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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

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

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

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

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

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

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

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

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

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

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

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

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

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

Adverse Reactions to Contrast Material. Recognition, Prevention and Treatment - ...

Oct 1, 2002 - Adverse reactions to contrast agents range from a mild inconvenience, such as itching associated with hives, to a life-threatening emergency. Renal toxicity is a well known adverse reaction associated with the use of intravenous contrast material. Other forms of adverse reactions ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1001/p1229.html

Atypical Pathogens and Challenges in Community-Acquired Pneumonia - American Family ...

Apr 1, 2004 - Atypical organisms such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are implicated in up to 40 percent of cases of community-acquired pneumonia. Antibiotic treatment is empiric and includes coverage for both typical and atypical organisms. Doxycycline, a ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1699.html

Clinically Significant Drug Interactions - American Family Physician

Mar 15, 2000 - A large number of drugs are introduced every year, and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Multiple drug regimens carry the risk of adverse ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1745.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

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

Improving Quality by Doing Less: Overtreatment - Editorials - American Family Physician

Mar 1, 2015 - The third in a series of AFP editorials that addresses the related issues of over-screening, overdiagnosis, and overtreatment. Overtreatment is an important harm that commonly follows overscreening and overdiagnosis.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0301/p289.html

Minimizing Adverse Drug Events in Older Patients - American Family Physician

Dec 15, 2007 - Adverse drug events are common in older patients, particularly in those taking at least five medications, but such events are predictable and often preventable. A rational approach to prescribing in older adults integrates physiologic changes of aging with knowledge of pharmacology. ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1215/p1837.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Diabetic Foot Ulcers: Pathogenesis and Management - American Family Physician

Nov 1, 2002 - Foot ulcers are a significant complication of diabetes mellitus and often precede lower-extremity amputation. The most frequent underlying etiologies are neuropathy, trauma, deformity, high plantar pressures, and peripheral arterial disease. Thorough and systematic evaluation and ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1101/p1655.html

CDC Develops Guideline for Opioid Prescribing - Practice Guidelines - American Family ...

Jun 15, 2016 - A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0615/p1042.html

Management of the Hyperosmolar Hyperglycemic Syndrome - American Family Physician

Oct 1, 1999 - Hyperglycemic hyperosmolarity is part of a clinical spectrum of severe hyperglycemic disorders ranging from pure hyperglycemic hyperosmolarity without ketosis to diabetic ketoacidosis, with significant overlap in the middle. From 50 to 75 percent of hospitalizable patients who have ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1468.html

Ectopic Pregnancy - American Family Physician

Feb 15, 2000 - Ectopic pregnancy occurs at a rate of 19.7 cases per 1,000 pregnancies in North America and is a leading cause of maternal mortality in the first trimester. Greater awareness of risk factors and improved technology (biochemical markers and ultrasonography) allow ectopic pregnancy to be ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1080.html

Uncommon Adverse Effects of Commonly Abused Illicit Drugs - Editorials - American ...

Jul 1, 2013 - Illicit drug use should be considered in the differential diagnosis of many clinical presentations, because the list of known deleterious effects is growing. There are an increasing number of case reports involving uncommon adverse effects of commonly abused illicit drugs.

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0701/p10.html

Potential Harms of Computed Tomography: The Role of Informed Consent - Editorials - ...

Sep 1, 2013 - The use of CT imaging has risen dramatically in the past two decades, and there is substantial evidence that it is overused. One concern is that the harms and risks of CT have been underestimated and poorly understood, and are not often discussed with patients. These harms should be ...

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0901/p294.html

Exercise and Pregnancy Loss - FPIN's Clinical Inquiries - American Family Physician

Apr 1, 2015 - Regular exercise for up to seven or more hours per week (including low-intensity and high-intensity aerobics, jogging, cycling, and swimming) is not associated with increased rates of miscarriage in the first to mid-second trimesters. Patients may continue bending and lifting at work, ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0401/p437.html

Impact of Anorexia, Bulimia, and Obesity on the Gynecologic Health of Adolescents - ...

