What’s New 3rd Quarter
July 2001

Here is a description of what's new in the PATIENT ED® system for July 2001. This quarter’s update gives you new medical content, and a new User Guide.

 

A complete report of all revisions is available in electronic form on the PATIENT ED® CD-ROM. Choose "What’s New" from the Welcome screen that appears after you put the PATIENT ED® CD into your CD-ROM drive.


New Medical Content


This quarter’s update includes 40 new templates and 17 new instruction elements. We added 16 new illustrations and 43 new medications.


Our policy is to completely review any template over 2 years old. For this release we completely revised and updated 85 templates and made minor changes to 134 more. We also revised dose forms or brand names for 15 medications. We revised the patient information for 112 medications.

 

A complete report of all the new medical content appears below.


After you install this update, all of the new drugs and guideline templates will be available to you, except for those templates you have customized. If you have personalized any guideline templates, some of the new revised templates may be "hidden" by the customizations you've made. After you install this update, the Setup program will generate a report of any personalized templates on your system that may be "hiding" new content. You may want to review the changes we have made to those templates, and consider deleting or manually updating your personalized versions of them.

 

To delete a personalized version of a template, start and sign onto the PATIENT ED® Editor.

  • From the File menu, choose Delete EduCare Template. The Select EduCare Template form appears.

  • Select the template you want to delete using the QuickLists just as you do in the Patient Ed® Provider application.

  • In most cases, you will see a message confirming deletion of your personal template.

  • If you have Site Author permission and there is a customized site version of the chosen template, you will see the Select Template Version form. This form displays a list of all existing versions of the chosen template. Select the version of the template you want to delete and choose OK. You will need to delete all versions of the template, including any site version, in order to have all your providers see all of the new medical content.

To delete additional customized versions of templates, repeat the steps above. For more information on deleting templates, see the Help file in the PATIENT ED® Editor.


New Guideline Templates

Angina pectoris, unstable

Cervical cancer

Cervical cancer screening

Cervicitis

Cesarean section

Chronic pain

Contusion, finger

Crushing injury, finger

Dermatitis, perioral

Diarrhea, traveler's

Dyspareunia, older adult

Dysthymia

Falls, older adult

Glaucoma, acute

Hammertoe

Hormone replacement therapy, overview

Hyperemesis gravidarum

Hypertension, pregnancy-induced

Hypertension, reactive

Hypertension, systolic

Hypertension, with diabetes

Hypertension, with heart failure

Hypothermia, older adult

Meningitis, bacterial

Meningitis, viral

Morning sickness

Nipple soreness, breast-feeding

Obsessive-compulsive disorder, adult

Peripheral vascular disease, in diabetes

Pilonidal abscess

Placenta previa

Placental abruption

Pre-eclampsia

Pregnancy, multiple

Proctalgia fugax

Pruritus vulvae

Psychosis, unspecified

Rh incompatibility

STDs, unspecified, empiric treatment

Urethral syndrome


New Instruction Elements

 

These are new Home Care instruction elements. They have been included in some of the new templates (listed above) and added to existing templates (listed as revised templates below) as seemed appropriate by the medical staff at Medifor. Like all instruction elements, these are available in the PATIENT ED® Editor for your use in customizing any template.


Black cohosh, using

Cholesterol screening

Diet, Mediterranean

Diet, Therapeutic Lifestyle Changes (TLC)

Food safety, food prep and storage

Ginseng, using

Head injury, neuro checks, adult

Headaches, frequent

Hypothermia prevention, older adult

Kava, using

Mood swings

Neuroleptic malignant syndrome

Proteinuria check, specified

Proteinuria precaution

Scoliosis brace

Tardive dyskinesa

Toe extension stretches


New Illustrations

 

We have added 16 illustrations to the appropriate new templates. Like all instruction elements, these are available in the PATIENT ED® Editor for your use in customizing any other template.


Achilles tendon

Ankylosing spondylitis

Asthma airway

Birth stages

Computer ergonomics

Elbow, anterior, w/bursa

Elbow, anterior, w/ligaments

Elbow, lateral, w/ ligaments

Ganglion

Hiatal hernia

Intussusception

Knee cruciate ligaments and menisci

Osteitis pubis

Placenta previa

Placental abruption

Toenail trimming, ideal


New Medications

 

abacavir sulfate/lamivudine/zidovudine (Trizivir)

aminoglutethimide (Cytadren)

anisindione (Miradon)

azelastine hcl ophthalmic (Optivar)

bimatoprost (Lumigan)

3% calamine, 1% pramoxine, 0.3% camphor (Aveeno Anti-itch)

cefepime hcl (Maxipime)

cefotaxime (Claforan)

clindamycin/benzoyl peroxide (Benzaclin)

colloidal oatmeal (Aveeno)

cosyntropin (Cortrosyn)

diclofenac gel (Solaraze)

esomeprazole magnesium (Nexium)

formoterol fumarate (Foradil Aerolizer)

galantamine hydrobromide (Reminyl)

