CPD article: Guiding the owner: the use of supplements in canine osteoarthritis management

2021 ◽  
Vol 26 (11) ◽  
pp. 248-254
Author(s):  
Robyn Lowe
Keyword(s):  
Side Effect ◽  
Health Benefits ◽  
Evidence Base ◽  
Over The Counter ◽  
Multiple Products ◽  
Canine Osteoarthritis

Owners often reach for over-the-counter supplements for the management of canine osteoarthritis, believing them to be natural, side effect-free options. Some may ask for your opinion as a veterinary professional, whereas others will come to you already using certain products. It is imperative to be aware of the evidence for the relevant products and to encourage the use of good quality products as the first option. The aim should be to help prevent owners of arthritic dogs wasting their money buying multiple products with little or no evidence to back up their use, to be wary of bold unsubstantiated claims for improvements or health benefits, and to ensure that supplements are not used as a sole intervention for the management of arthritic pain, as they are unlikely to have the evidence base to support this claim.

scholarly journals Combining antidepressants: a review of evidence

2009 ◽  
Vol 15 (2) ◽  
pp. 90-99 ◽  
Author(s):  
Lena Palaniyappan ◽  
Lisa Insole ◽  
Nicol Ferrier
Keyword(s):  
Side Effect ◽  
Evidence Base ◽  
Side Effect Profile ◽  
Combined Treatments ◽  
Limited Evidence ◽  
Additional Advantage ◽  
Treatment Approaches ◽  
The Uk

SummarySequenced (stepped) treatment approaches are widely endorsed in the management of depression. Combining antidepressants is a recognised step for those failing to respond to monotherapy. Despite the limited evidence base, this strategy is widely used by clinicians in practice. Not every combination used clinically has a sound neuropharmacological rationale and the use of such combinations may increase the side-effect burden without any additional advantage to the patient. Efficacy of various antidepressant combinations along with the data on side-effect profile and toxicity of such combined treatments are reviewed here. The different combinations are considered by each class of antidepressant available in the UK.

Nosedrops and S.I.D.S

PEDIATRICS ◽  
1991 ◽  
Vol 88 (2) ◽  
pp. 419-419
Author(s):  
GERALD B. HICKSON
Keyword(s):  
Side Effect ◽  
Case Reports ◽  
Common Side Effect ◽  
Wide Spread ◽  
Over The Counter ◽  
Ability To Act ◽  
Life Threatening ◽  
Therapeutic Doses

In Reply.— The purpose of our paper was to examine the question of safety concerning over-the-counter (OTC) release of promethazine.1 Our stated opinion, that the drug is not appropriate for OTC release, was based on more than a suggested relationship with SIDS, but also on the drug's common side effect of sedation, ability to act as a cerebral stimulant even in therapeutic doses inducing hallucinations, convulsions and encephalopathy in some children, case reports concerning promethazine use and apparent life-threatening events, the potential for families to misuse this drug due to its sedative and antiemetic properties, and most importantly, FDA standards of safety for OTC medications which require "a low potential for harm which may result from abuse under conditions of wide spread availability."2

scholarly journals Chest Pain From Supplement Use in an Active Duty Soldier: A Case Report

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1857-e1859
Author(s):  
Rachel E Bridwell ◽  
Michael J Yoo ◽  
Jordan J Grove ◽  
Patrick C Ng
Keyword(s):  
Quality Assurance ◽  
Case Report ◽  
Chest Pain ◽  
Safety Profile ◽  
Side Effect ◽  
Active Duty ◽  
Over The Counter ◽  
Supplement Use ◽  
Deleterious Side Effect ◽  
Minimal Data

Abstract In the active duty population, over-the-counter performance enhancing supplements are readily available and consumed, primarily in an unsupervised manner. While some of the active ingredients, such as caffeine and creatine, have been well studied, other sympathomimetic and vasoactive components in these products have minimal data regarding their safety profile. Further potentiating the associated risks of consumption, the quantities and purities of the reported ingredients are often unverified and can vary from serving to serving. We present a case of the deleterious side effect profiles of these lesser studied components in overconsumption in an active duty soldier. Although improvements are being made regarding product safety, the paucity of ingredient regulation and quality assurance can result in warfighter morbidity and mortality, especially when these supplements are abused or combined with other products.