Aug 1, 2001 - Dieting behaviors and nutrition can have an enormous impact on the gynecologic health of adolescents. Teenaged patients with anorexia nervosa can have hypothalamic suppression and amenorrhea. In addition, these adolescents are at high risk of osteoporosis and fractures. Unfortunately, ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0801/p445.html

The Effects of Combination Contraceptives on Weight - Cochrane for Clinicians - ...

Dec 1, 2012 - Compared with placebo or no intervention, the use of combination contraceptives was not associated with weight gain. Most studies comparing different types of combination contraceptives showed no statistically significant effects on weight.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1009.html

Electronic Cigarettes for Smoking Cessation - FPIN's Help Desk Answers - American ...

Mar 15, 2016 - Nicotine-containing e-cigarettes may be more effective than placebo devices for smoking cessation. They may also aid in smoking reduction, but the quality of available evidence is low. Little is known about their safety.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0315/p492.html

Diethylstilbestrol Exposure - American Family Physician

May 15, 2004 - Diethylstilbestrol is a synthetic nonsteroidal estrogen that was used to prevent miscarriage and other pregnancy complications between 1938 and 1971 in the United States. In 1971, the U.S. Food and Drug Administration issued a warning about the use of diethylstilbestrol during pregnancy...

American Family Physician : Article

https://www.aafp.org/afp/2004/0515/p2395.html

Neurological Complications of Scuba Diving - American Family Physician

Jun 1, 2001 - Recreational scuba diving has become a popular sport in the United States, with almost 9 million certified divers. When severe diving injury occurs, the nervous system is frequently involved. In dive-related barotrauma, compressed or expanding gas within the ears, sinuses and lungs ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0601/p2211.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

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

Neurologic Complications of Prostate Cancer - American Family Physician

May 1, 2002 - Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0501/p1834.html

Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663.html

Benefits and Risks of Psychiatric Medications During Pregnancy - American Family Physician

Aug 15, 2002 - Traditionally, psychiatric medications were withheld during pregnancy because of fear of teratogenic and other effects. The emergence of evidence of the safety of most commonly used psychiatric medications, the availability of this information in the form of online databases, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p629.html

Does Screening Mammography Lead to Overdiagnosis of Invasive Breast Cancer? - AFP ...

Mar 15, 2013 - Implementation of a universal mammographic screening program leads to an increase in the diagnosis of invasive breast cancer, because of improved detection of clinically significant cancer and overdiagnosis.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0315/p408.html

Does Metformin Increase the Risk of Fatal or Nonfatal Lactic Acidosis? - Cochrane for ...

Nov 1, 2010 - In patients without standard contraindications to metformin therapy, metformin does not increase the risk of lactic acidosis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/1101/p1068.html

Smallpox Vaccine: Contraindications, Administration, and Adverse Reactions - American ...

Sep 1, 2003 - Since the terrorist attacks of September 11, 2001, and the anthrax exposures in the following weeks, concern that smallpox could be used as a biologic weapon has increased. Public health departments and the U.S. military have begun the process of vaccinating soldiers and civilian ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0901/p889.html

Managing Issues Related to Antiretroviral Therapy - American Family Physician

Aug 15, 2003 - Antiretroviral regimens are complicated and difficult for patients to follow, and they can have serious side effects, such as osteonecrosis and bone demineralization. Protease inhibitor therapy has been associated with hyperlipidemia, hyperglycemia, gastrointestinal symptoms, and ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0815/p675.html

Risks of Bisphosphonate Use - FPIN's Clinical Inquiries - American Family Physician

Nov 15, 2013 - Bisphosphonates are associated with a small risk of atypical femoral shaft fractures, which increases with duration of use. Bisphosphonates are associated with a small risk of osteonecrosis of the jaw, which is more common in patients who are older, female, or have poor dental hygiene ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1115/p697.html

Management Options for Early Incomplete Miscarriage - Cochrane for Clinicians - ...

Feb 1, 2011 - For the management of incomplete miscarriage, limited-quality evidence shows that medical treatment with misoprostol (Cytotec), expectant care, and surgical evacuation have a completion of miscarriage success rate between 80 to 99 percent in pregnancies at less than 13 weeks' ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/0201/p258.html

One in Five Patients Overdiagnosed with Lung Cancer Screening - POEMs - American Family...

