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  Les benzodiazépines en ...  
Les benzodiazépines peuvent être administrées à des doses supérieures à une dose équivalant à 10 mg de diazépam dans certains cas, mais les données à cet effet sont limitées.
Benzodiazepines may be used in higher than 10 mg diazepam-equivalent doses in some circumstances, but data were limited.
  Les benzodiazépines en ...  
Un examen de l’innocuité et des lignes directrices relatives aux fortes doses de benzodiazépines, ainsi que de la « dose prudente » — dose au-delà de laquelle une évaluation plus poussée et une surveillance plus étroite du patient s’imposent — pourrait permettre de trouver cet équilibre.
There is a need to balance the usefulness of benzodiazepines with the risk of side effects. A review of the safety and guidelines of high-dose benzodiazepines, and of “watchful dosing” — a dose, above which closer assessment and monitoring of patients is required — may help to strike that balance.
  The Use of OxyNEO® and...  
La préparation à libération contrôlée (OxyContin CR) contient une plus grande quantité d’oxycodone (5 mg à 80 mg) que la préparation à libération rapide (Oxy IR, 5 mg à 20 mg), de sorte que l’intervalle entre les doses est plus long.
Oxycodone is an opioid analgesic, with an abuse liability similar to that of morphine. Controlled-release formulations (OxyContin CR) contain more oxycodone (5 mg to 80 mg) than immediate-release formulations (Oxy IR, 5 mg to 20 mg) to allow for less frequent dosing. When the controlled-release tablet is swallowed whole, some oxycodone is released immediately; the rest is released into the body slowly due to a protective coating. However, if the tablet is chewed, crushed, or dissolved, the medication is released all at once. This may happen accidentally, or deliberately to achieve a euphoric high. OxyNEO is a new controlled-release formulation (10 mg to 15 mg) designed to reduce misuse. If OxyNEO is crushed and added to water, it becomes a thick, gel-like substance, which is difficult to inject.
  Comparaison des médicam...  
On n’a noté aucune différence statistiquement significative entre les deux doses utilisées dans l’essai sur Rebif (6 et 12 milli-unités internationales [mUI]). Comme les différences d’effet observées entre ces doses ne sont pas statistiquement significatives, le coût plus élevé du traitement faisant appel à la dose de 12 mUI (environ 21 000 $), comparativement à la dose de 6 mUI (environ 17 000 $), n’est sans doute pas justifié.
There is no statistically significant difference between the two doses used in the Rebif® trial (6 vs. 12 MIU). Since the differences in effect between the doses are not statistically significant, the higher premium for the 12 MIU dose (approximately $21,000) vs. 6 MIU (approximately $17,000) is probably not justified.
  Comparaison des médicam...  
Cependant, les divergences en ce qui concerne les paramètres d’évaluation utilisés dans les essais, la définition de ces paramètres, les caractéristiques des patients admis aux essais et les doses utilisées (pour les interférons) rendent difficile toute évaluation comparative des produits.
All of the products now appear to have evidence that they impact the progression of the disease. However variations in endpoints, definition of endpoints, patient characteristics, and differences in doses (for the interferons) make any comparative evaluation difficult.
  Comparaison des médicam...  
On n’a noté aucune différence statistiquement significative entre les deux doses utilisées dans l’essai sur Rebif (6 et 12 milli-unités internationales [mUI]). Comme les différences d’effet observées entre ces doses ne sont pas statistiquement significatives, le coût plus élevé du traitement faisant appel à la dose de 12 mUI (environ 21 000 $), comparativement à la dose de 6 mUI (environ 17 000 $), n’est sans doute pas justifié.
There is no statistically significant difference between the two doses used in the Rebif® trial (6 vs. 12 MIU). Since the differences in effect between the doses are not statistically significant, the higher premium for the 12 MIU dose (approximately $21,000) vs. 6 MIU (approximately $17,000) is probably not justified.
  Le sevelamer dans l’ins...  
On pourrait croire que les chélateurs des phosphates classiques (à base de calcium) ne conviennent pas chez tous les patients pour maîtriser l’hyperphosphatémie en raison de difficultés théoriques associées à leur usage et de l’hypercalcémie limitant les doses.
