Treatment Guidelines - 2013
January 1, 2013 (Issue 125)
February 1, 2013 (Issue 126)
- Drugs for Epilepsy
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. When used for the...
March 1, 2013 (Issue 127)
- Antiviral Drugs
The drugs of choice for treatment of viral infections (other than HIV) and their dosages are listed in Tables 1-6 on the pages that follow. Some of the indications and dosages recommended here have not been approved by the FDA. Vaccines used for the prevention of viral infections are discussed...
April 1, 2013 (Issue 128)
- Drugs for Pain
Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids and is often treated with adjuvant drugs such as antidepressants and antiepileptics. Combining different types of analgesics may provide an...
May 1, 2013 (Issue 129)
- Drugs for Allergic Disorders
The use of drugs to prevent and control symptoms of allergic disorders can be optimized when patients avoid exposure to specific allergens and/or environmental conditions that trigger or worsen their...
June 1, 2013 (Issue 130)
July 1, 2013 (Issue 131)
- Drugs for Bacterial Infections
The text that follows reviews some common bacterial infections and their empiric treatment pending the results of culture and susceptibility testing. The recommendations made here are based on the results of susceptibility studies, clinical trials, and the opinions of Medical Letter reviewers. Tables 1 and 2 list the usual dosages of antibacterial...
August 1, 2013 (Issue 132)
- Drugs for Asthma and COPD
INHALATION DEVICES — Metered-dose inhalers (MDIs) require coordination of inhalation with hand-actuation of the device. Valved holding chambers (VHCs) or spacers help some patients, especially young children and the elderly, use MDIs effectively. VHCs have one-way valves that prevent the patient from exhaling into the device, minimizing the need for coordinated...
September 1, 2013 (Issue 133)
- Drugs for Sexually Transmitted Infections
Many infections can be transmitted during sexual contact. The text and tables that follow include recommendations for management of sexually transmitted infections (STIs) other than HIV, viral hepatitis, and enteric infections. Some of the indications and dosages recommended here have not been approved by the...
October 1, 2013 (Issue 134)
- Drugs for Cognitive Loss and Dementia
Alzheimer's disease (AD) is the most common cause of dementia, but cognitive loss is also associated with other neurological conditions such as Parkinson's disease, dementia with Lewy bodies, and vascular dementia. Mild cognitive impairment (MCI) is generally defined as cognitive decline greater than expected for an individual's age and educational level, but...
November 1, 2013 (Issue 135)
- Drugs for Parkinson's Disease
The motor symptoms of Parkinson's disease (PD) are caused primarily by progressive degeneration of dopaminergic neurons in the substantia nigra. The non-motor symptoms of the disease are thought to be caused by degeneration of other neurotransmitter...
December 1, 2013 (Issue 136)
- Drugs for Migraine
Superseded by The Medical Letter "Drugs for Migraine" - Issue 1514, February 13, 2017
Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed...