Current practice guidelines in primary care - part 6

Tiền mãn kinh / sau mãn kinh • Xác định và điều trị thiếu hụt cảm giác, thần kinh bệnh - viêm khớp, tất cả đều có thể dẫn đến ↑ tần số ngã • Điều chỉnh liều lượng thuốc cho thuốc mà là gây ngủ, phản xạ chậm, ↓ phối hợp & làm suy yếu khả năng để phá vỡ tác động của một người của một mùa thu | DISEASE PREVENTION OSTEOPOROTIC HIP FRACTURE 103 OSTEOPOROTIC HIP FRACTURE PREVENTION FOR WOMEN AT RISK 1. COUNSEL ON 2. IDENTIFY AND REMEDY Tobacco cessation SECONDARY CAUSES Limit alcohol intake see table page 77 Regular weight-bearing exercise 30 min. 3x week Muscle strengthening exercise Adequate Ca2 intake 1 000-1 200 mg day Adequate vitamin D 800 IU day 1 1 1 PERIMENOPAUSAL POST-MENOPAUSAL ELDERLY Identify and treat sensory deficits See perimenopausal neurologic disease arthritis postmenopausal all of which can lead recommendations in to T frequency of falls addition Adjust drug dosages for drugs that Anchor rugs are sedating slow reflexes Minimize clutter ị coordination impair a person s Remove loose wires ability to break impact of a fall Use non-skid mats Gait balance training to ị risk of falls Add handrails in halls Identify and treat with osteoporosis-related bathrooms stairwells fractures and those with low bone mass. Ensure adequate lighting in halls stairwells entrances Wear sturdy low-heeled shoes Source Adapted from AACE clinical practice guidelines for the prevention treatment of postmenopausal osteoporosis. Endocrine Practice 2003 9 6 545-564 See page 76 for description of risks. Disease Prevention Organization Date Population Recommendations Comments Source STROKE Stroke AHA ASA 2006 Hypertension Screen and treat in accordance with JNC VII pages 142-144 . http www. Stroke 2006 37 1583-1633 ACP 2003 Atrial fibrillation Prioritize rate control de-emphasize rhythm. 1. Average stroke rate in patients with risk factors about 5 per year. 2. Meta-analysis Adjusted-dose warfarin and antiplatelet agents reduce absolute risk of stroke adjusted dose warfarin vs. placebo or no treatment absolute risk reduction per year NNT 37 antiplatelet agents vs. placebo or no treatment absolute risk reduction per year NNT 125 adjusted-dose warfarin vs. antiplatelet therapy absolute risk reduction per year NNT 111 . Risk of intracranial .