Clinical Medicine and Therapeutics最新文献_第4页

Metformin: A Review of Its Use in the Treatment of Type 2 Diabetes: 二甲双胍治疗2型糖尿病的研究进展

Clinical Medicine and Therapeutics Pub Date : 2009-09-25 DOI: 10.4137/CMT.S1085

N. Papanas, E. Maltezos

{"title":"Metformin: A Review of Its Use in the Treatment of Type 2 Diabetes:","authors":"N. Papanas, E. Maltezos","doi":"10.4137/CMT.S1085","DOIUrl":"https://doi.org/10.4137/CMT.S1085","url":null,"abstract":"Metformin is now the most widely prescribed oral hypoglycemic agent. This review outlines its use in the treatment of type 2 diabetes. The main mechanisms of action include reduction of appetite and of intestinal carbohydrate absorption, inhibition of hepatic gluconeogenesis, and increased glucose uptake by peripheral tissues. Metformin has been established as the drug of choice for the first-line treatment of type 2 diabetes. According to broadly accepted guidelines, it should be administered early at diagnosis of this metabolic disorder, alongside diet and exercise. This agent may also be safely and efficaciously combined with all other oral hypoglycemic agents, enabling a useful additive effect. Additionally, it may be prescribed in conjunction with insulin. This combination aims to offset insulin resistance, reduce insulin requirements and minimize weight gain. Of greater importance, metformin has been consistently shown to have a favorable effect on cardiovascular risk factors and to improve cardiovascular outcomes. Interestingly, the efficacy of metformin is accompanied by excellent safety: caution is only needed to avoid the drug in patients with obvious contraindications (mainly chronic renal failure, congestive heart failure, chronic obstructive pulmonary disease, liver disease). Moreover, the cost-effectiveness of metformin has been established. Generally, metformin is an excellent choice both in the specialized setting and in primary health care.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78009977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Pharmacotherapy Options in Cancer Treatment-Induced Bone Loss: Focus on Bisphosphonates 癌症治疗导致骨质流失的药物治疗选择:以双膦酸盐为主

Clinical Medicine and Therapeutics Pub Date : 2009-09-25 DOI: 10.4137/CMT.S2064

Kouta Ito

{"title":"Pharmacotherapy Options in Cancer Treatment-Induced Bone Loss: Focus on Bisphosphonates","authors":"Kouta Ito","doi":"10.4137/CMT.S2064","DOIUrl":"https://doi.org/10.4137/CMT.S2064","url":null,"abstract":"Bone loss and its associated risk of fracture is a serious long-term health issue for breast cancer and prostate cancer survivors. Hormone ablation therapy, in particular aromatase inhibitors (AIs) for breast cancer and androgen deprivation therapy (ADT) for prostate cancer, causes marked reduction in circulating estrogen or testosterone levels, resulting in increased bone resorption, decreased bone mineral density (BMD), and an increased risk of fragility fracture. In several clinical trials with small sample sizes and short follow-up periods, oral and intravenous bisphosphonates have been shown to improve BMD, but not actual fracture rates, in cancer patients on hormone ablation therapy. A number of professional organizations and expert panels recommend the use of bisphosphonates for selected patients at risk. Although bisphosphonates are generally well tolerated, physicians should be aware of safety concerns, including the risk of osteonecrosis of the jaw. With the growing number of older breast and prostate cancer survivors, additional research is needed to characterize patients who would benefit from pharmacotherapy and optimize strategies to prevent cancer treatment-induced bone loss.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85687353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Rational to Prescribe Tigecycline: Critical Analysis of the Evidence and Usage Algorithms by an Argentinean Experts Panel 目前合理处方替加环素:阿根廷专家小组对证据和使用算法的关键分析

Clinical Medicine and Therapeutics Pub Date : 2009-09-25 DOI: 10.4137/CMT.S3312

D. Curcio, L. Barcelona, W. Cornistein, C. Bantar, L. Barcan, P. Bonvehi, R. Reina, C. Bergallo, H. Biondi, J. Calderón, J. Castagnino, Paulo Chinchilla, M. Dignani, A. Esposto, Norma Pérez, C. Freuler, C. Luna, F. Ríos, C. Rodríguez, R. Valentini, W. Vazquez, S. Verbanaz, G. Vergara