Human insulin aspart (Novolog)

hydrocortisone sodium succinate (Solu-Cortef)

interferon alfacon-1 (Infergen)

lanolin, hydrous

Letrozole (Femara)

levonorgestrel-releasing intrauterine system (Mirena)

lidocaine plus epinephrine inj

lopinavir/ritonavir (Kaletra)

mannitol

medroxyprogesterone acetate/estradiol cypionate (Lunelle)

metyrapone (Metopirone)

mitotane (Lysodren)

nateglinide (Starlix)

nitroglycerin IV

petrolatum, PPG-2 myristyl ether propionate, glyceryl stearate, glycerin, simethicone, benzyl alcohol, silica, EDTA, sodium carbomer 1342 (DML Forte)

octreotide acetate (Sandostatin/Sandostatin LAR Depot)

pyrithione zinc (Zincon)

phytonadione (Aquamephyton/Mephyton)

25% sodium thiosulfate, 1% salicylic acid, 10% isopropyl alcohol, menthol, propylene glycol, EDTA, colloidal alumina (Versiclear)

Tacrolimus (Protopic)

telmisartan/hctz (Micardis HCT)

testolactone (Teslac)

testosterone pellets (Testopel)

testosterone propionate

3572 travoprost (Travatan)

vitamin E topical oil

zinc sulfate

ziprasidone hcl (Geodon)


Revised EduCare Templates™ All of the following have updated references and revised Q&A sections. Revisions were also made to other sections as noted.

Template name

Change(s)

Abnormal pap

Alcohol abuse

Meds: Added fluoxetine, carbamazepine, BuSpar, multivitamins, Provider guidelines changed for propranolol and atenolol

Home treatment: Added 325 Diet, normal to Diet

Followup: Added counselor, psychiatrist

Amenorrhea, secondary

Precautions: Added 246 Lower abd pain to Call

Illustrations: Add 166 Female repro anterior

Anemia, pernicious

Home treatment: Added 352 Vegetarian high protein, 1474 Vegan eating guidelines, 122 Vitamin use to Diet

Precautions: Changed default on 620 Symptoms not improved to 3 weeks; added 806 Paresthesia, 176 vision blurred, 243 Diarrhea, and 279 rash to Call

Angina pectoris, stable

Precautions: Added 205 Loss of consciousness, 739 TIA/Stroke to Urgent

Illustrations: Added 69 Angioplasty, 70 Atherosclerotic plaque formation, 71 coronary bypass

Aortic stenosis, adult

Meds: Added digoxin and furosemide, rheumatic fever prophylaxis, endocarditis dental prophylaxis

Asthma acute episode adult

Meds: Added Albuterol solution for neb, Xopenex, Proventil HFA, Maxair, Tornalate, Atrovent inhaler and soln for neb, and Aerochamber

Precautions: Added 298 Fever, call to Call

Asthma exertional adult

Meds: Added Proventil HFA, Maxair, Tornalate, Brethaire, Serevent inhaler and discus, Foradil and Tilade

Illustrations: Added 244 Asthma airway

Asthma exertional child

Meds: Added Maxair, Tornalate, Brethaire, Serevent, Serevent discus, Foradil, and Tilade

Illustrations: Added 244 Asthma airway

Asthma mild intermittent adult

Meds: Added Maxair, Tornalate, and Brethaire

Home treatment: Added 127 Influenza vaccine, 1228 Influenza vaccine recommended 

Illustrations: Added 244 Asthma airway

Asthma mild persistent adult

Meds: Added Maxair, Tornalate, Brethaire, Foradil, Azmacort, Aerobid-M, Advair, Intal, Tilade, Singulair, Accolate, Zyflo, and Aerochamber

Home treatment: Added 127 Influenza vaccine

Illustrations: Added 244 Asthma airway

Asthma mild persistent child

Meds: Added Albuterol solution for neb, Xopenex, Maxair, Tornalate, Serevent discus, Foradil, Beclovent, Azmacort, Aerobid M, Flovent, Pulmicort Turbuhaler, Pulmicort Respules, Advair, Intal, Cromolyn soln for neb, Tilade Inhaler, Singulair, Accolate and Zyflo

Illustrations: Added 244 Asthma airway

Asthma moderate, child

Meds: Added Foradil, Advair, Combivent, and DuoNeb

Home treatment: Added 127 Influenza vaccine

Illustrations: Added 244 Asthma airway

Asthma, moderate, adult

Meds: Added Foradil Aerolizer, ADVAIR DISKUS, COMBIVENT, several provider guidelines

Home treatment: Added 127 Influenza vaccine

Illustrations: Added 244 Asthma airway

Asthma, severe, adult

Meds: Added Foradil Aerolizer, ADVAIR DISKUS, COMBIVENT, several provider guidelines

Home treatment: Added 127 Influenza vaccine

Illustrations: Added 244 Asthma airway

Atrial fibrillation, chronic

Home treatment: 981 Exercise, aerobic, limited; 1265 Exercise options, seniors; 1312 DASH diet; 576 Alcohol limit, specified; 722 Low fat, specified; 1424 Magnesium supplement, diet, general

Precautions: Added 739 TIA/Stroke precaution to Emergent; moved 984 Tachycardia to Emergent; moved 239 Blood in Stool to Call; Added 767 Dyspnea and 593 Headache, severe to Urgent; added 1247 Frequent Falls to Call

