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See detailPharma clinics. Comment je traite ... ou préviens une douleur par "patches"
Pierard, Gérald ULg

in Revue Médicale de Liège (1998), 53(10), 586-7

There exists two distinct types of patches aiming at increasing the pain threshold either systematically or locally. The first type of analgesic patch is a real transdermal delivery system releasing ... [more ▼]

There exists two distinct types of patches aiming at increasing the pain threshold either systematically or locally. The first type of analgesic patch is a real transdermal delivery system releasing fentanyl. Such potent opioid drug exerts a systemic effect. The other type of patch associates lidocain and prilocain to induce a local anesthesia of the skin without inducing a systemic effect. [less ▲]

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See detailPharma clinics. Comment je traite ... un herpes labial récurrent.
Petit, L.; Braham, C.; Nikkels, Arjen ULg et al

in Revue Médicale de Liège (2002), 57(2), 67-71

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent ... [more ▼]

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent labial herpes are targeted by specific antiviral agents. Spectacular benefits obtained in the immunocompromised patients are less convincing in otherwise healthy subjects. Other prospective ways of therapy are under consideration, including lipopeptides and physical means aiming at modifying the cutaneous pH. [less ▲]

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See detailPharma clinics. Comment je traite ... un patient diabetique avec obesite severe.
Scheen, André ULg; Triches, K.; Luyckx, Françoise ULg et al

in Revue Médicale de Liège (1998), 53(7), 386-9

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive ... [more ▼]

Obesity plays a crucial role in type 2 diabetes pathophysiology and a major weight loss markedly improves glycaemic control. The common failure of classical treatments leads to the use of more aggressive weight-reduction approaches, such as very-low-calorie diets (VLCDs), anti-obesity drugs or even bariatric surgery. VLCDs are very successful in the short-term but rather disappointing in the long-term. Anti-obesity compounds only induce a modest mean weight reduction, even if some patients appear to be better responders. Interestingly, serotoninergic agents increase insulin sensitivity and glycaemic control, independently of weight loss. Bariatric surgery provides the most impressive results. In well-selected subjects, gastroplasty (either vertical ring gastroplasty or adjustable silicone gastric banding) generally induces a considerable weight loss which results in a remarkable and sustained glycaemic control improvement and allows the reduction, or even the suppression, of any antidiabetic treatment. This ultimate solution should not be neglected after failure of medical approaches, provided that the indication is correct, the surgical procedure is performed in a specialized centre and the followup is well organized by a multidisciplinary team. [less ▲]

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See detailPharma clinics. Comment je traite ... un trouble de la kaliémie
Neven, Ingrid; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2000), 55(1), 4-7

The treatment of dyskalemia must be primarily etiological and later symptomatic. When moderate but significant hypokalemia exists (K < 3 mmol/l or 3.5 mmol/l with cardiac disease), oral K supplements must ... [more ▼]

The treatment of dyskalemia must be primarily etiological and later symptomatic. When moderate but significant hypokalemia exists (K < 3 mmol/l or 3.5 mmol/l with cardiac disease), oral K supplements must be given. The intravenous route must be reserved for emergency or impossible oral administration. Acute and severe hyperkalemia (K > 7 mmol/l) must be first corrected by different intravenous measures with secondary oral intervention. In chronic and/or moderate hyperkalemia (K > 5.5 mmol/l), the oral route for treatment is prefered. In any case, the research of the cause (mainly drug induced) is fundamental. [less ▲]

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See detailPharma clinics. Comment je traite ... une anemie (3e partie).
Beguin, Yves ULg

in Revue Médicale de Liège (1995), 50(12), 497-8

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See detailPharma clinics. Comment je traite.... Certaines maladies metaboliques grace a une intervention pharmacologique ciblee sur l'intestin.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(11), 646-50

Besides the classical dietary regimen, it is possible to use specific pharmacological approaches, targeted at the intestine, in order to treat some metabolic disorders. Three approaches will be described ... [more ▼]

