Intravenous diuretic administration in the home environment

2021 ◽  
Vol 26 (12) ◽  
pp. 599-603
Author(s):  
Drew Payne
Keyword(s):  
Heart Failure ◽  
Home Environment ◽  
Adult Population ◽  
Diuretic Therapy ◽  
British Heart Foundation ◽  
First Line ◽  
Symptomatic Heart Failure ◽  
Advantages And Disadvantages ◽  
First Line Treatment ◽  
Heart Foundation

Chronic heart failure is a condition associated with ageing, affecting 1–2% of the adult population, raising to 70% of the adult population over 70 years of age. Diuretics are often the first-line treatment for patients with symptomatic heart failure, not just oedema. Traditionally, intravenous (IV) diuretic therapy has been administered only in hospitals. In 2012, the British Heart Foundation ran a pilot study investigating the effectiveness of IV diuretic administration within the home. Since then, there has been an increase in these services. This article examines the advantages and disadvantages of this service, whether community nurses are best placed to deliver this, and what the benefits to the patient might be.

scholarly journals Fixed combinations of glaucoma medications

2015 ◽  
Vol 143 (9-10) ◽  
pp. 626-631 ◽  
Author(s):  
Nikola Babic
Keyword(s):  
Intraocular Pressure ◽  
Fixed Combination ◽  
Pressure Control ◽  
Line Treatment ◽  
Efficacy And Safety ◽  
First Line ◽  
Advantages And Disadvantages ◽  
Role Efficacy ◽  
Indications For Use ◽  
First Line Treatment

The first line treatment in the management of glaucoma is topical medical therapy. Many patients with glaucoma require multiple medications for adequate intraocular pressure control. For patients who need multi-dose regimens to control intraocular pressure, fixed combinations offer convenience, efficacy and safety. This review summarizes the role, efficacy, mechanism of action and indications for use of modern fixed combination of topical glaucoma medications. The review shows the advantages and disadvantages of a prescribing fixed combination in daily clinical practice.

Randomized Phase II Trial of the Efficacy and Safety of Trastuzumab Combined With Docetaxel in Patients With Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer Administered As First-Line Treatment: The M77001 Study Group

2005 ◽  
Vol 23 (19) ◽  
pp. 4265-4274 ◽  
Author(s):  
Michel Marty ◽  
Francesco Cognetti ◽  
Dominique Maraninchi ◽  
Ray Snyder ◽  
Louis Mauriac ◽  
...  
Keyword(s):  
Disease Progression ◽  
Response Rate ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
First Line ◽  
Her2 Positive ◽  
Symptomatic Heart Failure ◽  
Time To Treatment Failure ◽  
Epidermal Growth ◽  
First Line Treatment

Purpose This randomized, multicenter trial compared first-line trastuzumab plus docetaxel versus docetaxel alone in patients with human epidermal growth factor receptor 2 (HER2) –positive metastatic breast cancer (MBC). Patients and Methods Patients were randomly assigned to six cycles of docetaxel 100 mg/m2 every 3 weeks, with or without trastuzumab 4 mg/kg loading dose followed by 2 mg/kg weekly until disease progression. Results A total of 186 patients received at least one dose of the study drug. Trastuzumab plus docetaxel was significantly superior to docetaxel alone in terms of overall response rate (61% v 34%; P = .0002), overall survival (median, 31.2 v 22.7 months; P = .0325), time to disease progression (median, 11.7 v 6.1 months; P = .0001), time to treatment failure (median, 9.8 v 5.3 months; P = .0001), and duration of response (median, 11.7 v 5.7 months; P = .009). There was little difference in the number and severity of adverse events between the arms. Grade 3 to 4 neutropenia was seen more commonly with the combination (32%) than with docetaxel alone (22%), and there was a slightly higher incidence of febrile neutropenia in the combination arm (23% v 17%). One patient in the combination arm experienced symptomatic heart failure (1%). Another patient experienced symptomatic heart failure 5 months after discontinuation of trastuzumab because of disease progression, while being treated with an investigational anthracycline for 4 months. Conclusion Trastuzumab combined with docetaxel is superior to docetaxel alone as first-line treatment of patients with HER2-positive MBC in terms of overall survival, response rate, response duration, time to progression, and time to treatment failure, with little additional toxicity.

