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Resolving C. difficile infection
A 76-year-old woman, D.N., is hospitalized with a severe E. coli urinary tract infection (UTI). She has taken ciprofloxacin 500 mg every 12 hours and is responding to it. Prior to admission, because she is allergic to sulfamethoxazole, D.N. was taking amoxicillin which has been discontinued. D.N. takes digoxin 0.125 mg and pravastatin (Pravachol, Bristol-Myers Squibb) 20 mg daily. Over the past 24 hours, she developed severe diarrhea and a 101°F temperature. Her stool specimen is positive for C. difficile. D.N. is receiving replacement fluids and electrolytes, but her physician is considering how to resolve the C. difficile infection. What do you recommend?
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Do expiration dates make a difference?
Fewer than a third of adults clean out their medicine cabinet annually—compared with 49% who update their wardrobe to reflect the current season.
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R.Ph.s feel pain of those on chronic opioid therapy
Opioids decrease pain and improve functioning. But some patients are reluctant to take opioids because they want to "be engaged in life." So said Pharm.D. Suzanne Amato Nesbit, clinical pharmacy specialist in pain management and clinical coordinator of the cancer pain service at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore.
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Herb-drug interactions: Interactions between saw palmetto and prescription medications
Patients over age 50 typically present with one chronic disease per decade. Each chronic disease typically requires long-term drug therapy, meaning most older patients require several drugs to maintain health. Simultaneously, use of complementary and alternative medicine (CAM) has increased in the United States in the last 20 years, reaching 36% in 2002; herbal medicine use accounts for approximately 22% of all CAM use. Older adults often add herbal medicines to prescription medications, yet do not always inform their physicians.
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