Jul 15, 2014 - In patients screened for lung cancer using low-dose computed tomography (LDCT), more than 18% of all lung cancers found are slow-growing and will not cause symptoms or harm during an average 6.4 years of follow-up. This risk of overdiagnosis should be part of the discussion regarding ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p112.html

Neurological Complications of Systemic Cancer - American Family Physician

Feb 15, 1999 - Neurologic complications occur frequently in patients with cancer. After routine chemotherapy, these complications are the most common reason for hospitalization of these patients. Brain metastases are the most prevalent complication, affecting 20 to 40 percent of cancer patients and ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p878.html

CIN Treatment May Increase Miscarriages but Does Not Affect Fertility - POEMs - ...

Apr 1, 2015 - In this analysis of 15 observational studies (it would be difficult and unethical to do randomized research on this topic), excision using any method for CIN did not affect fertility, although second trimester miscarriages were more likely. A study published at the same time found the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p490.html

Increased GI Bleeding After Switch from Warfarin to Dabigatran - POEMs - American ...

May 1, 2015 - The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p648.html

Pioglitazone Exposure Increases Bladder Cancer Risk - POEMs - American Family Physician

Jan 15, 2014 - This review of all available data found a significantly increased risk of bladder cancer among adults with type 2 diabetes treated with pioglitazone. Pioglitazone also significantly increases the risk of heart failure, and there is minimal, if any, patient-oriented evidence of benefit ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0115/p136.html

Long-term PPI Therapy and the Risk of Hip Fracture - AFP Journal Club - American Family...

Feb 1, 2008 - Does the long-term use of PPIs increase the risk of hip fracture? The physician must balance the risks and benefits of PPIs, especially in certain patients.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0201/p277.html

Prescribing for Older Adults: Finding the Balance - Editorials - American Family Physician

Dec 15, 2007 - ...ALLEN F. SHAUGHNESSY, PharmD, Tufts University Family Medicine Residency at Cambridge Health Alliance, Malden, Massachusetts Am Fam Physician. 2007 Dec 15;76(12):1768. Related Article On the other end of every prescription is a person with a biologic makeup that will react well,...

American Family Physician : Editorials

https://www.aafp.org/afp/2007/1215/p1768.html

Risks and Benefits of Combination Contraceptives - FPIN's Clinical Inquiries - American...

Dec 1, 2006 - The risks of using oral combination contraceptives include: a three- to sixfold increase in the incidence of venous thromboembolism (VTE) apparent by the fourth month of use and highest between six and 12 months of use; a two- to sixfold increase in the risk of ischemic stroke among ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2006/1201/p1915.html

Becaplermin (Regranex) for Diabetic Foot Ulcers - STEPS - 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

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

Beta2 Agonists in the Treatment of Asthma - Editorials - American Family Physician

Jul 15, 2006 - ...of this advisory are the findings of the Salmeterol Multicenter Asthma Research Trial,2 which was stopped because of a small but significant number of asthma-related deaths, and similar data from studies of formoterol (Foradil Aerolizer) that showed a possible increase in severe...

American Family Physician : Editorials

https://www.aafp.org/afp/2006/0715/p232.html

Counseling Parents About Vaccine Safety - Editorials - American Family Physician

Dec 1, 2008 - ...CLARISSA KRIPKE, MD, FAAFP, University of California, San Francisco School of Medicine San Francisco, California Am Fam Physician. 2008 Dec 1;78(11):1248. Related Content Many parents are concerned about vaccine safety. This concern is heightened by a widespread belief that...

American Family Physician : Editorials

https://www.aafp.org/afp/2008/1201/p1248.html

Dietary Supplement Use in Children: Concerns of Efficacy and Safety - Editorials - ...

Mar 15, 2005 - ...Increasing numbers of patients in the United States are using herbal therapies and dietary supplements; between 1990 and 1997, there was a fivefold increase in the use of herbal therapies.1 This increase is mirrored in children: more than 50 percent of all young children and more...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0315/p1068.html

Hyperglycemic Crises: Improving Prevention and Management - Editorials - American ...

May 1, 2005 - ...it also has been shown that quarterly visits for children with type 1 diabetes to endocrine clinics can significantly reduce the number of emergency admissions for DKA.12 A prospective study of 1,243 patients with type 1 diabetes from infancy to 19 years of age showed that elevated...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0501/p1659.html

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