CHRONIC CONSTIPATION:
The best treatments are bulk laxatives and osmotic laxatives.
MIRALAX (polyethylene glycol) is the preferred osmotic laxative.
CHRONIC PAIN:
For patients with chronic cancer or non-cancer pain, non-inhaled medical cannabis or
cannabinoids “slightly improve pain levels….slightly improve sleep quality and physical
functioning compared to placebo.”
SPIRITUAL ASSESSMENT:
Upon hospitalization, addressing end-of-life care should be accompanied by a spiritual
assessment.
LOW-DOSE ASPIRIN FOR PRIMARY PREVENTION OF CVD:
The USPSTF recommends against 81 mg aspirin for adults 60 years and older for the
prevention of cardiovascular disease. For patients age 40-59 low-dose aspirin is
suggested but not recommended.
NSAID’s (non-steroidal anti-inflammatory drugs) given for more than 3 days at higher
doses post-operatively, or after an acute fracture, leads to delayed healing, or non-
healing of the fracture.
RED MEAT AND CANCER:
Higher red meat consumption increases the risk of breast, colorectal, colon, rectal,
lung, and esophageal squamous carcinomas. RECOMMENDATION: Lower
consumption of red and processed meat.
STATINS FOR PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE IN ADULTS:
Summary of USPSTF Recommendations:
Adults age 40-75 with 1 or more CVD risk factors plus a 10-year CVD risk of 10% or
greater—take a statin
Adults age 40-75 with 1 or more CVD risk factors plus a 10-year CVD risk of 7.5-10.0 %
Consider taking a statin
Adults 76 years and older—recommend against taking statin.
TREATMENT OF LOW BACK PAIN:
Determine the cause and origin of the pain.
Treatment is patient-centered and holistic
Exercises-aerobic, aquatic, mechanical, Pilates, strength training, walking, tai chi.
Acupuncture, Electrical stimulator, ultrasound
Medications—Cymbalta, NSAID’s, Lyrica, Flexeril
Avoid—acetaminophen, opioids, benzodiazepines.
References: FPIN’S HELP DESK ANSWERS Christensen L, Calquin M, Daly S. “Does the
consumption of red and processed meats increase the risk of Cancer?” JAMA 2023
Apr;107(4):424-5.
AFP Clinical Answers Am Fam Phys. 2023 Apr;107(4):352.
AFP Clinical Answers Am Fam Phys. 2023 Feb;107(2):130.
U.S. Preventive Services Task Force “Statin Use for the primary Prevention of Cardiovascular Disease in Adults: Clinical Summary of USPSTF Recommendations” Am Fam Phys 2023 Feb;107(2):183-184.
Practice Guidelines Management of low back pain. Am Fam Phys. 2023 April;107(4):435-437.
