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Compiling a complete medical history
It is critical to obtain a coherent medical history, yet older patients are often vexing historians, presenting unique challenges. The roots of these challenges are complex, and must be understood to be effectively managed. A complete history is essential in the construction of a differential diagnosis, and avoiding drug-drug interactions.
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Choosing an antiepileptic: Selecting drugs for older patients with epilepsy
After age 65, the incidence of epilepsy increases rapidly. Approximately 1.5% of Medicare recipients and 10% of nursing home residents are being treated with antiepileptic drugs (AEDs). The most commonly used AED is phenytoin, a first generation agent. Appropriate drug selection in this population is complicated by the fact that multiple comorbidity is commonplace.
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Osteoporosis in postmenopausal women: Therapy options across a wide range of risk for fracture
Fractures related to osteoporosis are frequently associated with chronic pain and decreased quality of life, as well as significant morbidity and mortality. Postmenopausal women are at higher risk for developing osteoporosis and osteoporosis-related fractures. Osteoporotic fractures are commonly asymptomatic, necessitating a need for proactive screening, diagnostic testing, and more importantly, therapeutic intervention that will rapidly reduce the risk of fractures in at-risk patients.
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