Lofexidine for opiate detoxification

2004 ◽  
Vol 16 (5) ◽  
pp. 239-245 ◽  
Author(s):  
Jenny Bearn
Keyword(s):  
Withdrawal Symptom ◽  
Symptom Severity ◽  
Side Effect ◽  
Evidence Base ◽  
Side Effect Profile ◽  
Clinical Value ◽  
Opiate Antagonists ◽  
Favourable Side Effect Profile ◽  
Better Than ◽  
Treatment Settings

The evolving role for lofexidine in the treatment of opiate detoxification over the last decade is reviewed. Lofexidine is no better than methadone or clonidine in attenuating withdrawal symptom severity, although it has a more favourable side-effect profile than clonidine. In conjunction with opiate antagonists, lofexidine may facilitate accelerated withdrawal, although activity and low liability for misuse, lofexidine may be more widely acceptable to clinicians than methadone, particularly those working in out-patient, non-specialist and prison treatment settings. Further studies in these treatment settings will be particularly apposite since, apart from the studies highlighted, the evidence base for the clinical value of lofexidine is mainly to be derived from in-patient trials.

scholarly journals Concomitant health benefits package design and research prioritisation: development of a new approach and an application to Malawi

2021 ◽  
Vol 6 (12) ◽  
pp. e007047
Author(s):  
Laetitia Schmitt ◽  
Jessica Ochalek ◽  
Karl Claxton ◽  
Paul Revill ◽  
Dominic Nkhoma ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Benefits ◽  
Health Sector ◽  
Research Priorities ◽  
Evidence Base ◽  
Preventive Therapy ◽  
Acute Malnutrition ◽  
Health Coverage ◽  
Life Years ◽  
Research Prioritisation

Health benefits packages (HBPs) are increasingly used in many countries to guide spending priorities on the path towards universal health coverage. Their design is, however, informed by an uncertain evidence base but research funds available to address this are limited. This gives rise to the question of which piece of research relating to the cost-effectiveness of interventions would most contribute to improving resource allocation. We propose to incorporate research prioritisation as an integral part of HBP design. We have, therefore, developed a framework and a freely available companion stand-alone tool, to quantify in terms of net disability-adjusted life-years (DALYs) averted, the value of research for the interventions considered for inclusion in a package. Using the tool, the framework can be implemented using sensitivity analysis results typically reported in cost-effectiveness studies. To illustrate the framework, we applied the tool to the evidence base that informed the Malawi Health Sector Strategic Plan 2017–2022. Out of 21 interventions considered, 8 investment decisions were found to be uncertain and three showed strong potential for research to generate large health gains: ‘male circumcision’, ‘community-management of acute malnutrition in children’ and ‘isoniazid preventive therapy in HIV +individuals’, with a potential to avert up to 65 762, 36 438 and 20 132 net DALYs, respectively. Our work can help set research priorities in resource-constrained settings so that research funds are invested where they have the largest potential to impact on the population health generated via HBPs.

scholarly journals Should oral contraceptive pills be available without a prescription? A systematic review of over-the-counter and pharmacy access availability

2019 ◽  
Vol 4 (3) ◽  
pp. e001402 ◽  
Author(s):  
Caitlin E Kennedy ◽  
Ping Teresa Yeh ◽  
Lianne Gonsalves ◽  
Hussain Jafri ◽  
Mary Eluned Gaffield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Evidence Base ◽  
Primary Data ◽  
Cross Sectional ◽  
Over The Counter ◽  
Oral Contraceptive Pills ◽  
Unintended Pregnancies ◽  
The Usa ◽  
Continuation Rates

IntroductionMaking oral contraceptives (OC) available over the counter (OTC) could reduce barriers to use. To inform WHO guidelines on self-care interventions, we conducted a systematic review of OTC availability of OCs.MethodsWe reviewed data on both effectiveness and values and preferences surrounding OTC availability of OCs. For the effectiveness review, peer-reviewed articles were included if they compared either full OTC availability or pharmacist-prescribing (behind-the-counter availability) to prescription-only availability of OCs and measured an outcome of interest. For the values and preferences review, we included peer-reviewed articles that presented primary data (qualitative or quantitative) examining people’s preferences regarding OTC access to OCs. We searched PubMed, CINAHL, LILACS and EMBASE through November 2018 and extracted data in duplicate.ResultsThe effectiveness review included four studies with 5197 total participants. Two studies from the 2000s compared women who obtained OCs OTC in Mexico to women who obtained OCs from providers in either Mexico or the USA. OTC users had higher OC continuation rates over 9 months of follow-up (adjusted HR: 1.58, 95 % CI 1.11 to 2.26). One study found OTC users were more likely to report at least one WHO category 3 contraindication (13.4% vs 8.6%, p=0.006), but not category 4 contraindications; the other study found no differences in contraindicated use. One study found lower side effects among OTC users and high patient satisfaction with both OTC and prescription access. Two cross-sectional studies from the 1970s in Colombia and Mexico found no major differences in OC continuation, but some indication of slightly higher side effects with OTC access. In 23 values and preference studies, women generally favoured OTC availability. Providers showed more modest support, with pharmacists expressing greater support than physicians. Support was generally higher for progestogen-only pills compared with combination OCs.ConclusionA small evidence base suggests women who obtain OCs OTC may have higher continuation rates and limited contraindicated use. Patients and providers generally support OTC availability. OTC availability may increase access to this effective contraceptive option and reduce unintended pregnancies.Systematic review (PROSPERO) registration numberCRD42019119406.

