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See detailPharma-clinics. Comment je traite ... le zona
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (1999), 54(2), 71-75

The treatment of herpes zoster relies on the intravenous or oral administration of antiviral drugs. Oral aciclovir for shingles is hindered by its low bioavailability. New antiviral drugs with improved ... [more ▼]

The treatment of herpes zoster relies on the intravenous or oral administration of antiviral drugs. Oral aciclovir for shingles is hindered by its low bioavailability. New antiviral drugs with improved oral bioavailability (famciclovir and valaciclovir) allow a better efficacy. The opportuneness of treating herpes zoster is different in the immunocompetent and immunocompromised patients, and during childhood and pregnancy. [less ▲]

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See detailPharma-clinics. Comment je traite ... les verrues péri-ungueales
Lambert, Jean-Luc ULg; Richert, Bertrand ULg; de LA BRASSINNE, Michel ULg

in Revue Médicale de Liège (1999), 54(8), 646-52

Warts are common benign lesions for which no specific antiviral treatment is available. In some cases, patients and doctors can be put off by poor results. Before selecting any treatment for peri- and ... [more ▼]

Warts are common benign lesions for which no specific antiviral treatment is available. In some cases, patients and doctors can be put off by poor results. Before selecting any treatment for peri- and subungual warts, it is of utmost importance to bear in mind the risk of damaging the nail matrix. This paper reviews the advantages and inconveniences of the current available treatments in this location. [less ▲]

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See detailPharma-clinics. Comment je traite ... un sujet avec une concentration basse de cholesterol HDL.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(12), 727-31

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile ... [more ▼]

The decision to treat an individual with low HDL cholesterol level depends on his overall cardiovascular risk profile and the therapeutic strategy is based upon the characteristics of the lipid profile (isolated abnormality, associated hypertriglyceridaemia or combined elevation of LDL cholesterol). The treatment must favour diet and exercise, before considering a possible pharmacological approach. Results are usually acceptable with better life habits and appropriate diet when low HDL cholesterol level is associated to hypertriglyceridaemia. From a pharmacological point of view, the best results are obtained with fibrates or nicotinic acid. However, results are often disappointing when low HDL cholesterol level is isolated. [less ▲]

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See detailPharma-clinics. Comment je traite ... Une infection par le VIH. II. Inhibiteurs nucléosidiques de la transcriptase reverse
Moutschen, Michel ULg; Nkoghe, D.; Leonard, Philippe ULg et al

in Revue Médicale de Liège (1997), 52(12), 750-2

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See detailPharma-clinics. Comment je traite... II. Approche thérapeutique du cancer colorectal métastatique
Jerusalem, Guy ULg; Bours, Vincent ULg; Fillet, Georges ULg

in Revue Médicale de Liège (1998), 53(6), 318-21

Since its introduction in 1953, 5-fluorouracil based chemotherapy remained the standard treatment in advanced colorectal cancer. Continuous infusion or biochemical modulation by folinic acid enhanced the ... [more ▼]

Since its introduction in 1953, 5-fluorouracil based chemotherapy remained the standard treatment in advanced colorectal cancer. Continuous infusion or biochemical modulation by folinic acid enhanced the therapeutic efficacy of this agent. Quality of life is limited by the toxicity of these regimens as well as by the frequent visits to the hospital during each cycle. Raltitrexed, a thymidylate synthase inhibitor, offers similar antitumoral activity together with a tolerability in comparison to standard 5-fluorouracil based chemotherapy and its simple dosage schedule also contributes to better quality of life. New chemotherapeutic agents are currently in development for the treatment of patients refractory to 5-fluorouracil. Irinotecan and oxaliplatin demonstrate promising activity. [less ▲]

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See detailPharma-clinics. Comment je traite... un patient diabétique de type 1 par pompe portable à insuline
Philips, J. C.; Scheen, André ULg

in Revue Médicale de Liège (1996), 51(11), 678-80

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See detailPharma-Clinics. Comment je traite... un patient diabétique de Type 2 par régime
Paquot, Nicolas ULg

in Revue Médicale de Liège (1996), 51(8), 497-9

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See detailPharma-clinics. Comment je traite... une acné du visage
Pierard, Gérald ULg

in Revue Médicale de Liège (1996), 51(5), 327-31

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See detailPharma-Clinics. Essais cliniques medicamenteux: importance et role du medecin generaliste .
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 17-20