scholarly journals Morbidnoe ozhirenie - vozmozhnostikonservativnoy terapii

2010 ◽  
Vol 7 (4) ◽  
pp. 40-43 ◽  
Author(s):  
E V Ershova ◽  
E A Troshina ◽  
O S Fedorova ◽  
S A Butrova
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Conservative Therapy ◽  
Adult Population ◽  
Line Treatment ◽  
Social Significance ◽  
First Line ◽  
Associated Diseases ◽  
Overall Effectiveness ◽  
First Line Treatment

Medico-social significance of morbid obesity, occurring in 2-4% of the adult population in Russia, results from the severity of obesity- associated diseases. Conservative therapy of morbid obesity is the first line treatment and is mostly a preparation for bariatric surgery, because the overall effectiveness of conservative measures for morbid obesity does not exceed 5-10%.

scholarly journals Medical Treatment of Heart Failure with Reduced Ejection Fraction – Prognostic Indication

2017 ◽  
Vol 10 ◽  
Author(s):  
Giuseppe Rosano
Keyword(s):  
Heart Failure ◽  
Beta Blockers ◽  
Great Success ◽  
Therapeutic Approaches ◽  
First Line ◽  
Reduced Ejection Fraction ◽  
Medical Interventions ◽  
The Past ◽  
Patients With Heart Failure ◽  
First Line Treatment

An up-to-date review on guideline directed medical therapies that aim to improve prognosis in HFrEF patients.  Research on medical interventions that may improve prognosis in patients with chronic heart failure has had great success in the past decades. Therefore, there are well- established classes of drugs – ACEi, beta- blockers, MRAs – that should be used as first line treatment in all patients with heart failure. In the past few years newer therapeutic approaches have been shown to improve prognosis in patients with heart failure but, since the evidence generated by these newer classes of drugs is less than that of the first three classes of drugs these therapies should be implemented only after an initial treatment with the first line drugs has been implemented. This article reviews the advances that have achieved in the treatment of heart failure in terms of a prognostic benefit.

Analysis of first-line treatment in older patients with metastasic colorectal cancer

2021 ◽  
pp. 107815522098422
Author(s):  
Arantxa Magallón Martínez ◽  
Maria J Agustín Ferrández ◽  
Andrea Pinilla Rello ◽  
Vicente Gimeno-Ballester ◽  
Angel Escolano Pueyo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trials ◽  
Older Patients ◽  
Adult Population ◽  
Real Life ◽  
Line Treatment ◽  
First Line ◽  
Palmoplantar Erythrodysesthesia ◽  
Dose Reductions ◽  
First Line Treatment

Objective The purpose of this study was to analyse the effectiveness and safety of first-line treatment of metastatic colorectal cancer (CRCm) in older patients treated in a tertiary hospital. Material and methods This was an observational and retrospective study, including patients aged 75 years or older, with CRCm, who received chemotherapy treatment in 2017. The main variables studied were type of treatment, Progression-Free Survival (PFS), Overall Survival (OS), dose reductions, and treatment delays due to adverse events. Results A total of 59 patients (71.2% men) with a median age of 76 years were enrolled in this study. About 70% presented colon cancer, with the left colon being the most frequent location. They were treated with 9 different schemes, in most cases using polychemotherapy and biological agents. The median PFS and OS was 12 and 30 months, respectively. A total of 23/59 of patients started treatment at doses lower than recommended in the clinical practice guidelines. In terms of safety, 34/59 of patients had at least one dose reduction, and 30/59 suffered one treatment delay. The most frequent adverse reactions were asthenia, peripheral neuropathy, diarrhoea, and palmoplantar erythrodysesthesia. Conclusion Our patients presented baseline clinical characteristics similar to the general adult population, with no tumour characteristics associated with advanced age. The efficacy and toxicity were similar to those in the clinical trials, although our patients had more dose reductions. Considering the heterogeneity of patients and in the absence of clinical trials in the older population, real-life studies can be very useful.

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