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    Initial dose: 50 mg orally once a day, as needed, 1 hour prior to sexual activity Maintenance: 25 to 100 mg orally once a day, as needed, 1 hour prior to sexual activity Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity. Use: Treatment of erectile dysfunction Revatio (R): Oral: -Initial dose: 5 or 20 mg orally three times a day, 4 to 6 hours apart -Maximum dose: 20 mg orally three times a day Injection: -Initial dose: 2.5 or 10 mg IV bolus three times a day Comments: -No greater efficacy was achieved with oral doses higher than the maximum recommended dose. -A 10 mg injection dose is predicted to provide pharmacological effect equivalent to the 20 mg oral dose. Use: Treatment of PAH (WHO Group I) in adults to improve exercise ability and delay clinical worsening Initial dose: 25 mg orally once a day 1 hour prior to sexual activity Use: Treatment of erectile dysfunction Erectile dysfunction: -Mild to moderate renal dysfunction (Cr Cl 30 to less than 80 m L/min): No adjustment recommended. -Severe renal dysfunction (Cr Cl less than 30 m L/min): 25 mg orally once a day 1 hour prior to sexual activity Pulmonary Arterial Hypertension: Revatio (R): -No adjustment recommended. Erectile dysfunction: -Initial dose: 25 mg orally should be considered in patients with any degree of hepatic impairment Pulmonary Arterial Hypertension: Revatio (R): -Mild to moderate hepatic dysfunction (Child-Pugh Class A and B): No adjustment recommended. -Severe hepatic dysfunction (Child-Pugh Class C): Has not been studied Concomitant administration with alpha blockers: -Initial dose: 25 mg orally 1 hour prior to sexual activity -Patients should be stable on alpha blocker therapy prior initiating treatment with this drug. By clicking Subscribe, I agree to the Terms & Conditions and Privacy Policy and understand that I may opt out of subscriptions at any time.

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    This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The guideline offered 8 recommendations ranked according to level of evidence and benefit-harm relationship. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. Key Action Statement 6D: Clinicians should encourage avoidance of tobacco smoke exposure. Three of the recommendations—diagnostic criteria, observation, and choice of antibiotics—led to significant discussion, especially among experts in the field of otitis media (OM). The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. Key Action Statement 6B: Clinicians should recommend annual influenza vaccine to all children according to the schedule of the Advisory Committee on Immunization Practices, AAP, and AAFP. Strength: Recommendation.2Key Action Statement 6C: Clinicians should encourage exclusive breastfeeding for at least 6 months. Also, at the time the guideline was written, information regarding the heptavalent pneumococcal conjugate vaccine (PCV7) was not yet published. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. Key Action Statement 6A: Clinicians should recommend pneumococcal conjugate vaccine to all children according to the schedule of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, American Academy of Pediatrics (AAP), and American Academy of Family Physicians (AAFP). Since completion of the guideline in November 2003 and its publication in May 2004, there has been a significant body of additional literature on AOM. The guideline provides a specific, stringent definition of AOM. Key Action Statement 5B: Clinicians may offer tympanostomy tubes for recurrent AOM (3 episodes in 6 months or 4 episodes in 1 year with 1 episode in the preceding 6 months). Although OM remains the most common condition for which antibacterial agents are prescribed for children in the United States clinician visits for OM decreased from 9 children in 1995–1996 to 6 children in 2005–2006. ANTIBIOTICS REVIEW zithromax 500 mg side effects When Is That Pain Hep B-related and When Is It Something Else. The Diagnosis and Management of Acute Otitis Media - Pediatrics
     
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