Drugs

What medical therapies can be used in the treatment of acute mechanical low back pain? Medical therapies for pain relief include analgesics such as acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), and muscle relaxants, as well as local application of heat. Data regarding the efficacy of opioid analgesics for acute low back pain is limited. Of note, …

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How are organ or tissue threatening autoimmune problems treated in patients with a PID syndrome? In general, autoimmunity that is organ-threatening should be treated, and the options for treatment are generally the same as for immunocompetent patients. Rigorous exclusion of infection, to the extent that is practically possible, and closer follow-up of the PID syndrome …

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treatment plan for hemochromatosis Phlebotomy is performed twice weekly until transferrin saturation is <50% and ferritin is <50 μg/L (up to 2–3 years) and then as required (usually every 3–4 months) to maintain low normal serum levels (ferritin <300 μg/L in men, <200 μg/L in women). Life expectancy of symptomatic patients is extended considerably by …

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How is homocystinuria treated? What symptoms can be expected to respond? Effective treatment requires early diagnosis to prevent mental retardation, which is the basis for newborn screening for inborn errors of metabolism. Vitamin B 6 and B 12 and folate are cofactors for the different enzymes involved in methionine metabolism. Half of patients respond to vitamin B 6 . Large doses …

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Medications that cause Osteonecrosis Are there any other medications that are associated with Osteonecrosis ? Recently, protease inhibitors, used to treat human immunodeficiency virus infections, have been implicated in causing ON. These medications have caused lipodystrophy, diabetes mellitus, hyperlipidemia, and hypercoagulability. Hyperlipidemia and hypercoagulable states may lead to ON. Bisphosphonates have been associated with ON of the jaw.

How do corticosteroids cause Osteonecrosis? GCs cause ON by both direct and indirect effects on cells. Direct effects include increased apoptosis of osteoblasts, osteocytes, and endothelial cells. Indirect effects include increased hypercoagulability, decreased angiogenesis, and modulated local vasoactive amine production, which can contribute to the ischemia. Finally, increased intraosseous pressure because of adipogenesis and fat …

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How much corticosteroid puts a patient at risk for Osteonecrosis? Overall, 10% to 30% of patients on GCs develop ON. A previous review estimated a 4.6-fold increase in the rate of ON for every 10 mg/day increase in the mean daily dose of prednisone during the first 6 months of therapy. More recent reports suggest …

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