Bite, cat, face

Meds: penicillin, clarithromycin deleted; added Ceftin, clindamycin, Cipro, TMP/SMZ; doxycycline changed med note

Home treatment: Added 519 sun protection, wound, temporary; 1513 Aloe vera topical; 1521 Vitamin E topical; 1269 Wound care adhesive closure

Precautions: Added 298 Fever, call and 724 Fever, call, child to Call

Bradycardia, adult

Precautions: Moved 205 Loss of Consciousness, 210 Dyspnea to Urgent

Bronchitis acute adult

Meds: Added trimethoprim/sulfamethoxazole, and amoxicillin

Bursitis, elbow

Illustrations: Added 245 Elbow, anterior w/bursa

Cat scratch disease

Precautions: Added 823 Cellulitis and 879 Cellulitis, child to Urgent; added 242 Vomiting, adult to Call

Congestive heart failure

Meds: Added dosing range for ACE inhibitors, hydralazine, new sig and dose form for isosorbide monohydrate

Conjunctivitis, allergic

Precautions: Added 175 Eye Pain to Call

Conjunctivitis, viral

Home treatment: Added 379 Learn to use eye ointment

Depression, major, adult

Meds: Added fluvoxamine

Home treatment: Added 678 Exercise, stress reduction; 1527 Ginseng, using; 1531 Kava, using

Precautions: Added 1532 Mood Swings to Call

Depression, post-partum

Meds: Added Celexa, Zoloft, Paxil, Prozac. Effexor, Wellbutrin, Remeron, Serzone, trazodone, amitriptyline, nortriptyline, BuSpar, lorazepam, clonazepam, diazepam, Ambien, and Sonata
Home treatment: Added 696 stress reduction
Followup: Added counselor, psychiatrist

Dermatitis, contact, unspecified Meds: added Halog, Psorcon, Cyclocort, Cutivate, Hydrocortisone 2.5%, Desonide, Celestone Soluspan, Triamcinolone 40 mg/ml inj, Aveeno, Cetaphil, Eucerin, Aquaphor, DML Forte
Diabetes mellitus, followup, adult

Meds: Added Cholesterol lowering agents and NCEP guidelines

Home treatment: Added 139 Aspirin for CHD to Medication use; 1265 Exercise options older adults, 981 Exercise aerobic, and 123 Stop smoking to Diet; 91 Low fat low cholesterol, 325 Diet normal, 1525 Diet Mediterranean, 1539 TLC diet to Diet; 127 Influenza, 129 Pneumococcal to Immunizations; 685 Dental care, 74 Foot care toenails, 73 Foot care shoes, 326 Foot care infection prevention, 1422 Foot care inspection to Physical measures; Added 1524 Cholesterol screening

Precautions: Moved to Urgent: hypoglycemia

Followup: Added ophthalmologist

Illustrations: Added 238 Toenail trimming ideal

Diabetes mellitus, type 1, adult

Q&A: added new paragraph

Meds: Added Cholesterol lowering agents and NCEP guidelines

Home treatment: Added 325 Diet normal 1525 Diet Mediterranean, and 1539 Diet TLD to Diet; 123 Stop smoking to Activity; 74 Foot care, cutting toenails, 73 Foot care, shoes, 326 Foot care, infection prevention, and 1422 Foot inspection vascular disease to Physical Measures; 127 Influenza shot, 128 Pneumococcal vaccine, and 685 Dental care to Health Maintenance; 1524 Cholesterol screening

Illustrations: Added 238 Toenail trimming ideal

Diabetes mellitus, type 2

Q&A: added new paragraph

Meds: Added Cholesterol lowering agents and NCEP guidelines

Home treatment: Added to Diet: 325, normal, 1525 Diet Mediterranean, 1539 Diet TLC. To Lifestyle Modifications: 123 Stop smoking. To Physical measures: 74 Foot care, cutting toenails; 73 Foot care, shoes; 326 Foot care, infection prevention; 1422 Foot inspection, vascular disease. To Health Maintenance: 685 Dental care; 127 Influenza shot; 128 Pneumococcal vaccine, 1524 Cholesterol screening

Followup: Added: Ophthalmologist to help us treat you

Illustrations: Added 238 Toenail trimming ideal

Diarrhea, acute non-bloody, adult

Home treatment: Added 1030 Dairy products, avoid

Precautions: Added 316 Syncope to Urgent; 242 Vomiting to Call

Diarrhea, chronic, adult Home treatment: Added 1030 Dairy products, avoid
Diarrhea, chronic, child Home treatment: Added 1339 ORT no dehydration, 1340 ORT mild dehydration, 1444 Diet post-ORT child, 1445 Diet post-ORT infant, 1030 Dairy avoid specified
DUB child-bearing years

Home treatment: Changed Pap test default to 2 years; added 1504 Pregnancy test return

Precautions: Added 273 Vaginal discharge abnormal, 795 Menstrual period missed, 271 Menorrhagia, 502 Menorrhagia not better, 286 Pallor to Call; moved 172 Dizziness to Urgent

