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The next patient in your exam room is a 16-year-old young woman who says she needs effective contraception. She has tried oral contraceptives (OCs), but she says she has trouble remembering to take a daily pill. What options can you offer her?
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While the contraceptive transdermal patch (Ortho Evra, Ortho-McNeil Pharmaceutical, Raritan, NJ) and the contraceptive vaginal ring (NuvaRing, Organon, West Orange, NJ) are gaining increased use among women, many providers report that oral contraceptives (OCs) remain a popular form of birth control.
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Take a look at the last 10 patient charts in your outbox. If oral contraceptives (OCs) were prescribed, which ones were selected? When it comes to prescriptions for younger women, about 24% of respondents to the 2004 Contraceptive Technology Update Contraception Survey say their No. 1 pill of choice is Ortho Tri-Cyclen Lo (Ortho-McNeil Pharmaceutical, Raritan, NJ).
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When it comes to oral contraceptives (OCs), when should pills be prescribed, and when should they be withheld? Respondents to the 2004 Contraceptive Technology Update Contraception Survey take a cautious approach when it comes to providing pills for older women who smoke.
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B-type natriuretic peptide (BNP) is a biomarker released by cardiac ventricular myocytes. Its usefulness is mainly in the emergency room for the evaluation of acute dyspnea, to evaluate for cardiac failure. BNP may have usefulness as a screening test for preclinical heart disease, for risk stratification and for guidance with therapy.
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Although regular aspirin use reduces the risk for colorectal adenoma formation as shown in previous randomized-controlled trials, the protective effect now seems to be greatest at substantially higher doses (> 14 standard tablets/week) than currently recommended for cardiovascular prophylaxis.
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The FDA has approved a combination product of amlodipine and atrovastatin for the treatment of patients with comorbid hypertension and hypercholesterolemia.
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The ECG shown in the Figure was obtained in the emergency department (ED) from a 61-year-old woman with a history of significant hypertension. She was alert, oriented, and not in acute distress at the time this tracing was recorded, although she was markedly hypertensive and experiencing some chest pain. No prior ECG was available. The patient was treated in the ED with several doses of Adenosine and eventually converted to sinus rhythm. Your thoughts on the rhythm and the management?