scholarly journals Role of GandharvaHasta Tail in Geriatric Constipation - A Case Study

2018 ◽  
Vol 6 (06) ◽  
Author(s):  
Kranti N. Khekale
Keyword(s):  
Older Adults ◽  
Side Effect ◽  
Single Case ◽  
The Elderly ◽  
Sweet Taste ◽  
Over The Counter ◽  
Evidence Based Treatment ◽  
Common Complaint

Constipation is a common complaint in older adults. Although constipation is not a physiologic consequence of normal aging, decreased mobility and other medical conditions may contribute to its increased prevalence in older adults. The prevalence of constipation rises dramatically with age, with some estimates approaching 50% among adults over 80 years of age. There are a variety of over-the-counter and prescription laxatives available for the treatment of constipation. There are many laxatives sold in the market. They have not been studied in controlled trials to make a recommendation. Its side effect may be harmful to patient. There is no one best evidence-based treatment for chronic constipation in the elderly. this study, shows single case of geriatric patient suffering from constipation wherein  Gandharvahasta tailwas given 10ml orally. The reference of Gandharvahasta tail is  Bhaishajya Ratanavali. Gandharvahasta tail acts as mild laxative with sweet taste, pleasant smell. Gandharvahasta Tail shows significant result with no side effect. It is easily palatable so there is no compliant for taking medicine.

scholarly journals Domperidone induced galactorrhea: rare presentation of a common drug

2020 ◽  
Vol 9 (11) ◽  
pp. 1735
Author(s):  
Suman Ruhela ◽  
Indira Sahu ◽  
Manish Ruhela ◽  
Rakesh Kumar Ola
Keyword(s):  
Female Patient ◽  
Side Effect ◽  
Migraine Headache ◽  
Rare Presentation ◽  
Over The Counter ◽  
Common Drug ◽  
Rare Side Effect

Domperidone is one of the cheapest and also effective anti-emetic drugs which is very commonly used as an over-the-counter drug. Galactorrhoea is a rare side effect of domperidone. We report a case of a female patient who was prescribed domperidone for migraine headache with vomiting. While taking the drug, she developed galactorrhoea, and after discontinuing domperidone therapy, her galactorrhoea subsided.

scholarly journals Over-the-counter anti-oxidant therapies for use in multiple sclerosis: A systematic review

2015 ◽  
Vol 21 (12) ◽  
pp. 1485-1495 ◽  
Author(s):  
Jason R. Plemel ◽  
Camille A. Juzwik ◽  
Curtis A. Benson ◽  
Michael Monks ◽  
Chelsea Harris ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Ginkgo Biloba ◽  
Neurological Impairment ◽  
Evidence Base ◽  
Exclusion Criteria ◽  
Over The Counter ◽  
Conflicting Evidence ◽  
Anti Oxidant ◽  
Future Work

Background: Anti-oxidant compounds that are found in over-the-counter (OTC) supplements and foods are gaining interest as treatments for multiple sclerosis (MS). They are widely used by patients, sometimes without a clear evidence base. Objective: We conducted a systematic review of animal and clinical research to determine the evidence for the benefits of OTC anti-oxidants in MS. Methods: Using predefined criteria, we searched key databases. Two authors scrutinized all studies against inclusion/exclusion criteria, assessed study risk-of-bias and extracted results. Results: Of the 3507 titles, 145 met criteria and included compounds, α(alpha)-lipoic acid (ALA), anti-oxidant vitamins, Ginkgo biloba, quercetin, resveratrol and epigallocatechin-3-gallate (ECGC). The strongest evidence to support OTC anti-oxidants was for compounds EGCG and ALA in animal models; both consistently showed anti-inflammatory/anti-oxidant effects and reduced neurological impairment. Only vitamin E, Ginkgo biloba and ALA were examined for efficacy in pilot clinical trials with either conflicting evidence or evidence of no benefit. Conclusion: OTC anti-oxidants EGCG and ALA show the most consistent benefit, however only in preclinical studies. There is no evidence that they alter MS relapses or progression. Future work should focus on testing more of these therapies for clinical efficacy before recommending them to MS patients.

Sign in / Sign up

Export Citation Format

Share Document