Illustrations: Added 48 Female repro sag, 166 Female repro anterior

DUB, premenopausal

Home treatment: Added 96 High Fiber to diet

Precautions: Added 205 Loss of consciousness to Urgent; added 201 Weakness, 286 pallor, 172 Dizziness, 568 Weakness worse, and 569 Weakness not better 1 week to Call Illustrations: Added 48 Female repro sag

Dysfunctional uterine bleeding pubertal Illustrations: Add 166 Female repro anterior
Dysmenorrhea, primary Meds: Added a new guideline for oral contraceptives; added Lo-Ovral, Microner, Depo-Provera and deleted danazol Illustrations: Added 48 Female repro sag, 166 Female repro anterior
Dyspareunia Meds: Added lubricating jelly 60 gm tube use vaginally as needed
Illustrations: Add 166 Female repro anterior
Fibrocystic breast disease Meds: Added Danazol, magnesium gluconate, Genora 1/50, Genora 1/35, Demulen 1/35, Lo-Ovral, Loestrin, Levlen, Desogen, Ortho-Cyclin, and Estrostep  
Home treatment: Deleted 50 Apply cold compress, added 1500 Cold compress for inflammation
Illustrations: Added 84 breast exam
Gastritis, acute Meds: Added Protonix, Cytotec, Helicobacter Pylori treatment- Prevpak, Helidac Therapy, Tritec, Biaxin, Metronidazole, Prilosec, Prevacid, Tetracycline, Amoxicillin, bismuth subsalicylate, Tricyclic Antidepressants- imipramine, amitriptyline, and Nexium. Added Pepcid warnings
Home treatment: Deleted 743 Low sugar, 92 Low sodium general from Diet; added 325 Diet, normal
Precautions: Added 298 Fever, call to Call
GERD adult Meds: Added Protonix, Mylanta susp, Gaviscon chewable, Nexium, and new Pepcid warnings
Home treatment: Added 138 Weight, ideal, BMI-based
Precautions: Moved 387 Angina, new to Emergent
Illustrations: Added 237 Hiatal hernia
Gonorrhea, female Meds: Added Suprax, Rocephin, Cipro, Floxin, Zithromax, doxycycline, erythromycin; deleted spectinomycin
Precautions: Deleted Toxic shock from Urgent
Illustrations: Add 166 Female repro anterior
Gynecomastia

Meds: Added tamoxifen, anastrozole, and testolactone

Headache, unspecified Meds: Added ketoprofen, Ketorolac, Ultram, Percocet, Zyrtec, Drixoral, Allegra-D and deleted brompheniramine/phenylpropanolamine.
Precautions: Added 1529 Headaches frequent adult
Hearing loss, neural Meds: Added prednisone
Precautions: Added 300 Symptoms, worse and 1056 Symptoms, new to Call
Followup: Added audiologist
Hepatitis, B Meds: Deleted prochlorperazine 10 mg tablets #12 Take 1 three times daily
Home treatment: 1232 Hepatitis B, control spread MOVED to Infection control; added 91 Low fat diet to Diet
Precautions: Added 205 Loss of consciousness and 195 Confusion to Urgent
Hormone replacement therapy, followup Meds: Added Fosamax, Evista, Actonel, Lipitor, Zocor, Pravachol, Lescol, Baycol and NCEP guidelines for prevention of CAD
Home treatment: added 123 Stop smoking; 1523 black cohosh
Hormone replacement therapy, perimenopause Meds: Added estropipate, esterified estrogens, Cenestin, Prometrium, Fosamax, Evista, Actonel, Lipitor, Zocor, Pravachol, Fluvastatin, Baycol and NCEP guidelines for prevention of CAD
Home treatment: Added 1523 Black cohoshPrecautions: Deleted precautions for children
Followup: Deleted references to "your child"
Hormone replacement therapy, post-menopausal Meds: Added Fosamax, Evista, Actonel, Lipitor, Zocor, Pravachol, Lescol, Baycol and NCEP guidelines for prevention of CAD
Home treatment: Added 1523 Black cohosh
Followup: Added referral to dietitian
Hormone replacement therapy, postsurgical

