Physician Knowledge e-Newsletter - V2 Issue 3, September 2005
Below you will find information related to the Knowledge Based Systems
at MGHS
(Please note you
must be connected to the MGHS Network to gain access to these systems)
InfoPOEMs
We're thrilled to announce that the American Academy of Family Physicians
has added InfoRetriever to its list of approved EBM CME resources for
the point of care. Very soon, family practice physicians will be able
to earn Continuing Medical Education (CME) credits at the point of care
by using InfoRetriever.
The AAFP Commission on Continuing Medical Education is responsible for
the recommending key evidence-based medicine resources to the AAFP Board
of Directors.
The commission reviews sources and only recommends them if they adhere
to the following criteria:
Offers consistent, reproducible search of the evidence
Documents how evidence is reviewed and updated
Describes how the strength of evidence is evaluated
Emphasizes patient-oriented evidence over disease-oriented evidence
Involves family physicians and the family medicine perspective in the
generation of content
Explicitly rates the strength of the evidence
InfoRetriever met all criteria in order to qualify as an approved source
for point of care CME!
InfoPOEMS and InfoRetriever are essential tools that provide clinicians
with evidence-based information when they need it, at the point of care.
By assessing the information for relevance and validity, and providing
an immediate and easy-to-search database, InfoPOEMs and InfoRetriever
ease the pressures of "information overload."
Natural Medicines
You can now get the
newest Natural Medicines CE course Natural Medicines in the Clinical
Management of Premenstrual Syndrome.*
You can also use any of the many prior courses on many other conditions.
All are accredited for physicians, pharmacists, NPs, PAs, CNMs, RDs.
If you are also a subscriber to Pharmacist's Letter or Prescriber's Letter
you will see that when you do any search on those websites, that they
now automatically search Natural Medicines Comprehensive Database at the
same time.
We make updates to Natural Medicines Comprehensive Database every business
day. Here are a few of special interest to you:
• Ginkgo is now thought to interact with omeprazole (Prilosec)...and
potentially many other drugs. New research shows that ginkgo INDUCES cytochrome
P450 2C19 enzymes...and therefore DECREASES omeprazole (Prilosec) levels
by up to 40%. Ginkgo might also decrease levels of other drugs metabolized
by this enzyme... nelfinavir (Viracept), amitriptyline (Elavil), citalopram
(Celexa), propranolol (Inderal), lansoprazole (Prevacid), diazepam (Valium)
and many others. Advise patients not to take ginkgo if they are taking
drugs that might interact.
• Blond psyllium (Metamucil, etc) will be used more for lowering
cholesterol. There is already good evidence that psyllium can modestly
reduce cholesterol levels. New evidence shows that adding a psyllium supplement
5 grams three times daily to simvastatin 10 mg daily can reduce cholesterol
levels as well as simvastatin 20 mg daily. Consider a psyllium supplement
as an alternative to increasing statin doses in patients who need additional
cholesterol lowering.
• Snack Defense is a new weight loss product promoted by Herbalife.
The company suggests that it can decrease cravings for sweets and prevent
snacking between meals. But there is not much scientific support for these
claims. The product's main ingredient is garcinia. Most evidence shows
that garcinia is not effective for increasing satiety or weight loss.
Other ingredients include chromium and gymnema. There is contradictory
evidence for chromium...and there's no reliable proof to support gymnema
for weight loss. Tell patients not to rely on this product for reducing
snacking and weight loss.
• Calcium and vitamin D are now getting more attention for premenstrual
syndrome (PMS). Several studies have already shown that taking calcium
supplements 1000-1200 mg/day can decrease symptoms of PMS. Now, an Arch
Intern Med study suggests that women who consume more calcium and vitamin
D from their DIET also have a lower risk of developing PMS symptoms...compared
to women who consume less. This is another good reason to encourage women
to get adequate calcium intake.
You can read more about calcium, vitamin D, and many other supplements
used for premenstrual syndrome in our latest eCE...Natural Medicines in
the Clinical Management of Premenstrual Syndrome.
Check out the power
features at www.naturaldatabase.com...
Natural Product Effectiveness Checker,
Natural Product / Drug Interaction Checker,
Disease / Medical Conditions Search,
Colleagues Interact Search.