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect ... [more ▼]

Clinical trials are an essential step in the development of a drug. They must be conducted according to strict rules called "Good Clinical Practice" or GCP. GCP requirements aim to guarantee a perfect methodology in the planning, realization and interpretation of clinical trials. The latter can be divided in four phases: phase 1 aiming to demonstrate the safety and to investigate the pharmacokinetics/metabolism of the drug in healthy volunteers; phase 2 aiming to study the intrinsic activity (generally versus a placebo) and safety of the compound in a rather small number of (hospitalized) patients; phase 3 aiming to confirm the comparative efficacy (versus a placebo or a reference drug) and safety of the pharmacological agent in a quite large number of (ambulatory) patients; and phase 4 carried out after commercialization, to verify the clinical utility of the drug in conditions of daily practice. Because he/she occupies a crucial position in the recruitment and follow-up of outpatients, the general practitioner should play a more active role in clinical trials, provided that he/she could work in collaboration with academic centers specialized in clinical pharmacology which can help to perform studies in accordance with GCP requirements. [less ▲]

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See detailPharma-clinics. Le dopage a l'erythropoietine ou l'utilisation detournee des progres therapeutiques.
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(8), 499-502

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude ... [more ▼]

Sport performance depends on the capacity of oxygen transport to the exercising skeletal muscles. Performance may be increased thanks to an haematocrit augmentation, either by training in high altitude, using blood transfusions, or injecting erythropoietin (Epo). Since the synthesis of Epo by bioengineering, doping with recombinant human Epo has become popular in sports in general, and in cycling in particular. This new kind of doping might have been responsible for several sudden deaths in young athletes, essentially in racing cyclists. Until now, such a doping is hardly to be detected. However, it should deserve careful consideration from both public health authorities and sports communities in order to stop what could become a real plague. [less ▲]

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See detailPharma-clinics. Le medicament du mois. L'aceclofenac (Biofenac).
Scheen, André ULg

in Revue Médicale de Liège (1999), 54(1), 62-4

Aceclofenac, a phenylacetic acid derivative, is a new nonsteroidal anti-inflammatory drug (NSAID). It is indicated in the symptomatic treatment of pain and inflammatory or degenerative arthropathies ... [more ▼]

Aceclofenac, a phenylacetic acid derivative, is a new nonsteroidal anti-inflammatory drug (NSAID). It is indicated in the symptomatic treatment of pain and inflammatory or degenerative arthropathies: osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, abarticular inflammations, posttrauma or postoperative inflammations. The usual oral dosage of aceclofenac is 100 mg twice daily in adults. Its clinical efficacy seems to be similar to that of other NSAIDs, but its safety profile, especially gastro-intestinal tolerance, appears to be better. Finally, in vitro studies suggested that aceclofenac may exert positive effect on cartilage matrix metabolism. [less ▲]

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See detailPharma-clinics. Le medicament du mois. L'alendronate (Fosamax).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(4), 220-2

Alendronate (Fosamax, Merck Sharp & Dohme) is an aminobisphosphonate which inhibits bone turnover by suppressing the activity of osteoclasts without increasing the risk of osteomalacia. Alendronate is ... [more ▼]

Alendronate (Fosamax, Merck Sharp & Dohme) is an aminobisphosphonate which inhibits bone turnover by suppressing the activity of osteoclasts without increasing the risk of osteomalacia. Alendronate is highly effective at preventing bone loss associated to absence of endogenous estrogen and induces a sustained increase in bone mass. Fosamax is indicated and reimbursed in the treatment of osteoporosis in postmenopausal women, with either an history of bone fracture confirmed by X-ray exam or obvious osteoporosis assessed by bone mineral density measurement. The recommended dosage is 10 mg once daily, continuously. The drug should be absorbed after an overnight fast to improve its bioavailability and with a big glass of plain water to reduce the risk of oesophageal ulcerations. Large randomized controlled trials for up to 3 years have demonstrated that alendronate is able to reduce the risk and rate of occurrence of vertebral and nonvertebral fractures in postmenopausal women. [less ▲]