Home treatment: Added 1523 Black cohosh

Hypotension, orthostatic, older adult Meds: fludrocortisone changed sig + guideline; midorine changed sig + guideline; DDAVP guideline; ephedrine guideline; added indomethacin, ibuprofen, Effexor, clonidine, propranolol, pindolol, nadolol, atenolol
Precautions: Added 239 Blood in Stool to Call
Infertility, female Home treatment: Added 123 Stop Smoking, 1517 Home ovulation kit
Precautions: Added 208 Depression to Call
Illustrations: Added 48 Sagittal female reproductive organs
Low back pain, chronic Precautions: Added 787 Weakness specified (leg)
Followup: Added referral to physical therapy
Mastitis Meds: Added Clindamycin capsules
Home treatment: Deleted 50 Apply cold compress, added 1500 Cold compress for inflammation
Precautions: Added 298 Fever, call to Call
Illustrations: Added 49 Anterior breast
Meningitis, unspecified Home treatment: Added 649 Stay home, child, general
Precautions: Moved 204 Seizures from Urgent to Emergent; added 199 Stiff neck, 434 Confusion worse to Urgent; moved 195 Confusion from Call to Urgent; added 242 Vomiting, adult and 646 Vomiting, child to Call
Menopause, new onset Meds: Added Vitamin E, Cenestin Prometrium, Prempro, Premphase, Activelle, Estratest, Effexor, Clonidine, Belladonna alk/pb; deleted Premarin vag cream and Estraderm, megestrol acetate; added estropipate, esterified estrogens, Fosamax, Evista, Actonel, Lipitor, Zocor, Pravachol, Fluvastatin, Baycol and NCEP guidelines for prevention of CAD
Home treatment: Added 1523 Black cohosh, 1531 kava using, 1524 cholesterol screening
Precautions: Added 387 Angina, new to Emergent; moved 739 TIA/Stroke from Urgent to Emergent; added 254 Dysuria, 265 Incontinence, and 1532 Mood swings to Call
Followup: Added referral to dietitian
Menstrual irregularity childbearing years Home treatment: 1426 PMS Diet
Precautions: Added 246 Lower abd pain to Call
Illustrations: Added 48 Female repro sag
Mitral stenosis ICD9 Codes: Deleted V58.61
Meds: added diuretics, Plavix, endocarditis prophylaxis
Home treatment: Added 1050 SBE prophy, 685 Dental care
Precautions: Added 387 Angina, new to Emergent; 211 Hemoptysis to Urgent; 610 Dyspnea adult, 662 Dyspnea at rest to Call
Nasal fracture

Meds: Added etodolac, ketoprofen, ketorolac, Vicodin and Percocet

Osteoarthritis, back Meds: Added Mobic, misoprostol, glucosamine sulfate, chondroitin sulfate and Vitamin C
Home treatment: Added to Diet: 163 Calcium, increase, 1490 Calcium, nondairy sources, 1520 Vitamin D. Added to Exercises: 981 Exercise aerobic limited, 1265 Exercise options older adult, 1434 Exercise low impact, sore joints
Precautions: Added to Urgent: 1008 Cauda equina. Moved 200 Paresthesia from call to Urgent
Illustrations: Added 61 Anterior spine
Osteoarthritis, general Meds: Added Cytotec, Arthrotec, Zostrix, Mobic, glucosamine sulfate, chondroitin sulfate, vitamin C
Home treatment: Added to exercise: 981 Exercise aerobic limited, 1265 Exercise options older adult, 1434 Exercise options sore joints; added to Diet: 163 Calcium increase, 1490 Calcium nondairy sources, 1520 Vitamin D Precautions: Added to call: 200 Paresthesia
Osteoarthritis, hands Meds: Added: Mobic, misoprostol, glucosamine sulfate, chondroitin sulfate and Vitamin C
Home treatment: Added to Diet: 163 Calcium increase, 1490 Calcium nondairy sources, 1520 Vitamin D
Followup: Added physical therapist
Osteoarthritis, hip Meds: Added: methylprednisolone acetate injection, Mobic, misoprostol, glucosamine, chondroitin sulfate, vitamin C
Home treatment: Added 1520 Vitamin D
Followup: Added referral to orthopedic surgeon
Osteoarthritis, neck Meds: Added Mobic, misoprostol, glucosamine sulfate, chondroitin sulfate and Vitamin C
Home treatment: Added to Diet: 163 Calcium, increase, 1490 Calcium, nondairy sources, 1520 Vitamin D. Added to Exercises: 1399 Neck ROM, 1438 Neck stretches, 1439 Shoulder rolls, 1481 Neck stretch using chair, 981 Exercise aerobic limited, 1265 Exercise options older adult, 1434 Exercise low impact sore joints. Added to Lifestyle modifications: 138 Weight reduction, ideal weight
Precautions: Added 200 Paresthesia (arm) to Urgent
Illustrations: Added 213 Neck ROM, 226 Shoulder rolls, 224 Neck stretch, chair
Ovarian cyst, adult Meds: Added oral contraceptives: Ortho-Novum, Ovral, Norinyl, Loestrin
Home treatment: Changed Pap test default to 1 year
Precautions: Added 205 Loss of Consciousness to Emergent
Illustrations: Added 48 Sagittal female reproductive organs
Perimenopause Meds: Added Fosamax, Evista, Actonel, Lipitor, Zocor, Pravachol, Lescol, Baycol and NCEP guidelines for prevention of CAD
Home treatment: Added 1523 Black cohosh, 1531 kava using, 1527 Ginseng using
Precautions: 1532 Mood swings
Followup: Added referral to dietitian
Pilonidal cyst

Meds: Deleted antibiotics (now in new template Pilonidal abscess)

Pleurisy Meds: Added acetaminophen w/codeine, Vicodin, Percocet and deleted antibiotic section
Precautions: Added 387 Angina, new to Emergent; Moved 521 Pleuritic pain worse and 462 Dyspnea worse to Urgent; added 298 Fever, call to Call
Post-partum exam cesarean Precautions: Added 208 Depression to Call
Illustrations: Add 166 Female repro anterior
Post-partum exam vaginal