Besides the classical dietary regimen, it is possible to use specific pharmacological approaches, targeted at the intestine, in order to treat some metabolic disorders. Three approaches will be described: anionic resins for treating hypercholesterolaemia, alpha-glucosidase inhibitors for treating diabetes mellitus and reactive hypoglycaemia, and intestinal lipase inhibitors for treating obesity. All these drugs are based on original concepts, but their clinical use is often limited by the occurrence of digestive side-effects. The latter may generally be reduced by progressive and individual titration of the dosage of each drug and/or by following an appropriate diet. [less ▲]

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See detailPharma clinics. Comment je traite.... L'arthrose. 1ère partie: Rappel physiopathologique et traitement symptomatique
Reginster, Jean-Yves ULg; Henrotin, Yves ULg

in Revue Médicale de Liège (2001), 56(2), 63-7

Osteoarthritis is now considered in all developed countries as a major burden for public health. During several years, the pharmacological management of osteoarthritis mainly focused on symptoms relief ... [more ▼]

Osteoarthritis is now considered in all developed countries as a major burden for public health. During several years, the pharmacological management of osteoarthritis mainly focused on symptoms relief without interaction with the long-term structural progression of this disease. Based on recently published consensus, the present article summarizes the currently available options in the symptom-modifying management of osteoarthritis. [less ▲]

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See detailPharma clinics. Comment je traite.... L'arthrose. 2eme partie: Nouvelles perspectives therapeutiques
Reginster, Jean-Yves ULg; Henrotin, Yves ULg

in Revue Médicale de Liège (2001), 56(3), 135-9

Besides the management of symptoms of osteoarthritis, a lot of interest was raised for molecules aiming at slowing down the structural progression of the disease. This paper summarizes the currently ... [more ▼]

Besides the management of symptoms of osteoarthritis, a lot of interest was raised for molecules aiming at slowing down the structural progression of the disease. This paper summarizes the currently available data allowing to discuss the efficacy and tolerance of these chemical entities. [less ▲]

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See detailPharma clinics. Le médicament du mois. L'imiquimod (Aldara): un immunomodulateur pour la peau.
Hermanns-Le, Trinh ULg; Nikkels, Arjen ULg; Uhoda, Isabelle et al

in Revue Médicale de Liège (2002), 57(2), 116-8

Imiquimod is the first drug of a new therapeutic class encompassing cutaneous immune response modifiers. This molecule induces the synthesis and release of macrophage-related cytokines. It boosts some ... [more ▼]

Imiquimod is the first drug of a new therapeutic class encompassing cutaneous immune response modifiers. This molecule induces the synthesis and release of macrophage-related cytokines. It boosts some local immune responses. These properties are used to treat cutaneous viral condylomas. Other prospective therapeutic goals are presently scrutinized. [less ▲]

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See detailPharma clinics. Le medicament du mois. La cerivastatine (Lipobay, Cholstat).
Scheen, André ULg

in Revue Médicale de Liège (2000), 55(2), 117-20

Cerivastatin, commercialized under the trade names of Lipobay by Bayer and Cholstat by Fournier Pharma, is a new synthetic statin. Because of its high affinity for HMG-CoA reductase enzyme that it ... [more ▼]

Cerivastatin, commercialized under the trade names of Lipobay by Bayer and Cholstat by Fournier Pharma, is a new synthetic statin. Because of its high affinity for HMG-CoA reductase enzyme that it specifically and selectively inhibited in the hepatocytes, cerivastatin exerts its cholesterol-lowering effect at very low doses, between 0.1 and 0.3 mg/day. Cerivastatin is indicated, after diet failure, in the treatment of primary forms of isolated hypercholesterolaemia or combined hyperlipidaemia. It is presented by the two pharmaceutical companies as 0.1, 0.2 and 0.3 mg filmed tablets. Usual dose is 0.3 mg, once daily, to be reduced in presence of renal failure. Cerivastatin is metabolised within the liver by two different families of cytochrome P450, which limits the risk of drug interferences. Besides this potential advantage as compared with some other statins, its pharmacodynamic activity and safety profile seem to be similar to those of other agents of the same pharmacological family. [less ▲]

