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American Family Physician June 1, 2002 Jeffrey L. Cummings	Guidelines for Managing Alzheimer's Disease: Part I. Assessment Family physicians play a key role in assessing and managing patients with Alzheimer's disease and in linking the families of these patients to supportive services within the community.
American Family Physician February 15, 2006 Rayner et al.	Behavior Disorders of Dementia: Recognition and Treatment Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. Goals of treatment should include symptom reduction and preservation of quality of life.
Nurse Practitioner August 2011 Davis et al.	Supportive approaches for Alzheimer Disease Alzheimer disease accounts for almost 80% of all dementia diagnoses. Currently, more than 5 million Americans suffer from this debilitating illness, with the highest prevalence in the oldest age groups.
American Family Physician October 1, 2003 Vincent W. Delagarza	Pharmacologic Treatment of Alzheimer's Disease: An Update Alzheimer's disease is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction, particularly in cholinergic neurons. Drugs that inhibit the degradation of acetylcholine within synapses are the mainstay of therapy.
American Family Physician January 15, 2003 Ables & Baughman	Antidepressants: Update on New Agents and Indications Many antidepressants have been released in the United States over the past two decades. This article is an update of information about the newer agents for depression and new indications for older antidepressants.
American Family Physician October 15, 2002 Zamorski & Albucher	What to Do When SSRIs Fail: Eight Strategies for Optimizing Treatment of Panic Disorder Effective management of panic disorder is a common challenge for family physicians. Selective serotonin reuptake inhibitors (SSRIs) are the drugs of choice for this condition because of their safety and efficacy. But not all patients have a favorable response to SSRI therapy.
American Family Physician May 15, 2004 Birrer & Vemuri	Depression in Later Life: A Diagnostic and Therapeutic Challenge Depression in elderly persons is widespread, often undiagnosed, and usually untreated. Because there is no reliable diagnostic test, a careful clinical evaluation is essential.
American Family Physician June 1, 2003 Motsinger et al.	Use of Atypical Antipsychotic Drugs in Patients with Dementia Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. To minimize side effects, these medications should be started at low dosages that are increased incrementally.
American Family Physician October 1, 2000 Michael F. Gliatto, M.D.	Generalized Anxiety Disorder Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms...
American Family Physician August 1, 2006 Warner et al.	Antidepressant Discontinuation Syndrome Antidepressant discontinuation syndrome occurs in approximately 20% of patients after abrupt discontinuation of an antidepressant medication that was taken for at least six weeks.
American Family Physician September 15, 2000 Kim S. Griswold, M.D., M.P.H. & Linda F. Pessar, M.D.	Management of Bipolar Disorder A comprehensive management program, including collaboration between the patient's family physician and psychiatrist, should be implemented to optimize medical care...
Nursing March 2012 Daniel A. Hussar	New Drugs 2012: part I In this article, you'll learn about 11 recently approved drugs.
American Family Physician August 15, 2002 Ward & Zamorski	Benefits and Risks of Psychiatric Medications During Pregnancy Decisions regarding the use of psychiatric medications should be individualized, and the most important factor is usually the patient's level of functioning in the past when she was not taking medications.
Nurse Practitioner May 2010 Townsend-Roccichelli et al.	Managing sleep disorders in the elderly This article will provide an overview of sleep physiology in the aging population, identify common sleep disorders, and suggest pharmacologic and nonpharmacologic treatment options.
Nursing February 2010 Daniel A. Hussar	New Drugs 2010, PART 1 In this article, you'll learn about 16 new drugs.
American Family Physician November 15, 2000 Son & Kirchner	Depression in Children and Adolescents Depression among children and adolescents is common but frequently unrecognized. It affects 2 percent of prepubertal children and 5 to 8 percent of adolescents...
American Family Physician November 15, 2003 Jones et al.	Common Problems in Patients Recovering from Chemical Dependency This article describes how to care for patients recovering from chemical dependency, including special concerns that arise during the treatment of common medical conditions, to avoid adverse outcomes or relapse into addiction.
Nursing June 2010 Daniel A. Hussar	New drugs 2010, part 2 In this article, you'll learn about 14 recently marketed new drugs.
American Family Physician April 15, 2003 Dickerson et al.	Premenstrual Syndrome Premenstrual syndrome, a common cyclic disorder of young and middle-aged women, is characterized by emotional and physical symptoms that consistently occur during the luteal phase of the menstrual cycle.
American Family Physician December 1, 2002 Aukerman et al.	Management of the Acute Migraine Headache As many as 30 million Americans have migraine headaches. The impact on patients and their families can be tremendous, and treatment of migraines can present diagnostic and therapeutic challenges for family physicians.
Nursing May 2012 Tim Blake	Three Medication Pathways for Bipolar Disorder No matter where you work, you're likely to care for patients with bipolar disorder, which affects about 2.6% of people age 18 and older per year.
American Family Physician September 1, 2003 Sierpina et al.	Gingko Bilboa Clinical issues of safety, dosing, use in the perioperative period, and pharmacology are addressed in this review.
American Family Physician April 1, 2006 Neef & Walling	Dementia with Lewy Bodies: An Emerging Disease Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism.
Nurse Practitioner September 2010 Moloney & Cranwell-Bruce	Pharmacological Management of Migraine Headaches Migraine is one of the top 20 causes of disability worldwide, occurring in 17.6% of women and 5.7% of men
American Family Physician February 15, 2001 Karen S. Santacruz & Daniel Swagerty	Early Diagnosis of Dementia As more treatment options become available, it will become increasingly important to diagnose dementia early...
American Family Physician February 1, 2005 Maizels & McCarberg	Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels.