Precautions: Added 208 Depression to Call

Prenatal care first trimester followup

Prostatitis Home treatment: Added 614 Avoid sex, specified; 927 Avoid sex, sx gone
Precautions: Added 313 Chills, 710 Fever, urgent, and 242 Vomiting, adult to Urgent; Added 397 Fever not improved and 255 Hematuria to Call, changed default on 920 Fever, after tx to 101 degrees
Psoriasis Meds: topical corticosteroids section broken into very high potency, high potency, medium potency, and mild potency
Home treatment: Added 837 Apply Moisturizer to Physical Measures
Precautions: Added 208 Depression general, 620 Sx not better 2 months to Call
Return: Changed variables to 2 months
Seborrhea, unspecified Meds: high-potency topical corticosteroids deleted, added Diflucan, tar shampoos
Precautions: Changed variable in 620 to 6 weeks
Sinusitis, bacterial Precautions: Added 298 Fever, call to Call
Spider bite, black widow Home treatment: Deleted 1509 Anaphylaxis
Precautions: Added 205 Loss of consciousness to Emergent; 242 Vomiting, 210 SOB, 266 Urinary obstruction, 307 Muscle cramping, 593 Headache severe, adult to Urgent; 298 Fever, call and 823 Cellulitis, adult to Call
Spider bite, brown recluse or hobo Home treatment: Deleted 1509 Anaphylaxis
Precautions: Added 204 Seizure to Emergent; 242 Vomiting, 196 Lethargy, 210 SOB, and 593 Headache severe, adult to Urgent; 298 Fever, call and 823 Cellulitis, adult to Call
Syncope, cardiac

Precautions: moved 205 Loss of Consciousness to Urgent, added 300 Symptoms worse under Call

Syncope, etiology unknown, adult

Precautions: Added 739 TIA/Stroke to Emergent

Syncope, etiology unknown, older adult Meds: added fludrocortisone and midorine
Precautions: Added 210 Dyspnea to Urgent
Tinea versicolor

Meds: Added Oxistat, Versiclear, selenium sulfide 1% lotion, Nizoral 1% shampoo, DHS Zinc 2% shampoo, Sporanox tablets, Diflucan tablets; deleted clotrimazole, miconazole, tolnaftate

Tinea, pedis

Meds: Added Loprox, Naftin, Mentax, tolnaftate, miconazole; changed Sporanox, griseofulvin and Diflucan

Vaginal bleeding, postmenopausal (formerly DUB, postmenopausal) Keywords: Added bleeding, uterine, vaginal
Meds: Changed medroxyprogesterone acetate, conjugated estrogens; added ethinyl estradiol, Ortho-Novum, ferrous sulfate, Niferex; deleted megestrol acetate
Precautions: Added 730 Vaginal bleeding, 1003 Vaginal bleeding with HRT to Call
Illustrations: Added 48 Female repro sag, 166 Female repro anterior
Vaginitis, prepubertal

Meds: Added miconazole nitrate vaginal, amoxicillin, cephalexin, Polysporin, and Estrace

Vaginitis, unspecified

Meds: Added Terazol-7, Vagistat-1, Femstat-3.Home treatment: Added 643 Notify sexual partner

 

Other changes made to existing templates:

 

Template name

Change(s)

Abdominal aortic aneurysm

Meds: Added Lipitor, Zocor, pravastatin, fluvastatin, Baycol, lovastatin, cholestyramine pwd, colestipol, nicotinic acid, gemfibrozil, Tricor, aspirin and NCEP guidelines for management of high cholesterol