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See detailPharma clinics. Le médicament du mois. La lercanidipine (Zanidip)
Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (1999), 54(10), 832-834

Lercanidipine (Zanidip) is a new calcium antagonist belonging to the dihydropyridine family suitable for the first-line treatment of hypertension. This molecule displays a high specificity and selectivity ... [more ▼]

Lercanidipine (Zanidip) is a new calcium antagonist belonging to the dihydropyridine family suitable for the first-line treatment of hypertension. This molecule displays a high specificity and selectivity for vascular smooth muscle cells and has, in spite of a short plasma half-life, a long duration of action due to its liposolubility. The usual and once a day dose to treat high blood pressure of any grade is 10 mg, which if needed could be increased to 20 mg once a day. It has a gradual onset of effect on blood pressure, thus leading to a good tolerability and hopefully a better compliance in the treatment of hypertension. No adaptation of the dose is needed in older patients or in patients with moderate renal or liver impairment. [less ▲]

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See detailPharma Clinics. Le médicament du mois. Le benzamycin, une actualisation du traitement topique de l'acné
Pierard, Gérald ULg

in Revue Médicale de Liège (1997), 52(2), 120-2

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See detailPharma clinics. Le medicament du mois. Le clopidogrel (Plavix).
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(3), 186-9

Clopidogrel is launched in Belgium by Sanofi-Synthelabo and Bristol-Myers Squibb under the trade name of Plavix. It is a potent and irreversible ADP receptor antagonist that proved to be more effective ... [more ▼]

Clopidogrel is launched in Belgium by Sanofi-Synthelabo and Bristol-Myers Squibb under the trade name of Plavix. It is a potent and irreversible ADP receptor antagonist that proved to be more effective than aspirin as antiplatelet agent in the multicentre, randomised double-blind CAPRIE study. It is indicated, at a dosage of 75 mg/day, for the reduction of atherosclerotic events including myocardial infarction, ischaemic stroke and vascular death in patients with atherosclerosis manifested by recent stroke, myocardial infarction or established peripheral vascular disease. Furthermore, recent studies demonstrated that the combination of clopidogrel with aspirin is more effective than aspirin alone and better tolerated than the combination ticlopidine-aspirin for the prevention of atherothrombosis after placement of intravascular stents. Ongoing trials are evaluating the efficacy and safety of such clopidogrel-aspirin combination after acute ischaemic coronary events or in patients at very high risk of stroke. Thus the indications of clopidogrel may become even larger in a next future. [less ▲]

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See detailPharma clinics. Le medicament du mois. Le montelukast (Singulair)
Louis, Renaud ULg

in Revue Médicale de Liège (2001), 56(6), 460-2

Montelukast (Singulair, Merck Sharp

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See detailPharma-clinics comment je traite ... une infection par le VIH. III. Les inhibiteurs non nucléosidiques de la transcriptase inverse
Nkoghe, D.; Moutschen, Michel ULg; Leonard, Philippe ULg et al

in Revue Médicale de Liège (1999), 54(12), 909-11

Non nucleoside reverse transcriptase inhibitors (NNRTI) are a new arm in the treatment of the HIV infection. They inhibit the replication by direct non competitive binding to the enzyme, and do not ... [more ▼]

Non nucleoside reverse transcriptase inhibitors (NNRTI) are a new arm in the treatment of the HIV infection. They inhibit the replication by direct non competitive binding to the enzyme, and do not require phosphorylation. The fast emergence of resistance in monotherapy obliges to use them in a triple association. The 103 mutation confers a cross-resistance. The most common adverse event is rash. Association with nucleoside analogues is additive or even synergistic. They are metabolized by the cytochrome P450. Within a combined therapy, their efficiency is comparable to protease inhibitors, notably in patients with low viral load. [less ▲]