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See detailPharma-clinics. Le medicament du mois. L'atorvastatine (Lipitor).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(6), 374-7

Atorvastatin, commercialized by the pharmaceutical companies Parke-Davis and Pfizer under the trade name Lipitor, is a new statin acting as a potent hypolipidaemic drug. By inhibiting HMG-CoA reductase ... [more ▼]

Atorvastatin, commercialized by the pharmaceutical companies Parke-Davis and Pfizer under the trade name Lipitor, is a new statin acting as a potent hypolipidaemic drug. By inhibiting HMG-CoA reductase, the key-enzyme of cellular synthesis of cholesterol, it increases the expression of LDL receptors and promotes the hepatic extraction of circulating LDL. It has a more potent action than other available statins, both on LDL cholesterol and triglyceride levels. Atorvastatin is indicated, after diet failure, in the treatment of primary hypercholesterolaemia or combined hyperlipidaemia. Lipitor is available as tablets of 10 and 20 mg. The usual doses is 10 mg once a day, to be increased up to 20 mg/day if necessary. In rare severe cases, the doses may be increased up to 80 mg/day. [less ▲]

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See detailPharma-clinics. Le medicament du mois. La combinaison fixe dipyridamole--acide acetylsalicylique (Aggrenox).
Scheen, André ULg

in Revue Médicale de Liège (2000), 55(10), 957-9

Aggrenox, launched in Belgium by Boehringer Ingelheim, is a fixed-dose combination of extended-release dipyridamole (200 mg) and aspirin (25 mg), two antiplatelet agents with different and complementary ... [more ▼]

Aggrenox, launched in Belgium by Boehringer Ingelheim, is a fixed-dose combination of extended-release dipyridamole (200 mg) and aspirin (25 mg), two antiplatelet agents with different and complementary mechanisms of action. It is recommended, twice daily, in the protection against secondary stroke and transient ischaemic attacks. The placebo-controlled European study ESPS 2 (European Stroke Prevention Study 2) demonstrated that the administration of this combination was twice as effective as either agent alone in the secondary prevention of stroke in patients with prior stroke or transient ischaemic attack. [less ▲]

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See detailPharma-clinics. Le medicament du mois. La levofloxacine (Tavanic).
Scheen, André ULg

in Revue Médicale de Liège (2000), 55(11), 1015-7

Levofloxacin, the (-)-(S)-enantiomer isolated from the racemate ofloxacin, is launched by Aventis under the trade name of Tavanic. This new oral and parenteral antibiotic belongs to the fluoroquinolone ... [more ▼]

Levofloxacin, the (-)-(S)-enantiomer isolated from the racemate ofloxacin, is launched by Aventis under the trade name of Tavanic. This new oral and parenteral antibiotic belongs to the fluoroquinolone family and exerts a bactericidal activity upon a large spectrum of microorganisms, including Gram negative and Gram positive bacilli (among which Streptococcus pneunomiae), and atypical respiratory pathogens. It also has interesting pharmacokinetic properties. Besides the classical indications of other fluoroquinolones (especially complicated urinary tract infections, including pyelonephritis, and severe skin and soft tissue infections), levofloxacin is indicated for the treatment of acute sinusitis, acute exacerbations of chronic bronchitis and community-acquired pneumonia. [less ▲]

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See detailPharma-clinics. Le medicament du mois. La moxonidine (Moxon).
Scheen, André ULg

in Revue Médicale de Liège (2000), 55(1), 61-3

Moxonidine (Moxon, Solvay Pharma) is the first member of a new class of centrally-acting antihypertensive agents. The selective activation of central I1 imidazoline receptors results in an inhibition of ... [more ▼]

Moxonidine (Moxon, Solvay Pharma) is the first member of a new class of centrally-acting antihypertensive agents. The selective activation of central I1 imidazoline receptors results in an inhibition of peripheral sympathetic activity and produces arterial vasodilatation. Moxonidine is indicated in the treatment of essential arterial hypertension, at a usual daily dose of 0.4 mg (initial dose of 0.2 mg/day), in one administration per day. Its tolerance profile is better than that of other centrally-acting antihypertensive agents which stimulate alpha-2 adrenergic receptors, and similar to that of medications of other classes. As monotherapy, the antihypertensive efficacy of moxonidine is similar to that of most other antihypertensive agents. In case of insufficient response, moxonidine may be associated with other antihypertensive compounds, which leads to a better efficacy with no deterioration of its good tolerance profile. [less ▲]