____________________________________
You can now get the
newest Natural Medicines CE course Natural Medicines in the Clinical Management
of Anxiety.*
You can also use any of the many prior courses on many other conditions.
All are accredited for physicians, pharmacists, NPs, PAs, CNMs, RDs.
If you are also a subscriber to Pharmacist's Letter or Prescriber's Letter
you will see that when you do any search on those websites, that they
now automatically search Natural Medicines Comprehensive Database at the
same time.
We make updates to Natural Medicines Comprehensive Database every business
day. Here are a few of special interest to you:
• Cocoa from dark chocolate is getting a lot of media attention
for its potential cardiovascular benefits. Preliminary evidence suggests
it might block markers of inflammation, decrease platelet stickiness,
and cause vasodilation. There is also preliminary evidence that consuming
100 grams of dark chocolate daily can modestly lower blood pressure in
the elderly patients with isolated systolic hypertension. But explain
that this benefit is only for dark chocolate, NOT milk chocolate. The
"dutching" process makes milk chocolate tasty, but probably
removes most of the beneficial components. The kind that may have benefits
is not the kind many of us like to eat, and this does not come out in
typical press reports.
• Echinacea is coming under fire after a big new study showed no
benefit for preventing or treating colds. Previous studies have also shown
that echinacea is NOT effective for preventing the common cold. But several
other studies have shown that echinacea CAN modestly reduce the severity
and duration of the common cold. The problem is that most echinacea studies
have used different echinacea plants, plant parts, preparation methods,
and doses. The new study is no exception. It used different extracts than
any previous study. Since all these different studies used different methods,
it's not surprising that the evidence for echinacea is so confusing and
inconsistent. If patients want to try it, advise them to start soon after
symptom onset. Explain that it might not provide much, if any, improvement.
• Theanine is becoming a popular dietary supplement for anxiety
and relieving stress. It's in brand name products such as Fatigued to
Fantastic, Anxietol 7, Somnolin, and many others. Theanine is an amino
acid contained in green tea. It is thought to increase levels of serotonin
and GABA. Preliminary evidence suggests that it can make people feel more
tranquil. But explain there's no proof it can treat anxiety.
For more information on theanine and many other supplements used for anxiety,
get our latest eCE...Natural Medicines in the Clinical Management of Anxiety.
Check out the power features at www.naturaldatabase.com...
Natural Product Effectiveness Checker,
Natural Product / Drug Interaction Checker,
Disease / Medical Conditions Search,
Colleagues Interact Search.
Stat!Ref:
»
New Editions:
-Adams and Victor's Principles of Neurology - 8th Ed. (2005)
-Williams Obstetrics - 22nd Edition (2005)
» Supplemental Updates:
- ACP Medicine
- ACS Surgery: Principles & Practice
- USP DI® Drug Information for the Health Care Professional
- USP DI® Advice for the Patient®
- Infectious Diseases: The Clinician's Guide to Diagnosis, Treatment,
and Prevention
- Griffith's 5-Minute Clinical Consult
- AHFS Drug Information® » New ACP's PIER Modules Added in June:
-Pneumocystis carinii Pneumonia
-Perioperative Management of Hypertension
-Rocky Mountain Spotted Fever
-Nephrotic Syndrome
-TORCH Diseases in Pregnancy
-Kidney Transplantation
» Supplemental Updates:
Monthly Updates:
- ACP Medicine
- ACS Surgery: Principles & Practice
- USP DI® Drug Information for the Health Care Professional
- USP DI® Advice for the Patient®
- Infectious Diseases: The Clinician's Guide to Diagnosis, Treatment,
and Prevention
- The Review of Natural Products
Quarterly Updates:
- Davis's Drug Guide for Nurses - 9th Ed. (2005)
- AAFP Conditions A TO Z (2005) » New ACP's PIER Modules Added in
July:
-Benign Paroxysmal Positional Vertigo
-Perioperative Management of Adrenal Insufficiency
-Basal Cell Carcinoma
- AHFS Drug Information
- Mosby's Drug Consult » New ACP's PIER Modules Added in August:
- Cluster Headache
- Chronic Pancreatitis
- Central Nervous System Lymphoma
- Anal Cancer
- Renal Tubular Acidosis
- Multiple Sclerosis
- Crohn's Disease
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