Abstract：
:Cytochrome P450 enzymes are essential for the metabolism of many medications. Although this class has more than 50 enzymes, six of them metabolize 90 percent of drugs, with the two most significant enzymes being CYP3A4 and CYP2D6. Genetic variability (polymorphism) in these enzymes may influence a patient's response to commonly prescribed drug classes, including beta blockers and antidepressants. Cytochrome P450 enzymes can be inhibited or induced by drugs, resulting in clinically significant drug-drug interactions that can cause unanticipated adverse reactions or therapeutic failures. Interactions with warfarin, antidepressants, antiepileptic drugs, and statins often involve the cytochrome P450 enzymes. Knowledge of the most important drugs metabolized by cytochrome P450 enzymes, as well as the most potent inhibiting and inducing drugs, can help minimize the possibility of adverse drug reactions and interactions. Although genotype tests can determine if a patient has a specific enzyme polymorphism, it has not been determined if routine use of these tests will improve outcomes.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Lynch T,Price Asubject
Has Abstractpub_date
2007-08-01 00:00:00pages
391-6issue
3eissn
0002-838Xissn
1532-0650journal_volume
76pub_type
杂志文章,评审abstract：:Although local anesthesia usually is used in surgical procedures, field or nerve blocks can provide more effective anesthesia in some situations. In a field block, local anesthetic is infiltrated around the border of the surgical field, leaving the operative area undisturbed. In field blocks, epinephrine may be added ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2004-02-01 00:00:00
abstract：:AIDS dementia complex is a major source of disability for many AIDS patients. Less commonly, the spinal cord or peripheral nerves are affected by HIV infection. Physicians working with AIDS patients must differentiate these manifestations from those caused by the infectious, neoplastic and vascular complications. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-12-01 00:00:00
abstract：:Appropriate preconception health care improves pregnancy outcomes. When started at least one month before conception, folic acid supplements can prevent neural tube defects. Targeted genetic screening and counseling should be offered on the basis of age, ethnic background, or family history. Before conception, women s...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2002-06-15 00:00:00
abstract：:The best condoms are made of latex, are lubricated and coated with a spermicide, and have a reservoir tip. Condoms can protect against conception and sexually transmitted diseases, including acquired immunodeficiency syndrome. When condoms are used properly and in combination with vaginal spermicidal foam, the contrac...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-06-01 00:00:00
abstract：:Henoch-Schönlein purpura is an acute, systemic, immune complex-mediated, leukocytoclastic vasculitis. It is characterized by a triad of palpable purpura (without thrombocytopenia), abdominal pain, and arthritis. Most patients have an antecedent upper respiratory illness. More than 90 percent of Henoch-Schönlein purpur...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：:Melanoma is an increasingly common malignancy, and it affects a younger population than most cancers. Risk factors for melanoma include white race, sun sensitivity, family history of melanoma, and melanocytic nevi. Sunburn and intermittent sun exposure appear to increase the risk of developing melanoma. The role of po...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2005-07-15 00:00:00
abstract：:Nearly 40 percent of Americans complain about insomnia. Such complaints are even more common among the elderly, possibly because sleep efficiency decreases with age. As a result, the use of hypnotics in this age group is high--sometimes too high. Hypnotics can be addictive, and many have a low therapeutic index. The b...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-08-01 00:00:00
abstract：:Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common tick-borne illness in the United States. Transmission occurs primarily through the bite of an infected deer tick (Ixodes scapularis). Identification of an erythema migrans rash following a tick bite is the only clinical manifestation suffic...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-06-01 00:00:00
abstract：:Thyroid function tests, radioiodine uptake and scintiscanning, and antithyroid antibody titers are the main laboratory tests useful in the management of goiter. Scintiscanning and ultrasonography aid in differentiating a functioning adenoma from a "cold" solid nodule--a crucial distinction since the incidence of cance...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:Careful examination of a fresh, properly collected urine specimen can indicate the presence of urinary tract disease or uncover unsuspected local or systemic pathology. Urinalysis also can lead to a more complete understanding of a systemic disorder or can assure both the patient and the physician that urinary tract d...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely nor...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1996-03-01 00:00:00
abstract：:Although heart failure is a common clinical syndrome, especially in the elderly, its diagnosis is often missed. A detailed clinical history is crucial and should address not only current signs and symptoms of heart failure but also signs and symptoms that point to a specific cause of the syndrome, such as coronary art...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2000-03-01 00:00:00
abstract：:Dorsal penile nerve block with lidocaine is safe and effective for reducing the pain associated with newborn circumcision. Administering the anesthesia adds little time or expense to the overall routine. Complications are minor, limited to local bleeding and hematoma formation. Family physicians performing circumcisio...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1991-04-01 00:00:00