Traditional (calcium-based) phosphate binders may not be perceived as suitable for controlling hyperphosphatemia in all patients because of theoretical concerns about their use, and dose-limiting hypercalcemia. Sevelamer is the first non-calcium-based phosphate binder to receive Health Canada approval. Given a large differential cost between this new agent and traditional therapies, the appropriate use of this new therapy requires examination.
  Le sevelamer dans l’ins...  
Le financement du sevelamer exigera des ressources supplémentaires. Aux doses quotidiennes habituelles, la différence de coût par patient entre le carbonate de calcium et le sevelamer est de 4127 $ par année.
Funding sevelamer will require additional resources. The difference in cost per patient between calcium carbonate and sevelamer at usual daily doses is $4,127 annually. Substituting sevelamer for calcium carbonate for all patients with ESRD in Canada would increase expenditures by $70,620,616 annually. Restricting access to those ≥65 years old, or based on biochemical criteria, results in increased expenditures between $14,712,628 and $36,016,514.
  Comparaison des médicam...  
Bien que le prix de ces médicaments soit comparable, la méthodologie utilisée dans les divers essais cliniques (surtout en ce qui concerne les critères d’admission des patients, les paramètres évalués et les doses administrées) varie considérablement d’un essai à l’autre, de sorte qu’il est impossible de tirer des conclusions définitives sur la comparaison de ces produits.
This rapid assessment brings together the major studies involving the four drugs available in various countries for the treatment of MS: Avonex® (interferon beta 1-a), Rebif® (interferon beta 1-a), Betaseron® (interferon beta 1-b), and Copaxone® (glatiramer acetate or copolymer 1) (Tables 1 and 2). Although these drugs are priced similarly, clinical trial methodology (in particular inclusion criteria, outcome measures, and doses used) have been sufficiently different that definitive conclusions as to their comparability cannot be made.
  Rapports d’examen rapid...  
Injectable Prolonged Release Risperidone Administration: Safety of Combining Doses
Point of Care Urinalysis in the Emergency Department: Clinical and Cost- Effectiveness
  Sujets portant sur... |...  
Quelles sont les données probantes ? Associations et fortes doses d’antipsychotiques atypiques contre la schizophrénie (
Cannabinoids for the Treatment of Post-Traumatic Stress Disorder: A Review of the Clinical Effectiveness and Guidelines (
  Rapports d’examen rapid...  
Different Doses of Meropenem in Adult Patients in the Hospital: Clinical Effectiveness
Vibration Therapy for Adults: Clinical Effectiveness
  Rapports d’examen rapid...  
What is the clinical effectiveness of disposable mucosal atomization devices for the administration of benzodiazepines? Is there evidence supporting accuracy of atomized doses with benzodiazepines of different viscous states and other physical properties?
What is the clinical effectiveness of using 5/8 inch and 1 inch needles for intramuscular and subcutaneous immunization of children? What are the guidelines associated with use of 5/8 inch and 1 inch needles for intramuscular and subcutaneous immunization of children?
  Antipsychotiques atypiq...  
8. Agence canadienne des médicaments et des technologies de la santé. Atypical antipsychotics for schizophrenia: combination therapy, high doses, and clozapine - current practice study. Ottawa: ACMTS; 2011.
8. Canadian Agency for Drugs and Technologies in Health. Atypical antipsychotics for schizophrenia: combination therapy, high doses, and clozapine - current pracitce study. Ottawa: CADTH; 2011. (CADTH optimal use report). Forthcoming.
  Antipsychotiques atypiq...  
9. Agence canadienne des médicaments et des technologies de la santé. Atypical antipsychotics for schizophrenia: combination therapy and high doses -- project protocol [Internet]. Ottawa: ACMTS; 2011.
9. Canadian Agency for Drugs and Technologies in Health. Atypical antipsychotics for schizophrenia: combination therapy and high doses -- project protocol [Internet]. Ottawa: CADTH; 2011. [cited 2011 Sep 7]. (CADTH optimal use report; vol. 1, no. 1a). Available from: http://www.cadth.ca/media/pdf/H0503_atypical_antipsych_protocol_o-u_e.pdf
  Considérations d’ordre ...  
Les écarts au traitement de référence de trois jours (c.-à-d. augmentation des doses ou prolongation de la médication) se traduisaient par un accroissement du coût différentiel des fluoroquinolones par rapport au TMP-SMX.