American Family Physician October 1, 2002 Bhatia & Bhatia	Diagnosis and Treatment of Premenstrual Dysphoric Disorder From 2 to 10 percent of women of reproductive age have severe distress and dysfunction caused by premenstrual dysphoric disorder, a severe form of premenstrual syndrome. Current research implicates mechanisms of serotonin as relevant to etiology and treatment.
Nurse Practitioner March 2012 Vanya Hamrin et al.	Evaluation and Management of Pediatric and Adolescent Depression The primary care setting is an appropriate venue for screening and identifying pediatric depression. Nurse practitioners can provide initial management or referral to psychiatric mental health professionals for evidence-based treatments.
Nursing February 2009 Daniel A. Hussar	New Drugs 09: Part 1 Learn about 10 new drugs, including nebivolol HCl, the newest beta-adrenergic blocking agent for hypertension.
American Family Physician November 15, 2002 Cynthia M. Williams	Using Medications Appropriately in Older Adults Finding the right balance between too few and too many drugs will help ensure increased longevity, improved overall health, and enhanced functioning and quality of life for the aging population.
American Family Physician December 1, 2004 McConaghy & Smith	Outpatient Treatment of Systolic Heart Failure Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients.
American Family Physician January 1, 2007 Shashi & Subhash Bhatia	Childhood and Adolescent Depression Safe and effective treatment of major depression in this age group requires accurate diagnosis, suicide risk assessment, and use of evidence-based therapies.
Nursing April 2012 Elliott et al.	Managing alcohol withdrawal in hospitalized patients A focused nursing assessment is critical in identifying the potential for alcohol withdrawal symptoms in all hospitalized patients. This article discusses how to assess patients at risk and how to use these assessment findings as a basis for nursing interventions.
American Family Physician September 1, 2001 William D. Smucker & Marjaneh Hedayat	Evaluation and Treatment of ADHD Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder...
Nurse Practitioner August 2009 Fisher & Valente	Evaluating and managing insomnia Insomnia is the most frequent complaint in sleep disorders, and in the past, it had been viewed as a transient problem related only to other medical issues. That line of thought has changed
American Family Physician February 1, 2005 Richard D. Blondell	Ambulatory Detoxification of Patients with Alcohol Dependence An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol treatment program and a responsible support person who can monitor progress, and should not have significant, acute, comorbid conditions or risk factors for severe withdrawal.
Nurse Practitioner February 2011 Jennifer M. Belavic	Annual Drug Update: 2010 in Review In 2010, the FDA approved several new drugs and new indications for use in primary care. From new therapies for adults with rheumatoid arthritis to a combination drug for benign prostatic hyperplasia, NPs need to be aware of the latest medications now available.
American Family Physician September 15, 2001 Douglas D. Ross & Carla S. Alexander	Management of Common Symptoms in Terminally Ill Patients: Part II. Constipation, Delirium and Dyspnea In addition to pain, patients who are approaching the end of life commonly have other symptoms...
American Family Physician November 1, 2005 Steven H. Williams	Medications for Treating Alcohol Dependence Medications for treating alcohol dependence primarily have been adjunctive interventions, and only three medications -- disulfiram, naltrexone, and acamprosate -- are approved for this indication by the U.S. Food and Drug Administration.
American Family Physician August 15, 2001 Thomas P. Guck	Assessment and Treatment of Depression Following Myocardial Infarction Depression is an independent risk factor in the development of and mortality associated with cardiovascular disease in otherwise healthy persons...
American Family Physician February 15, 2002 Grace Brooke Huffman	Evaluating and Treating Unintentional Weight Loss in the Elderly Unintentional weight loss in the elderly patient can be difficult to evaluate. Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality...
Nursing June 2011 Daniel A. Hussar	New Drugs 2011: Part 2 In this article, you'll learn about seven recently approved drugs, including: fingolimod hydrochloride, an oral drug indicated to treat patients with relapsing forms of multiple sclerosis.
American Family Physician April 15, 2001 H. Russell Searight	Conduct Disorder: Diagnosis and Treatment in Primary Care Conduct disorder is a common childhood psychiatric problem that has an increased incidence in adolescence. The primary diagnostic features of conduct disorder include aggression, theft, vandalism, violations of rules and/or lying...
American Family Physician September 1, 2001 Douglas D. Ross & Carla S. Alexander	Fatigue, Anorexia, Cachexia, Nausea and Vomiting Physical symptoms other than pain often contribute to suffering near the end of life. Management involves a diagnostic evaluation for the cause of each symptom when possible, treatment of the identified cause when reasonable, and concomitant treatment of the symptom...
American Family Physician February 15, 2005 Ham, Waters & Oliver	Treatment of Panic Disorder Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder.
American Family Physician January 1, 2006 MODI Lowder	Medications for Migraine Prophylaxis Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention.
American Family Physician August 1, 2002 Daphne P. Bicket	Using ACE Inhibitors Appropriately Although angiotensin-converting enzyme (ACE) inhibitors have documented clinical benefits in a variety of clinical situations, the disparity between the evidence from clinical trials and bedside medicine is well documented.
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
Nurse Practitioner April 2012 Firestone et al.	Optimizing fibromyalgia management This article summarizes current information regarding the etiology, pathophysiology, clinical presentation, diagnostic standards, and pharmacologic and non-pharmacologic treatments necessary to successfully manage FM.
American Family Physician November 1, 2000 Searight, Burke & Rottnek	Adult ADHD: Evaluation and Treatment in Family Medicine Attention-deficit/hyperactivity disorder (ADHD) affects 30 to 50 percent of adults who had ADHD in childhood. Accurate diagnosis of ADHD in adults is challenging and requires attention to early development and symptoms of inattention, distractibility, impulsivity and emotional lability...