropriate and Safe Use of Diagnostic Imaging - American Family Physician

Apr 1, 2013 - Risks of diagnostic imaging include cancer from radiation exposure and nephrogenic systemic fibrosis. The increase in volume of imaging between 1980 and 2006 has led to a sixfold increase in annual per capita radiation exposure. It is predicted that 2 percent of future cancers will be ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0401/p494.html

Prevention, Recognition, and Management of Serotonin Syndrome - American Family Physician

May 1, 2010 - Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity in the nervous system. It is characterized by mental status changes, autonomic instability, and neuromuscular hyperactivity. Most reported cases of serotonin syndrome are in patients...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1139.html

Subacute to Chronic Mild Traumatic Brain Injury - American Family Physician

Dec 1, 2012 - Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1045.html

Diabetic Ketoacidosis - American Family Physician

May 1, 2005 - A diagnosis of diabetic ketoacidosis requires the patient's plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. Beta-hydroxybutyrate is a better measurement ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1705.html

Health Effects of Prenatal Radiation Exposure - American Family Physician

Sep 1, 2010 - Pregnant women are at risk of exposure to nonionizing and ionizing radiation resulting from necessary medical procedures, workplace exposure, and diagnostic or therapeutic interventions before the pregnancy is known. Nonionizing radiation includes microwave, ultrasound, radio frequency,...

American Family Physician : Article

https://www.aafp.org/afp/2010/0901/p488.html

NSAID Prescribing Precautions - American Family Physician

Dec 15, 2009 - Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used, but have risks associated with their use, including significant upper gastrointestinal tract bleeding. Older persons, persons taking anticoagulants, and persons with a history of upper gastrointestinal tract bleeding ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1215/p1371.html

Respiratory Distress in the Newborn - American Family Physician

Oct 1, 2007 - The most common etiology of neonatal respiratory distress is transient tachypnea of the newborn; this is triggered by excessive lung fluid, and symptoms usually resolve spontaneously. Respiratory distress syndrome can occur in premature infants as a result of surfactant deficiency and ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1001/p987.html

Managing the Adverse Effects of Radiation Therapy - American Family Physician

Aug 15, 2010 - Nearly two thirds of patients with cancer will undergo radiation therapy as part of their treatment plan. Given the increased use of radiation therapy and the growing number of cancer survivors, family physicians will increasingly care for patients experiencing adverse effects of ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p381.html

Complications of HIV Infection: A Systems-Based Approach - American Family Physician

Feb 15, 2011 - Patients with human immunodeficiency virus (HIV) infection often develop multiple complications and comorbidities. Opportunistic infections should always be considered in the evaluation of symptomatic patients with advanced HIV/AIDS, although the overall incidence of these infections ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0215/p395.html

Common Adverse Effects of Antiretroviral Therapy for HIV Disease - American Family ...

Jun 15, 2011 - Family physicians are treating patients infected with human immunodeficiency virus in their practices more often. Long-term complications of this disease are multifactorial and can be related to the virus itself or to adverse effects of antiretroviral therapy. Each drug class has side ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1443.html

Diagnosis and Management of Preeclampsia - American Family Physician

Dec 15, 2004 - Preeclampsia is a pregnancy-specific multisystem disorder of unknown etiology. The disorder affects approximately 5 to 7 percent of pregnancies and is a significant cause of maternal and fetal morbidity and mortality. Preeclampsia is defined by the new onset of elevated blood pressure ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1215/p2317.html

Treating Diabetic Peripheral Neuropathic Pain - American Family Physician

Jul 15, 2010 - Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. Patients can realistically expect a 30 to 50 percent ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p151.html

Complications of Body Piercing - American Family Physician

Nov 15, 2005 - The trend of body piercing at sites other than the earlobe has grown in popularity in the past decade. The tongue, lips, nose, eyebrows, nipples, navel, and genitals may be pierced. Complications of body piercing include local and systemic infections, poor cosmesis, and foreign body ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2029.html

Venous Thromboembolism During Pregnancy - American Family Physician

Jun 15, 2008 - Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1709.html

Predicting the Risk of Postoperative Pulmonary Complications - Point-of-Care Guides - ...

Oct 15, 2019 - What is the best approach to evaluate postoperative pulmonary risk?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/1015/p499.html

Risks Associated with Long-Term Benzodiazepine Use - Editorials - American Family ...

Aug 15, 2013 - Many patients underestimate the degree of impairment caused by benzodiazepines. Benzodiazepines increase the risk of addiction, withdrawal, cognitive decline, motor vehicle crashes, and hip fracture. The risk of overdose is particularly great when combined with sedative drugs such as ...

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0815/p224.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Fitness-Related Cardiac Arrhythmias - Editorials - American Family Physician

Jan 15, 2019 - How many clinicians are aware that high levels of physical fitness predispose patients to cardiac rhythm abnormalities? Find out more.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0115/p78.html

Shoulder Dystocia - American Family Physician

Apr 1, 2004 - Shoulder dystocia can be one of the most frightening emergencies in the delivery room. Although many factors have been associated with shoulder dystocia, most cases occur with no warning. Calm and effective management of this emergency is possible with recognition of the impaction and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1707.html

Management of Common Opioid-Induced Adverse Effects - American Family Physician

Oct 15, 2006 - Opioid analgesics are useful agents for treating pain of various etiologies; however, adverse effects are potential limitations to their use. Strategies to minimize adverse effects of opioids include dose reduction, symptomatic management, opioid rotation, and changing the route of ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1347.html

Gastrointestinal Complications of Diabetes - American Family Physician

Jun 15, 2008 - Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1697.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jul 1, 2008 - The National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy has defined four categories of hypertension in pregnancy: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension. A maternal ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p93.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.html

Herbal and Dietary Supplement-Drug Interactions in Patients with Chronic Illnesses - ...

Jan 1, 2008 - Herbs, vitamins, and other dietary supplements may augment or antagonize the actions of prescription and nonprescription drugs. St. John's wort is the supplement that has the most documented interactions with drugs. As with many drug-drug interactions, the information for many dietary ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0101/p73.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

Bleeding with Anticoagulants: ACC Releases Expert Consensus Decision Pathway to Guide ...

Jul 1, 2018 - This Expert Consensus Decision Pathway from the American College of Cardiology (ACC) aims to provide physicians with decision-making assistance for managing bleeding events in patients taking anticoagulants.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0701/p57.html

Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - American ...

Sep 1, 2006 - Major complications of cirrhosis include ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal bleeding, and hepatorenal syndrome. Diagnostic studies on ascitic fluid should include a differential leukocyte count, total protein level, a ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0901/p767.html

Supplements and Sports - American Family Physician

Nov 1, 2008 - Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1101/p1039.html

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