Deviations from the base case 3-day treatment regimen (i.e. higher doses or longer durations of therapy) increased the incremental cost of fluoroquinolones relative to TMP-SMX.
  Utilisation appropriée ...  
Il s’agit d’un programme facultatif d’examen et d’évaluation par les pairs du personnel, du rendement de l’équipement, des programmes d’assurance et de contrôle de la qualité, de la qualité des images, des doses utilisées et du contrôle de la qualité du traitement des images100.
. The purpose of the report was to establish appropriate fees for the Medicare Benefits Schedule and review current funding arrangements for different diagnostic imaging modalities, as well as develop alternatives to fee-for-service funding mechanisms.56
  Rapports d’examen rapid...  
La prise prolongée de doses d’acétaminophène de plus de 2000 mg par jour pourrait être associée à un risque accru d’événements gastro-intestinaux, de toxicité hépatique et de dysfonctionnement rénal ou d’insuffisance rénale.
Based on this review, both codeine and acetaminophen/codeine provide better chronic pain relief than placebo. Chronic use of acetaminophen at doses higher than 2000 mg per day may be associated with increased risk of gastrointestinal events, liver toxicity, and renal dysfunction or failure. This review found evidence of increased risk of adverse events for patients treated with codeine or acetaminophen/codeine combination products compared to placebo. Acetaminophen/codeine treatment for post-operative pain was found to be associated with a higher risk of adverse events compared to placebo. No evidence was found on relative safety of different doses of either codeine or acetaminophen/codeine combination products.
  L’infliximab dans le tr...  
Les résultats révèlent que la perfusion d'infliximab, à raison de 5 mg ou de 10 mg/kg aux semaines 0, 2 et 6 est d'efficacité supérieure à celle de la perfusion de placebo dans la fermeture partielle (62 % c. 26 %; p=0,002) ou complète (46 % c. 13 %; p=0,001) des fistules après une période de 18 semaines. On ne constate pas d'écart notable de réponse entre les doses, quoique la dose de 5 mg/kg amène un taux de fermeture numériquement plus élevé.
For the treatment of fistulizing CD, one controlled clinical trial has been reported and another is underway. Three infusions of infliximab (5 or 10 mg/kg) at Weeks 0, 2 and 6 were superior to placebo in achieving partial (62% vs. 26%, p=0.002) and complete (46% vs. 13%, p=0.001) closure of fistulas over 18 weeks. No significant dose response was observed, although numerically higher closure rates were seen with 5mg/kg.
  Utilisation appropriée ...  
calcul des doses de rayonnement pour communication possible
bismuth shields to partially block radiation
  Rapports d’examen rapid...  
5. Quelles sont les données probantes cliniques sur l’innocuité de diverses doses des produits contenant l’association codéine-acétaminophène ?
5. What is the clinical evidence on patient safety associated with different doses of codeine/acetaminophen combination products?
  Antipsychotiques atypiq...  
La comparaison entre les essais cliniques est difficile en raison de la diversité des doses et des antécédents médicaux des participants; notons que les doses et les traitements antérieurs ne sont pas mentionnés pour la plupart.
It was difficult to compare across trials because of differences in dosing and because the RCTs included patients with various treatment histories — often, dosing levels and treatment history were not reported. There was also heterogeneity in reported outcomes (e.g., different definitions for inadequate control) and lack of data on many clinically important outcomes. In particular, there was insufficient evidence available for mortality, hospitalizations, relapse rates, suicidality, health-related quality of life, level of function, and long-term adverse effects of combination or high-dose antipsychotic use. PANSS and CGI were the primary efficacy outcomes reported in the majority of included RCTs; however, the relationship between the change in PANSS score and long-term clinical outcomes has not been well-established.42
  Antipsychotiques atypiq...  
La comparaison entre les essais cliniques est difficile en raison de la diversité des doses et des antécédents médicaux des participants; notons que les doses et les traitements antérieurs ne sont pas mentionnés pour la plupart.
