Therapy continuation

Retinoids. Table 1 Indications and mode of administration of commercially available retinoids in dermatological therapy (Continued)... 

The drug may take several days to produce an effect (relief of pain and tenderness). If some or all of the symptoms are not relieved after 2 weeks of therapy, continue taking tiie drug, but notify tiie primary health care provider. 

The most common adverse reaction associated with phenobarbital is sedation, which can range from mild sleepiness or drowsiness to somnolence. These dru > may also cause nausea, vomiting, constipation, bradycardia, hypoventilation, skin rash, headache fever, and diarrhea Agitation, rather than sedation, may occur in some patients. Some of these adverse effects may be reduced or eliminated as therapy continues. Occasionally, a slight dosage reduction, without reducing the ability of the drug to control the seizures, will reduce or eliminate some of these adverse reactions. 

The patient is monitored for adverse reactions. The sedation and drowsiness that sometimes occur with the use of an antianxiety drug may decrease as therapy continues. Prolonged tiierapy (> 3-4 months) may lead to dependence. 

Record the frequency and severity of symptoms by interviewing the patient after 6 to 8 weeks of acid-suppressing therapy. Continued symptoms may indicate the need for long-term maintenance therapy. 

Intensive insulin therapy, the administration of insulin three or more times daily to maintain preprandial blood glucose levels between 70 and 120 g/dL and postprandial blood glucose levels less than 180 g/dL, has been shown to decrease the incidence of proteinuria and albuminuria in patients with diabetes, both with and without documented nephropathy. The development and progression of nephropathy is also delayed in patients with type 1 DM receiving intensive insulin therapy. Continued benefits of intensive insulin therapy have been demonstrated up to 8 years after the study.16... 

Acne flare at start of therapy Continue therapy... 

Duration of therapy - Individualize the duration of therapy. Continue anticoagulant therapy until the danger of thrombosis and embolism has passed. 

Maintenance of therapy Continual reevaluation of the patient receiving IR tablets is important, with special attention to the maintenance of pain control and the relative incidence of side effects associated with therapy. If the level of pain increases, make efforts to identify the source of increased pain while adjusting the dose as described above to decrease the level of pain. 

Maintenance therapy- Continue the dosage that maintains normal serum uric acid levels. When there have been no acute attacks for 6 months or more and serum uric acid levels have remained within normal limits, decrease the daily dosage by 0.5 g every 6 months. Do not reduce the maintenance dosage to the point where serum uric acid levels increase. 

Triple therapy (omeprazole/clarithromycin/amoxiclllin)- Omeprazole 20 mg plus clarithromycin 500 mg plus amoxicillin 1000 mg each given twice/day for 10 days. If an ulcer is present at the initiation of therapy, continue omeprazole 20 mg for an additional 18 days. 

Duration of therapy Continue administration for a minimum of 48 to 72 hours after fever abates or after evidence of bacterial eradication has been obtained. Perioperative prophylaxis Discontinue prophylactic use within 24 hours after the surgical procedure. In surgery where infection may be particularly devastating, prophylactic use may be continued for 3 to 5 days following surgery completion. CEFACLOR ... 

ETFN patients with suspected fungal infections - After approximately 14 days of IV therapy, continue treatment with oral solution 200 mg twice daily until resolution of clinically significant neutropenia. The safety and efficacy of itraconazole use exceeding 28 days in ETFN is not known. 

A larger set of placebo-controlled studies show conclusively that imipramine is also effective for the treatment of panic disorders. Other agents shown to be effective in panic disorders include the SSRIs paroxetine, sertraline, fluvoxamine, fluoxetine and citalopram. Generally, initial treatment of moderate to severe panic disorders may require the initiation of a short course of benzodiazepines e.g. clonazepam (0.5 1 mg twice daily), and an SSRI. The patient will obtain immediate relief from panic attacks with the benzodiazepine whereas the SSRI may take 1 6 weeks to become effective. Once a patient is relieved of initial panic attacks, clonazepam should be tapered and discontinued over several weeks and SSRI therapy continued thereafter. There are no pharmacological treatments available for specific phobias, however controlled trials have shown efficacy for several agents, e.g. phenelzine, moclobemide. clonazepam, alprazolam, fluvoxamine. sertraline and paroxetine in the treatment of social phobia (Roy-Byrne and Cowlev, 2002). 

Solomon BL, Evaul JE, Burman KD, Wartofsky L. Remission rates with antithyroid drug therapy continuing influence of iodine intake Ann Intern Med 1987 107(4) 510-2. 

During acute episodes a broad-spectrum topical prophylactic antibiotic ointment, such as 0.3% tobramycin or 0.5% moxifloxacin, protects the cornea from secondary infection while it heals. The use of a therapeutic contact lens and topical NSAIDs, such as diclofenac sodium 0.1% solution or ketorolac 0.5% solution, provide symptomatic relief. The therapeutic soft contact lens also protects the regenerating epithelium and temporarily provides epithelial stability. A cycloplegic agent, such as 5% homatropine, should be instilled to decrease ciliary spasm and pain. Oral analgesics can be prescribed as needed (see Chapter 7). The eye should be examined in 24 hours and the therapy continued until the epithelial defect is healed. 

Randomized controlled trials of azathioprine, methotrexate, cladribine, intravenous immunoglobulin and cyclophosphamide have not shovm definite modification to the aggressive course of PP MS (Leary and Thompson, 2005). However, these immunosuppressant therapies continue to be evaluated in patients with active aggressive MS. 

Hundreds of patients have received huge doses of atropine and scopolamine (up to 250 mg), sometimes given three times a week for up to 4 mo, and this form of therapy continues in Eastern Europe today. A chronic behavioral syndrome of toxicity appears unlikely, and single or even multiple exposures to the anticholinergic drugs used In the volunteers, frequently at low doses, are deemed Insufficient to stimulate a persistent toxic syndrome. Of course. Individual susceptibility to acute effects, which may trigger a long-term effect, cannot be excluded. 

Although traditional medicines continue to be discovered and developed, the fields of biotechnology and gene therapy continue to advance. In addition, new methods to collect and evaluate clinical data on a real-time basis will help to speed the development process. 

In the non-exercising horse, increased blood lactate concentrations are sufficient evidence of a metabolic disturbance to initiate fluid therapy. They are an indication of poor tissue perfusion or increased circulating epinephrine (adrenaline) concentrations (James et al 1999). Hypovolemia and endotoxemia are common causes of increased lactate concentrations in the horse. Endotoxemia increases tissue lactate production both through circulatory changes, which reduce blood flow to the tissues and inappropriate anaerobic metabolism (Fink 1997). Whereas lactate is a good indicator of the need to start fluid therapy, continued high lactate concentrations should be assessed in the context of cardiovascular parameters, such as pulse rate, urine output and blood pressure, because decreases in plasma lactate concentration... 

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