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Pharmacological Options in the Management of Low Back Pain

Pharmacological Options in the Management of Low Back Pain

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Teaser: 

Dr. Ted Findlay, DO, CCFP, Clinical Assistant Professor, Department of Family Medicine, University of Calgary, Calgary, Alberta.

Abstract
Low back pain is one of the most common conditions for which patients seek medical attention. It can be managed with lifestyle modification, or less commonly medical and surgical intervention. Appropriate selection among various pharmacological options mandates an understanding of the underlying symptomatology and the over-riding treatment plan and objectives. The range of potential medications is substantial: over-the-counter analgesics include acetaminophen and non-steroidal anti-inflammatory drugs, muscle relaxants, and weak opioid combinations including codeine or tramadol. More potent versions of many of the same components are available on prescription, commonly employing stronger opioids either singly or in a combination analgesic. When the pain involves either chronic or neuropathic features, other classes of medications, including anti-epileptic drugs and anti-depressants, may be appropriate.
Key Words: low back pain, acute, chronic, neuropathic pain, nociceptive pain, medications.

FIVE REASONs to SWITCH TO EMR That Will Impact Your Patient Care

FIVE REASONs to SWITCH TO EMR That Will Impact Your Patient Care

Teaser: 

Ian PUN, MD, Family Physician, Scarborough, Ontario.

Abstract
Although many doctors have embraced and modernized their practices with a the advent of an EMR (Electronic Medical Record) system, there still a remaining majority who are hesitant to convert to a computerized recording keeping system fearing change and hassle. I have listed a few brief points urging doctors to change to a more efficient system that saves time and space which will ultimately improve patient care. In future articles, I will go into more detail of specific usages of EMR, specifically the open-source OSCAR McMaster EMR. I will also point of the issues of maintaining an EMR.
Key Words: OSCAR McMaster EMR, computerized medical records, electronic prescription, health information technology.

Why Are Physicians Still Prescribing Sulfonylureas as First Choice for Older Diabetic Adults?

Why Are Physicians Still Prescribing Sulfonylureas as First Choice for Older Diabetic Adults?

Teaser: 

Dr.Michael Gordon Michael Gordon, MD, MSc, FRCPC, Medical Program Director, Palliative Care, Baycrest Geriatric Health Care System, Professor of Medicine, University of Toronto, Toronto, ON.

Abstract
Diabetes Mellitus is very prevalent in the older population. It is one of the important causes of vascular problems which may play a role in the development of dementia, especially of the mixed variety. There has been much progress in the potential medications that can help promote successful glucose control and address the other metabolic correlates of Type 2 diabetes mellitus. Sulfonylureas should be used rarely and very carefully in older especially frail individuals because of their inherent risks. Getting physicians to change their prescribing practices in this frail elderly diabetic population is an important challenge to educators and drug program administrators.
Key Words: diabetes mellitus, sulfonylureas, diabetic management, treatment.

A Recurrent Painful Rash

A Recurrent Painful Rash

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Teaser: 

Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.

Abstract
Herpes simplex viruses (HSVs) are DNA viruses that present as vesicles in clusters on an erythematous base. Infection occurs when close contact between an individual without antibodies against the virus and a person shedding the virus takes place. Most HSV infections are self-limited. Lesions tend to reappear at or near the same location of the initial site of infection. Systemic symptoms such as fever, malaise and acute toxicity may appear, especially in primary infection. A viral culture from the skin vesicles can identify up to 80 to 90% of untreated infection early in the course. Antiviral treatments aim at shortening the disease course and preventing viral dissemination and transmission. Treatments are most effective when they are administered at the first sign of symptom onset.