Abdominal pain etiology unknown female Meds: Added Pepcid warnings, Nexium Protonix and Aciphex
Abdominal pain etiology unknown male Meds: Added Pepcid warnings, Nexium, Protonix, and Aciphex
Abdominal pain, etiology unknown, older adult Meds: Added Pepcid warnings
Abscess, unspecified Meds: Zyvox warnings
Actinic keratosis Meds: Added Solarase
Addiction unspecified Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Adjustment disorder with depressed mood, adult Home treatment: Added 1527 Ginseng, using; 1531 Kava, using
Adolescent health exam (female) 13-15 years Home treatment: Added 685 Dental care
Adolescent health exam (female) 16-19 years Home treatment: Added 685 Dental care
Adolescent health exam (male) 13-15 years Home treatment: Added 685 Dental care
Adolescent health exam (male) 16-19 years Home treatment: Added 685 Dental care
Adult health exam (female) 20-29 years Meds: Added Preven Emergency Kit and Plan B
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (female) 30-39 years Meds: Added Preven Emergency Kit and Plan B
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (female) 40-49 years Meds: Added Preven Emergency Kit and Plan B
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (female) 50-59 years Meds: Added Preven Emergency Kit and Plan B  
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (female) 60-69 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (female) 70-79 years frail Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (female) 70-79 years healthy Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (female) 80+ years frail Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (female) 80+ years healthy Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (male) 20-29 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (male) 30-39 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (male) 40-49 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (male) 50-59 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 dental care
Adult health exam (male) 60-69 years Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (male) 70-79 years frail Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (male) 70-79 years healthy Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (male) 80+ years frail Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Adult health exam (male) 80+ years healthy Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 1530 Hypothermia prevention; 685 Dental care
Alzheimer's disease early Meds: added Reminyl
Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Alzheimer's disease moderate Meds: added Reminyl
Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Alzheimer's disease severe Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Ankylosing spondylitis Illustrations: Added 243 Ankylosing spondylitis
Aortic stenosis, child Home treatment: Added 811 Dental care
Asthma followup child Illustrations: Added 244 Asthma airway
Asthma severe child Illustrations: Added 244 Asthma airway
Asthma, acute episode, child Illustrations: Added 244 Asthma airway
Asthma, mild intermittent child Illustrations: Added 244 Asthma airway
Bipolar disease Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
CAD Meds: Added cholesterol-lowering agents and NCEP guidelines
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet; 685 Dental care
Carpal tunnel syndrome Illustrations: Added 250 Computer ergonomics
Cervical radiculopathy Illustrations: Added 250 Computer ergonomics, 78 Herniated disc
Chest pain, etiology unknown Meds: Added Pepcid warnings, Nexium Protonix, Prevacid and Aciphex
Cholelithiasis, adult Meds: Added Pepcid warnings, Nexium, Protonix, Aciphex and Prevacid
Cholelithiasis, older adult Meds: Added Pepcid warnings, Nexium, Protronix, Prevacid and Aciphex
Chronic fatigue syndrome Home treatment: Added 1527 Ginseng, using; 1531 Kava, using
Precautions: 1532 Mood swings
Claudication Meds: Added cholesterol lowering agents and NCEP guidelines
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Concussion acute Home treatment: Added 1528 Head injury neuro checks adult
Precautions: Added 1529 Headaches frequent adult
Concussion post syndrome Precautions: Added 1529 Headaches frequent adult
Contraception, hormonal injections Meds: Added Lunelle
Contraception, IUD Meds: Added Mirena and Progestasert
COPD Illustrations: Added 244 Asthma airway
CVA Meds: Added statins: Lipitor, Zocor, Pravastatin, fluvastatin, Baycol, lovastatin; added cholestyramine, Colestipol, nicotinic acid, gemfibrozil, Tricor and NCEP guidelines for management of high cholesterol in adults (ATP III May 2001).
Delirium older adult Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Depression, major, adolescent Meds: Added desipramine, nortriptyline, Serzone, trazodone, Effexor and Wellbutrin
Diarrhea acute bloody adult Home treatment: Added 1526 Food safety
Epicondylitis medial Illustrations: Added 246 Elbow anterior w/ ligaments
Epicondylitis, lateral Illustrations: Added 241 Elbow lateral w/ligaments
Food poisoning Home treatment: Added 1526 Food safety
Fracture lower extremity foot Home treatment: Added 1538 Toe extension stretches
Ganglion Illustrations: Added 240 Ganglion
Gastritis, chronic Meds: Added Pepcid warnings, Nexium and Protonix
GERD, infant Meds: Added Pepcid warnings
Glaucoma Meds: Added Travatan and Lumigan
Head injury adult Home treatment: Added 1528 Head injury neuro checks adult
Precautions: Added 1529 Headaches frequent adult
Head injury child Precautions: Added 1029 Headaches frequent child
Headaches, cluster Precautions: Added 1529 Headaches frequent adult
Headaches, tension Precautions: Added 1529 Headaches frequent adult
Illustrations: Added 250 Computer ergonomics
Hiatal hernia Meds: Added Pepcid warnings, Nexium, Protonix
Illustrations: Added 237 Hiatal hernia
HIV, acute Meds: Added Kaletra, Trizivir, and lipid-lowering drugs: pravastatin, Lipitor, Baycol and Fluvastatin
Hypercholesterolemia Meds: Added Cholesterol-lowering agents and NCEP guidelines.Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Hypertension, essential, followup Meds: Change in provider guideline for diuretics and beta blockers
Hypertension, essential, new onset Refs: Updated
Meds: Added provider note to diuretics and beta blockers
Home treatment: Added provider guideline to 576 Alcohol, limit
Hypertriglyceridemia Meds: Added triglyceride lowering agents, aspirin, and NCEP guidelines
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Ingrown nail Illustrations: Added 238 Toenail trimming ideal
Intervertebral disc disorder Illustrations: Added 78 Herniated disc
Intussusception Illustrations: Added 239 Intussusception
Knee injury, anterior cruciate lig Illustrations: Added 248 Knee cruciate ligs & menisci
Knee injury, internal derangement Illustrations: Added 248 Knee cruciate ligs & menisci
Knee injury, meniscus, medial Illustrations: Added 248 Knee cruciate ligs & menisci
Lactose intolerance, primary, adult Q&A: Deleted information about secondary lactose intolerance
Meniere's disease Meds: Added prochlorperazine, hydrochlorothiazide and chlorthalidone
Metatarsalgia Home treatment: Added 1538 Toe extension stretches
Migraine unspecified Precautions: Added 1529 Headaches, frequent, adult
Mitral prolapse Home treatment: Added 685 Dental care
Myocardial infarction, acute Meds: Added fluvastatin, lovastatin, Baycol, cholestyramine, colestipol, nicotinic, gemfibrozil, Tricor, aspirin and NCEP guidelines for management of high cholesterol
Home treatment: Added 685 Dental care
Myocardial infarction, silent Meds: Added fluvastatin, lovastatin, Baycol, cholestyramine, colestipol, nicotinic acid, gemfibrozil, Tricor, aspirin and NCEP guidelines for management of high cholesterol
Home treatment: Added 685 Dental care
Neck pain Illustrations: Added 250 Computer ergonomics
Obesity, adult Meds: Added phendimetrazine
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
ODD Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Osteitis pubis Illustrations: Added 242 Osteitis pubis
Paranoia older adult Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Parkinson's disease Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Paronychia Illustrations: Added 238 Toenail trimming ideal
Pediculosis, capitis Meds: Added TMP/SMZ and Stromectol
Peptic ulcer disease, adult Q&A: Corrected typos
Meds: Added Pepcid warnings, Nexium Protonix and Aciphex
Peptic ulcer disease, perforated Meds: Added Pepcid warnings, Nexium, Protonix, Aciphex
Plantar fasciitis adult Home treatment: Added 1538 Toe extension stretches
Plantar fasciitis child Home treatment: Added 1538 Toe extension stretches
PMS Home treatment: Added 1531 Kava, using
Precautions: 1532 Mood swings
Pneumonia, atypical adult Meds: Added Levaquin, Avelox, Tequin, and Zagam
Pneumonia, bacterial, adult Meds: Added Avelox, Tequin, Zagam and Zyvox
Pneumonia, unspecified, adult Meds: Added Avelox, Tequin, Zagam and Zyvox
Pneumonia, unspecified, child Meds: Antibiotics arranged in different order
Prenatal care third trimester followup Illustrations: Added 236 Birth stages
Prenatal care third trimester initial Illustrations: Added 236 Birth stages
PVD lower extremities Meds: Added cholesterol lowering agents and NCEP guidelines
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Illustrations: Added 238 Toenail trimming ideal
Pyelonephritis, adult (formerly Pyelonephritis) Q&A: Deleted information related to children
Rosacea Meds: Added Akne-Mycin and Azelex
Schizophrenia Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Scoliosis Home treatment: Added 1536 Scoliosis brace
Seasonal affective disorder Home treatment: Added 1527 Ginseng, using; 1531 Kava, using
Skull fracture, adult Home treatment: Added 1528 Head injury neuro checks adult
Precautions: Added 1529 Headaches frequent adult
Skull fracture, child Precautions: Added 1029 Headaches, frequent, child
Strain, Achilles tendon Illustrations: Added 249 Achilles tendon
Stuttering child Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Subluxation, upper extremity, radial head Illustrations: Added 241 Elbow lateral w/ligaments
Temporal arteritis Illustrations: Added 1 Arteries of Head & Neck
Tendonitis, Achilles Illustrations: Added 249 Achilles tendon
Thoracic outlet syndrome Illustrations: Added 250 Computer ergonomics
Thrombophlebitis deep vein Meds: Added Innohep
Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Thrombophlebitis superficial Home treatment: Added 1524 Cholesterol screening, 1525 Diet Mediterranean, 1539 TLC diet
Thrush, adult Meds: New warnings for Sporanox
Tourette's syndrome child Precautions: Added 1533 Neuroleptic malignant syndrome to Urgent; 1537 Tardive dyskinesia to Call
Turf toe Home treatment: Added 1538 Toe extension stretches
Upper back pain Illustrations: Added 250 Computer ergonomics
VBAC Illustrations: Added 236 Birth stages
Well child exam 10-12 years Home treatment: Added 685 Dental care
Well child exam 5 year Home treatment: Added 685 Dental care
Well child exam 6 year Home treatment: Added 685 Dental care
Well child exam 7-9 years Home treatment: Added 685 Dental care
 

