Medical treatment guidelines

Medical treatment guidelines Here we are faced with the decision as to which medicine to recommend for a particular treatment. These guidelines are usually the result of a consensus between experts and they are intended to influence medical decision-making. Insofar as consensus guidelines can also take into consideration economic matters, again we are led to the question should/can economic evaluation play a part in this ... 

It must be remembered that for immediate field treatment most soldiers are equipped with only three 2 mg autoinjectors of atropine (as well as oxime, and possibly anticonvulsant injectors) for administration by themselves or a buddy . Most medical treatment doctrines call for oxime administration only with the first three autoinjectors of atropine. Additional oxime beyond this initial treatment will be administered under direction of a physician at a medical treatment facility. Additional atropine and anticonvulsant treatment is carried by the medic/corpsman in most West-em/NATO forces and will be absolutely required in cases of severe poisoning. US medical treatment guidelines call for the administration of the first CANA anticonvulsant (10 mg of diazepam)... 

The popularity of these drugs, especially the newer-generation antidepressants, has risen dramatically. It is questionable, however, why the trend to medicate all depressive symptoms continues to rise, especially after current medical treatment guidelines have recommended that depression associated with reactive or external environmental pressures do not call for drug therapy. Perhaps what complicates matters for practitioners is that some clients present symptoms reflective of both endogenous and... 

Anonymous. Treatment Guidelines from the Medical Letter. Drugs for Parkinson s disease. Med Lett 2004 2 41-46. 

Anonymous. Choice of contraceptives Treatment Guidelines from The Medical Letter. Med Lett 2004 2 55-62. 

In the decade that has passed since our article was published, the dust has settled around the issue of meta-analysis. It is no longer considered a controversial procedure. Meta-analyses of clinical trials are now routinely published in all of the top medical journals, and the National Institute for Health and Clinical Excellence (NICE), which publishes the treatment guidelines that are used by the NHS, crafts recommendations on the basis of meta-analyses that it conducts. Nevertheless, the editors were right about our article being controversial. Although some scholars in the field were persuaded by our analyses, others were sceptical, to put it mildly.2 The sceptics knew that antidepressants worked - if we had found otherwise, we must have done something wrong. Certainly there were other clinical trials of antidepressants beyond those that we had included in our analyses. Surely an analysis of those studies would point to a different conclusion. 

In this context, judging the qualifications of an alternative medicine practitioner can be difficult— there are no universally accepted guidelines. Some states require licensing of alternative medicine practitioners (e.g., acupuncturists, naturopathic herbalists), and licensure is often used by courts to establish school-specific standards of care. In cases where no licensing exists, courts apply conventional medical or lay standards of care. Eisenberg (1997) has proposed strategies for physicians in guiding patients who seek alternative medical treatment. 

In this chapter, we discuss the pharmacology of medications that are classified as anxiolytic, sedative, or hypnotic—primarily the benzodiazepines, buspirone, zolpidem, eszopiclone, and zale-plon. Subsequently, we present diagnosis-specific treatment guidelines (outlined in Table 3-1). The commonly used anxiolytics and hypnotics, together with their usual doses, are shown in Table 3-2. Many antidepressant medications are also effective in the treatment of anxiety disorders. The pharmacology of antidepressants is discussed in Chapter 2 their clinical use in anxiety disorders is addressed in the diagnosis-specific sections later in this chapter. 

Some patients with bipolar disorder will need antidepressants. Although the switch rate into mania or induction of rapid cychng by antidepressants is controversial, these agents do appear to present a risk for some patients, often with devastating consequences. Therefore, when a patient with bipolar disorder is prescribed an antidepressant, it should only be in combination with a medication that has established antimanic properties. Controlled comparative data on the use of specific antidepressant drugs in the treatment of bipolar depression are sparse. Current treatment guidelines extrapolate from these few studies and rely heavily on anecdotal chnical experience. Overah, tricyclic antidepressants should be avoided when other viable treatment options exist. Electroconvulsive therapy should be considered in severe cases. 

Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP. The Expert Consensus Guideline Series. Medication Treatment of Bipolar Disorder 2000. Postgrad Med 2000 Special Number l-104. 

Professional pharmacy and medical organizations [e.g., the American Pharmacists Association (APhA), the American Society of Health-System Pharmacists (ASHP), the National Community Pharmcists Association (NCPA), and the American Medical Association (AMA)] and health care organizations [e.g., the American Diabetes Association (ADA) or the American Heart Association (AHA)] also provide valuable information about many health conditions and value-added services. This information is important not only in the development of a service but also in justifying the need for a service with consumers and administrators. These organizations also provide treatment guidelines and additional resources that can be used when developing an operations plan for a service (see Chapter 25). 

Treatment guidelines for kids with bipolar disorder. (2005, February 23). Medical News Today. Retrieved from http //www.medicalnewstoday.com... 

Treatment guidelines for depression and anxiety increasingly emphasize the value of longer-term maintenance treatment with antidepressants in order to prevent recurrence of illness. It is therefore important to assess the adverse effects burden of longer-term medication. The change in adverse effects profile over 1 year of treatment has been studied in a double-blind, placebo-controlled study of maintenance treatment with imipramine (average daily dose 160 mg) in 53 patients with panic disorder (15). Adverse effects of imipramine, such as sweating, dry mouth, and increased heart rate, persisted over the year... 

The Expert Consensus Guideline Series, Medication Treatment of Bipolar Disorder 2000, has recommended... 

The release of a nerve agent near a school would put a strain on local prehospital and in-hospital resources, with airway equipment, supplies of 2-PAM and atropine, and pediatric intensive care beds being quickly used and depleted (Aghababian, 2002). Therefore, health care professionals should know how their community accesses the Strategic National Stockpile (SNS) and other resources to obtain medications and supplies in a timely manner. Additionally, hospitals should keep a 48-hour supply of pediatric equipment and pharmaceuticals on hand for their average daily census of pediatric patients, plus an additional 100 patients (Markenson Redlener, 2004). Stockpiled pharmaceuticals and equipment should be specifically for pediatric use or appropriately substituted for such use (Markenson Redlener, 2004). Hospital operations and preparedness policies should include pediatric care and treatment guidelines (Markenson Redlener, 2004). 

Available in the United States at this time for investigational use only. (Reproduced with permission from (2003) Treatment Guidelines, vol. 1(7), pp. 41-52 Medical Letter.)... 

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