It was difficult to compare across trials because of differences in dosing and because the RCTs included patients with various treatment histories — often, dosing levels and treatment history were not reported. There was also heterogeneity in reported outcomes (e.g., different definitions for inadequate control) and lack of data on many clinically important outcomes. In particular, there was insufficient evidence available for mortality, hospitalizations, relapse rates, suicidality, health-related quality of life, level of function, and long-term adverse effects of combination or high-dose antipsychotic use. PANSS and CGI were the primary efficacy outcomes reported in the majority of included RCTs; however, the relationship between the change in PANSS score and long-term clinical outcomes has not been well-established.42
  Rivaroxaban for the Tre...  
Comme la fourchette des doses efficaces et sans danger est étroite et comme la réponse peut être très différente d’un patient à l’autre, il faut faire régulièrement des tests de laboratoire pour surveiller l’anticoagulation.
The usual treatments for DVT include unfractionated heparin (UFH), low molecular-weight heparin (LMWH), and warfarin (or other vitamin K antagonists). There are limitations to these treatment options. The dose ranges at which the drugs are safe and effective are small and the response of patients to the drugs can be very different, so regular laboratory tests to monitor anticoagulation are required. Both types of heparin can only be given by injection. Vitamin K antagonists such as warfarin have a slow onset of action and interact with different foods and medications.
  Rapports d’examen rapid...  
4. Quelles sont les données probantes cliniques sur l’innocuité de diverses doses d’acétaminophène ?
4. What is the clinical evidence on patient safety associated with different doses of acetaminophen?
  Rapports d’examen rapid...  
3. Quelles sont les données probantes cliniques sur l’innocuité de diverses doses de codéine ?
3. What is the clinical evidence on patient safety associated with different doses of codeine?
  Antipsychotiques atypiq...  
Dans les études dont la population est adulte, la durée de la maladie au moment de l’étude va de 711 à 2212 ans (moyenne pondérée de 15,6 et écart-type [ET] de 4,8). Les essais cliniques étudient une vaste gamme de doses.
Of the 30 included RCTs, only one10 was conducted in adolescents (aged 10 to 18 years). Baseline duration of illness for the adult studies ranged from 711 to 2212 years (weighted mean [SD] 15.6 [4.8]). A broad range of antipsychotic doses were used in the included trials. Common outcome measures included schizophrenia symptom scales (e.g., Positive and Negative Symptoms Scale [PANSS], Brief Psychiatric Rating Scale [BPRS] scores, Clinical Global Impression [CGI]), response rate, cognition, withdrawals, and serious adverse events. No evidence was available for relapse or remission rates.
  Rapports d’examen rapid...  
Les données probantes laissent croire qu’à doses égales, la rosuvastatine réduit davantage le taux de LDL que les autres statines, mais qu’avec un bon réglage de leur posologie, les diverses statines produisent des réductions équivalentes du taux de LDL.
Evidence suggests that rosuvastatin has the most potent per milligram LDL lowering effect but with appropriate dosage adjustments different statins can provide equivalent LDL reductions. Data suggests similar effects on HDL, TG and CRP with rosuvastatin compared with other statins. Based on the identified literature, there is no significant difference in rates of adverse events between rosuvastatin and other statins.
  Facteurs de risque à  c...  
La fourchette de doses efficaces et sûres est restreinte et la réponse du patient peut varier, d’où la nécessité de surveiller l’anticoagulation à intervalles réguliers par une analyse sanguine en laboratoire.
The usual treatments for VTE include unfractionated heparin (UFH), low–molecular-weight heparin (LMWH), and warfarin (or other vitamin K antagonists). However, there are limitations to these treatment options. The dose ranges at which the drugs are safe and effective are small and the response of patients to the drugs can vary, so regular laboratory tests to monitor anticoagulation are required. Both types of heparin can only be given by injection. Vitamin K antagonists such as warfarin have a slow onset of action, and interact with different foods and medications. Three novel oral anticoagulants (NOACs) — rivaroxaban, dabigatran, and apixaban - are available in Canada. These agents are direct factor Xa or direct thrombin inhibitors that have a more predictable effect on anticoagulation. Rivaroxaban has been approved in Canada for the prevention of VTE in patients undergoing elective total hip replacement or total knee replacement, and the treatment of DVT without symptomatic PE.
  Les antithrombotiques d...  
Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial.
39. Eikelboom JW, Wallentin L, Connolly SJ, Ezekowitz M, Healey JS, Oldgren J, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation [Internet].
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