China
Africa
Explore chapters and articles related to this topic
Chest
Published in Henry J. Woodford, Essential Geriatrics, 2022
There are few data to suggest a prognostic benefit of inhaled therapies for COPD. Is the patient getting any symptomatic benefit? If this is unclear then a drug holiday could be considered. Check inhaler technique. Are they able to use the device correctly or would an alternative inhaler type be more suitable? Cognitive impairment may prevent the effective use of any inhaler type. The number of COPD exacerbations in the last year can aid decision-making. The withdrawal of ICS may be considered for people hospitalised with pneumonia. A trial of steroid withdrawal in people with severe COPD (mean age 64) found no significant increase in exacerbations, but some evidence of reduced lung function, over one year.54
Metabolic Approaches to the Treatment of Back Pain
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Carrie Diulus, Patrick Hanaway
Medications: When looking at a patient with back pain from a comprehensive standpoint, medication use and side effects must also be taken into consideration. An increasing number of patients are being referred for spinal evaluation for low back and leg pain which upon careful evaluation is related to statin use. Statin-related myalgias have been reported to be as low as 1%–2% and as high as 10% in clinical practice [37, 38]. Patients are frequently unaware of this side effect. A drug holiday can usually be safely considered in effected patients, there will be improvement in symptoms within a week or two. In higher-risk patients, consultation with the patient’s cardiologist is recommended prior to the drug holiday.
Chronic daily headache: diagnosis and treatment
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Increased activity of the on-cells in the pain modulation system of the brainstem could enhance the response to any painful or non-painful stimuli and result in sensitization. Ttie activity of this system is enhanced during opioid withdrawal. A similar mechanism may occur during drug-induced headaches. CM not associated with drug overuse may result from sensitization of nociceptors in the nucleus caudalis as a result of enhanced on-cell activity, which could be, in part, a problem of the network that modulates pain from the head and face. Continued high fluctuating doses of ergots, analgesics, or opioids could result in resetting of the pain control mechanisms in susceptible individuals, perhaps by enhancing on-cell activity, enhancing central sensitization through N-methyl-D-aspartate receptors, or blocking adaptive antinociceptive changes. Compensatory adaptive changes associated with frequent headaches (if they occur) may not be enough to allow continued drug effectiveness. If tolerance has decreased drug effectiveness, a drug holiday could renew the response.82 Drug overuse may, in part, prevent the occurrence of antinociceptive adaptive changes.
Gaps in evidence on treatment of male osteoporosis: a Research Agenda
Published in The Aging Male, 2023
Adam J. Rose, Susan L. Greenspan, Guneet K. Jasuja
The idea of drug holidays is only germane to bisphosphonate therapy, and not to therapy with other agents. However, since bisphosphonates are the mainstay of our treatment of osteoporosis, this is an important topic. Because bisphosphonates intercalate into the bone matrix, their duration of action may far outlast their serum half-life. Also, concerns that long-term bisphosphonate use might predispose patients to adverse events, such as atypical femoral fractures and osteonecrosis of the jaw have led to suggestions to pause bisphosphonate treatment after a certain number of years, and to restart it later, or to stop it altogether [57]. The expectation with the drug holiday is that this could achieve similar clinical benefits while minimizing side effects and the need to take medication [57].
Investigating the effects of age, IQ, dosing, and anthropometric measures on the treatment persistence in long-term methylphenidate use
Published in Nordic Journal of Psychiatry, 2023
Mustafa Tuncturk, Cagatay Ermis, Dicle Buyuktaskin, Eren Halac, Ekin Sut, Oben Ozkan, Nazan Gundogan, Guldal Unutmaz, R. Ogulcan Ciray, Serkan Turan, Aynur Akay Pekcanlar
The sample was divided into two groups according to the persistence status of patients. Persistence was defined as the continuation of MPH for at least two years in our study without more than 4 months of unplanned discontinuation [31]. Persistence also endorsed drug holidays only when a clinician suggested intermittent discontinuation of MPH treatment [31]. A drug holiday was defined as a planned and periodic break from MPH use during school vacations based on the suggestion of a clinician [32]. In our clinical practice, after the first year of treatment, drug holidays are commonly suggested during school vacations to reduce tolerance and side effects (e.g. growth parameters, etc.) when children have no academic task. Patients and families who abided by clinicians’ decisions and continued MPH treatment in the following school term were counted in the persistent group.
Introducing sexual dysfunction in mental care
Published in Expert Opinion on Drug Safety, 2021
Marie Gombert, Pura Ballester, Ana Segura, Ana M Peiró
Drugs involving a low risk of SD should be preferred. To decrease SD as a side effect of a drug, choose olanzapine, ziprasidone, quetiapine, and aripiprazole, rather than paliperidone, risperidone, and amisulpride. Avoid serotonergic antidepressants and choose agomelatine or bupropion. Interestingly, adding or switching to another medication may also be associated with ADRs, and with the risk of favoring a prescribing cascade. The adjoint strategies for treatment should be personalized [56]: (a) Giving time for a spontaneous ADR reduction; (b) Total or partial suspected drug deprescription as ‘drug holiday’ that can be a suspension of drug for 2 days in the week following half-life pharmacokinetic data; (c) Switch to a drug with fewer SD; (d) Diagnose, monitor, and treat the specific ADR.