{"title":"Current Rational to Prescribe Tigecycline: Critical Analysis of the Evidence and Usage Algorithms by an Argentinean Experts Panel","authors":"D. Curcio, L. Barcelona, W. Cornistein, C. Bantar, L. Barcan, P. Bonvehi, R. Reina, C. Bergallo, H. Biondi, J. Calderón, J. Castagnino, Paulo Chinchilla, M. Dignani, A. Esposto, Norma Pérez, C. Freuler, C. Luna, F. Ríos, C. Rodríguez, R. Valentini, W. Vazquez, S. Verbanaz, G. Vergara","doi":"10.4137/CMT.S3312","DOIUrl":"https://doi.org/10.4137/CMT.S3312","url":null,"abstract":"Tigecycline is the first of a new class of antibiotics named glycylcyclines and is active in vitro against a variety of gram-positive and gram-negative organisms, including nosocomial resistant pathogens such as vancomycin-resistant Enterococcus faecium, methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Enterobacteriaceae, and multidrug-resistant-Acinetobacter spp. This medication has been approved by the US Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal infections (cIAI), complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia. Tigecycline’s pharmacological and microbiological profile has also encouraged physicians’ to use the drug in other infections caused by resistant pathogens featuring limited therapeutics options (i.e. hospital-acquired pneumonia-HAP). In this study we publish the conclusions of an expert panel that identify and evaluate the evidence to support the use of Tigecycline in hospitalized patients with one of the following three infections: cSSSI, cIAI and HAP, including ventilator-associated pneumonia. Based on this data the panel developed an Algorithm Rational to Prescribe Tigecycline (ART) for each pathology.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80784530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Infliximab: A Review of its Use in the Treatment of Crohn’s Disease 英夫利昔单抗治疗克罗恩病的研究进展

Clinical Medicine and Therapeutics Pub Date : 2009-09-25 DOI: 10.4137/CMT.S2250

J. Molloy, Joel Z Stengel, Hays L. Arnold

引用次数: 1

Pharmacotherapy of Chronic Obstructive Pulmonary Disease: Focus on Arformoterol Tartrate 慢性阻塞性肺疾病的药物治疗:以酒石酸阿福莫特罗为主

Clinical Medicine and Therapeutics Pub Date : 2009-09-23 DOI: 10.4137/CMT.S2584

P. King

{"title":"Pharmacotherapy of Chronic Obstructive Pulmonary Disease: Focus on Arformoterol Tartrate","authors":"P. King","doi":"10.4137/CMT.S2584","DOIUrl":"https://doi.org/10.4137/CMT.S2584","url":null,"abstract":"Arformoterol tartrate is a newly developed long-acting ssβ2-agonist with both acute and prolonged bronchodilator effects. It is formed of 2 isomers (R,R/R,R) which distinguishes it from the more commonly used racemic formoterol (R,R/S,S). The active isomer is the (R,R) and in vitro arformoterol may have more potent anti-inflammatory effects than formoterol. It can only be given by a nebulizer. There have been 5 randomized, blinded trials which have assessed the use of arformoterol in chronic obstructive pulmonary disease (COPD). Arformoterol has been demonstrated to improve lung function and symptoms but the subjects tested did have a high degree of airway reactivity. The medication was well tolerated with a low incidence of side effects but the trials may not have been of sufficient duration to assess this adequately. Arformoterol should be used with caution in subjects with underlying cardiac disease. The current main use of arformoterol is in those subjects with COPD who require a long acting β2-agonist but who cannot use a dry powder or metered dose inhaler preparation. Arformoterol may only need to be given once a day and can be combined with other inhaled medication particularly tiotropium for additional benefit. It potentially has a role in the management of acute exacerbations.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78882191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A Review of Sildenafil in the Treatment of Pediatric Pulmonary Arterial Hypertension 西地那非治疗小儿肺动脉高压的研究进展

Clinical Medicine and Therapeutics Pub Date : 2009-09-23 DOI: 10.4137/CMT.S1959

U. Krishnan, Leif Lovig

引用次数: 5

Collaboration to Meet a Therapeutic Need: The Development of Nelarabine 合作满足治疗需求:奈拉宾的发展

Clinical Medicine and Therapeutics Pub Date : 2009-09-18 DOI: 10.4137/CMT.S2909

D. Kisor

引用次数: 0

Tigecycline in the Treatment of Community-Acquired Pneumonia 替加环素治疗社区获得性肺炎

Clinical Medicine and Therapeutics Pub Date : 2009-09-17 DOI: 10.4137/CMT.S2351

D. Curcio

{"title":"Tigecycline in the Treatment of Community-Acquired Pneumonia","authors":"D. Curcio","doi":"10.4137/CMT.S2351","DOIUrl":"https://doi.org/10.4137/CMT.S2351","url":null,"abstract":"Tigecycline is a first-in-class glycylcycline, broad-spectrum, intravenous antibacterial developed to overcome the two major mechanisms of tetracycline resistance (ribosomal protection and efflux). The drug has been approved in US for community-acquired bacterial pneumonia in adults. In vitro, tigecycline had good activity against a range of Gram-positive, Gram-negative and atypical community-acquired respiratory tract pathogens implicated in community-acquired pneumonia (CAP), including community-acquired Staphylococcus aureus, penicillin-resistant Streptococus pneumoniae and multidrug-resistant Enterobacteriaceae. Nonetheless, tigecycline shows in vitro low activity against against P. aeruginosa. Tigecycline provides high intrapulmonary concentrations that exceed the MIC90 of most of these respiratory pathogens. The combined results of two well designed, phase III studies demonstrated that tigecycline 100 mg initially, followed by 50 mg every 12 hours for 7–14 days was not inferior to recommended dosages of levofloxacin in the treatment of hospitalized patients with CAP. Clinical cure rates were 89.7% versus 86.3% in the clinically evaluable population and 81.0% versus 79.7% in the clinical modified intent-to-treat population. Tigecycline represents an appropriate choice for empirical monotherapy in the treatment of CAP, mainly in patients with risk factors for infections due to resistant bacteria.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85859020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

present and prospective pharmacotherapies in pulmonary Arterial Hypertension 肺动脉高压的当前和未来药物治疗

Clinical Medicine and Therapeutics Pub Date : 2009-09-17 DOI: 10.4137/CMT.S2108

Jennifer A. Johnson, A. Hemnes

引用次数: 0

Pharmacotherapy of Chronic Hepatitis B in Adults: Focus on Tenofovir Disoproxil Fumarate 成人慢性乙型肝炎的药物治疗:重点是富马酸替诺福韦二吡酯

Clinical Medicine and Therapeutics Pub Date : 2009-09-17 DOI: 10.4137/CMT.S1161

M. Jain, Cindy L. Zoellner, K. Garg

{"title":"Pharmacotherapy of Chronic Hepatitis B in Adults: Focus on Tenofovir Disoproxil Fumarate","authors":"M. Jain, Cindy L. Zoellner, K. Garg","doi":"10.4137/CMT.S1161","DOIUrl":"https://doi.org/10.4137/CMT.S1161","url":null,"abstract":"Treatment for hepatitis B (HBV), a global disease affecting over 400 million persons, has changed over the past 15 years. Many of the current treatments are oral therapies which suppress HBV viral load and improve liver-related outcomes. However, differences exist in the currently available therapies both in terms of potency and resistance. The newest HBV nucleotide to be approved for the treatment of hepatitis B is tenofovir disoproxil fumarate that when phosphorylated to its active form leads to DNA chain termination. Tenofovir is active against human immunodeficiency virus (HIV) and was approved for its treatment in 2001. It is also active against HBV and was approved for its treatment in 2008. Tenofovir has emerged as an effective and potent therapy against lamivudine resistant strains as well as wild type HBV. Tenofovir resistance to HBV is rare. Long-term use of tenofovir has been associated with renal and bone marrow toxicity in some HIV-infected patients. To date, this is the only oral therapy which is both potent and does not lead to viral resistance in both treatment naive and experienced patients. Further studies in HBV mono-infected persons are needed to evaluate long-term impact of tenofovir use.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85154393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0