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See detailPharma-Clinics. Le medicament du mois. La ranitidine bismuth citrate (Pylorid).
Scheen, André ULg

in Revue Médicale de Liège (1998), 53(1), 41-4

Ranitidine bismuth citrate (Pylorid, Glaxo-Wellcome) is a novel salt of ranitidine which provides a unique combination of properties: inhibition of secretion of gastric acid by competitive antagonism of ... [more ▼]

Ranitidine bismuth citrate (Pylorid, Glaxo-Wellcome) is a novel salt of ranitidine which provides a unique combination of properties: inhibition of secretion of gastric acid by competitive antagonism of the action of histamine at the histamine H2-receptor on the gastric parietal cell, mucosal protective effects and anti-Helicobacter pylori action. Ranitidine bismuth citrate provides effective healing and symptom relief, both in duodenal ulcer disease and in gastric ulcer disease. When coprescribed with certain antibiotics (clarithromycin alone or combined with amoxicillin or nitro-imidazole), it heals ulcers, eradicates Helicobacter pylori and prevents recurrence of the disease. Several clinical studies demonstrated that ranitidine bismuth citrate is well-tolerated and has quite similar efficacy as proton pump inhibitors. [less ▲]

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See detailPharma-clinics. Le medicament du mois. La sibutramine (Reductil).
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(9), 656-9

Sibutramine (Reductil, Abbott-Knoll, 10 mg and 15 mg) is a new appetite regulator recommended in the treatment of obesity. It is a noradrenaline and 5-hydroxytryptamine reuptake inhibitor which exerts its ... [more ▼]

Sibutramine (Reductil, Abbott-Knoll, 10 mg and 15 mg) is a new appetite regulator recommended in the treatment of obesity. It is a noradrenaline and 5-hydroxytryptamine reuptake inhibitor which exerts its effects in vivo predominantly via its secondary and primary amine metabolites. Sibutramine is indicated as an adjunctive therapy within a weight management programme in patients with obesity (BMI > or = 30 kg/m2) or in overweight subjects (BMI > or = 27 kg/m2) if other eight-related risk factors are present (dyslipidaemias, diabetes mellitus). In those patients with an inadequate response on initial dose of 10 mg per day (suggested as less than 2 kg weight loss in four weeks), the dose may be increased to 15 mg once daily, providing that sibutramine is well tolerated. Several large-scale randomized clinical trials demonstrated the efficacy of long-term (at least one year) treatment with sibutramine in obese subjects with or without type 2 diabetes. Sibutramine was also shown to help in maintaining long-term weight reduction. Most frequent side-effects are dry mouth and constipation, as well as mild increase in heart rate and arterial blood pressure. The impact of sibutramine on cardiovascular morbidity and mortality of obese nondiabetic and diabetic patients will be studied soon in a large international prospective clinical trial. [less ▲]

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See detailPharma-clinics. Le médicament du mois. La terbinafine (Lamisil)
Pierard, Gérald ULg

in Revue Médicale de Liège (1995), 50(8), 352-3

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See detailPharma-clinics. Le medicament du mois. Le celecoxib (Celebrex).
Scheen, André ULg

in Revue Médicale de Liège (2001), 56(1), 53-5

Celecoxib (Celebrex, Pharmacia) is a potent and selective inhibitor of the COX-2 isoform of cyclooxygenase which is used as nonsteroidal anti-inflammatory drug (NSAID). Its current indications are ... [more ▼]

Celecoxib (Celebrex, Pharmacia) is a potent and selective inhibitor of the COX-2 isoform of cyclooxygenase which is used as nonsteroidal anti-inflammatory drug (NSAID). Its current indications are osteoarthritis and rheumatoid arthritis. The usual recommended daily dosage of celecoxib is 200 mg (in one or two intakes per day), to be increased up to 400 mg (two intakes per day) if necessary. Its clinical efficacy seems to be similar to that of other NSAIDs. However, its safety profile, especially gastro-intestinal tolerance and perhaps renal safety, is much better because of the COX-2 selectivity. [less ▲]

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