abstract：:Injuries to the head and neck are common in sports. Sideline physicians must be attentive and prepared with an organized approach to detect and manage these injuries. Because head and neck injuries often occur simultaneously, the sideline physician can combine the head and neck evaluations. When assessing a conscious ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2006-10-15 00:00:00
abstract：:Breast milk is universally recommended as the preferred source of infant nutrition, in part because of its superior nutrient and immunologic properties. Successful breast feeding requires nursing on demand, prevention of sore nipples and convenient access to medical advice. For mothers relying on bottle feeding, cow's...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-07-01 00:00:00
abstract：:Causes of congestive heart failure include hypertension, coronary artery disease, alcohol abuse and valvular heart disease. Two-dimensional echocardiography with Doppler examination is excellent for identifying valvular heart disease. While noninvasive screening for coronary artery disease may seem cost-effective, the...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1990-09-01 00:00:00
abstract：:Family physicians should be aware of the potential effects and complications of vasectomy so they can appropriately counsel patients seeking sterilization. Vasectomy produces anatomic, hormonal and immunologic changes and, although not substantiated by clinical studies, has been reputed to be associated with atheroscl...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-15 00:00:00
abstract：:Several effective and inexpensive over-the-counter treatments are available for minor but troubling foot problems. In most cases, one week of therapy with topical terbinafine is effective for interdigital tinea pedis. Treatment of plantar warts with 17 percent salicylic acid with lactic acid in a collodion base is as ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2001-09-01 00:00:00
abstract：:Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose levonorgestrel, and ulipristal. The Yuzpe ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2014-04-01 00:00:00
abstract：:A previous venous thromboembolism is the most important risk factor for predicting recurrence of the condition. Several studies have shown that routine testing for inherited thrombophilias is not helpful in predicting the risk of recurrence or altering treatment decisions, and therefore is not cost-effective. Updated ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2011-02-01 00:00:00
abstract：:Hearing conservation programs have not kept pace with changes in the workplace and in the work force. Heavy industry and noisy factories have yielded to quiet computers and high technology. Chemicals, self-administered or prescribed, may replace noise as a chief source of hearing loss. The aging working population and...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1988-09-01 00:00:00
abstract：:The preparticipation physical evaluation is a commonly requested medical visit for amateur and professional athletes of all ages. The overarching goal is to maximize the health of athletes and their safe participation in sports. Although studies have not found that the preparticipation physical evaluation prevents mor...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：2015-09-01 00:00:00
abstract：:Schirmer's test is a simple, semiquantitative test of tear production. It is based on the physical tendency of a fluid to travel along a strip of porous material by capillary action due to surface tension. Sterile strips, standardized and prepackaged, are available from local scientific supply houses. The low cost and...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：:Rational use of psychoactive drugs in frail elderly patients requires an understanding of the physiologic changes produced by aging and chronic disease. Other drugs being used and the patient's nutritional status and lifestyle also must be considered. Affective disorders and thought disorders may be effectively treate...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:Asthmatics may develop a considerable increase in airways obstruction during the night or early hours of the morning. In most patients, this causes only mild symptoms. In others, the effects may be severe, resulting in sudden death. Greater awareness of the potential severity of nocturnal asthma, together with actual ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1976-12-01 00:00:00
abstract：:Physicians can create their own personal formulary by rigorously selecting and regularly using one or two drugs for each clinical condition they commonly encounter. The primary and secondary medical literature provides the necessary information to create this formulary. Primary literature sources include peer-reviewed...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：1996-06-01 00:00:00
abstract：:A herpes zoster infection in patients with lymphoma has been associated with subsequent metastatic disease involving the spinal cord and vertebrae of the affected dermatome segment. This correlation can be used in planning radiation therapy to avert neurologic complications secondary to spinal cord involvement. ...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1980-08-01 00:00:00
abstract：:Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome neurologic symptoms typically have a ...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2017-11-01 00:00:00
abstract：:Minor neurologic signs or transient ischemic attacks (TIAs) precede stroke in 50 percent of patients. In men, antiplatelet therapy decreases the risk of recurrent TIA and stroke. Carotid endarterectomy for TIA is now one of the most commonly performed vascular operations. Preoperatively, the arterial anatomy of the pa...
journal_title：American family physician
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:Congenital hearing loss is estimated to affect one in every 1,000 newborns. Causes of hearing loss can be conductive, sensorineural, mixed, or central. Known risk factors for congenital hearing loss include cytomegalovirus infection and premature birth necessitating a stay in the neonatal intensive care unit. However,...
journal_title：American family physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-05-01 00:00:00