Name Changes for Guideline Templates

 

OB065 Contraception (female), hormonal injection From Contraception (female), Depo-Provera
GU003 Pyelonephritis, adult From Pyelonephritis
EE003 Glaucoma, chronic open-angle From Glaucoma
GI038 Lactose intolerance, adult, primary From Lactose intolerance, primary

 

Revised Medications

 

Acetazolamide New dose form
Amiodarone New dose form
Beclomethasone inhaler New dose forms and brand name Qvar
brimonidine tartrate  New dose form
buspirone New dose form
fluvastatin New dose form
ipratropium bromide/albuterol sulfate New dose form and brand name Duoneb
l-hyoscyamine sulfate New dose form
methylphenidate New dose form
mirtazepine New dose forms
prednisolone New brand- Orapred
prednisolone sodium phosphate New dose form
tolterodine tartrate New dose forms
Tretinoin cream New dose form
Zolmitriptan New dose forms and brand name Zomig-ZMT

 


Medical Reviewers


Medifor wishes to thank the following for reviewing our content for July 2001:


 

AAFP Foundation, Health Education Program
Michael Boyer, MD

Sharon Carter, MD

Susan Crockett, MD

Craig Davidson, MD

Matt Frankel, MD

Larry Glazerman, MD

Martin Hopp, MD

Martha Johns, MD

Charlotte Metzler, MD

Steven Nace, MD

Howard Pastrich, MD

Susan Reimer, MD

Bruce Robinson, MD

Sanjay Srivatsa, MD

Brent Wesenberg, MD