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See detailPharma-clinics comment je traite ... une infection par le VIH. IV. Les inhibiteurs de protease
Leonard, Philippe ULg; Nkoghe, D.; Moutschen, Michel ULg et al

in Revue Médicale de Liège (2001), 56(11), 739-44

Protease inhibitors constitute the last class of antiretroviral drugs appeared on the market. They raised an enormous enthusiasm, reinforced by recent studies results. These molecules prevent the ... [more ▼]

Protease inhibitors constitute the last class of antiretroviral drugs appeared on the market. They raised an enormous enthusiasm, reinforced by recent studies results. These molecules prevent the formation of infectious viral particles, while inhibiting a viral enzyme that plays a key role in the cycle of replication of the HIV. Their efficiency, especially in association, is recognized for all stages of the infection and the intervening of a resistance often requires many mutations. However, the unexpected adverse events such as lipodystrophy and some interactions can limit their utilization in first intention. [less ▲]

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See detailPharma-clinics le medicament du mois. L'orlistat (xenical).
Scheen, André ULg; Ernest, Philippe ULg; Letiexhe, Michel ULg

in Revue Médicale de Liège (1999), 54(3), 192-6

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its ... [more ▼]

Orlistat (tetrahydrolipstatin), launched by Roche under the trade name Xenical, is a selective inhibitor of pancreatic and gastro-intestinal lipases. It reduces the digestion of dietary fat and its resorption through digestive mucosa by around 30%. It is indicated, at a dose of 3 x 120 mg/day (one dose with each meal) and together with a moderately low-calorie and low-fat diet, for the treatment of obesity. It has been shown, in placebo-controlled two-year trials, to almost double the number of obese subjects who succeed in loosing at least 10% of initial body weight. Independently, it contributes to decrease serum cholesterol levels by 6-10%. Because of its mechanism of action, this drug can induce intestinal side-effects which tend to decrease with time and with the reduction of fat intake, thus improving diet compliance. [less ▲]

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See detailPharma-clinics le médicament du mois. La nevirapine. Viramune
Nkoghe, D.; Leonard, Philippe ULg; Moutschen, Michel ULg et al

in Revue Médicale de Liège (1999), 54(12), 948-51

Nevirapine is the first non nucleoside reverse transcriptase inhibitor registered in Belgium and indicated in the treatment of HIV-1 infection. In association with 2 nucleoside analogues, its efficiency ... [more ▼]

Nevirapine is the first non nucleoside reverse transcriptase inhibitor registered in Belgium and indicated in the treatment of HIV-1 infection. In association with 2 nucleoside analogues, its efficiency is similar to a tritherapy with protease inhibitor, particularly in naive patients with low viral load. It has a good tolerance profile and is easy to take. Studies in progress should permit to widen its indications. [less ▲]

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See detailPharma-clinics le medicament du mois. Le naratriptan (naramig).
Scheen, André ULg

in Revue Médicale de Liège (1999), 54(3), 189-91

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the ... [more ▼]

Naratriptan, launched by Glaxo Wellcome under the trade name Naramig, is a potent and selective agonist of 5-HT1B and 5-HT1D vascular receptors. Available as tablets of 2.5 mg, it is indicated in the acute treatment of migraine, with or without aura. A single oral dose of 2.5 mg naratriptan is characterized by a satisfactory clinical efficacy (already significant after one hour, maximum after 4 hours and persisting during 24 hours), a reduction by half of the recurrence of the migraine crisis within the 24 hours and an excellent tolerance profile. [less ▲]

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See detailPharma-clinics le medicament du mois. Le rabeprazole (Pariet)
Louis, Edouard ULg

in Revue Médicale de Liège (2002), 57(1), 53-6

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market ... [more ▼]

Proton pomp inhibitors (PPI) have revolutionized the treatment of gastro-oesophageal reflux disease and gastro-duodenal ulcers. Rabeprazole (Pariet) is the last PPI arrived on the Belgian market. Controlled studies have shown an efficacy similar to emeprazole in the treatment of oeso-gastro-duodenal acid diseases. Rabeprazole has a favourable profile with rapid action and good safety. [less ▲]

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