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Co-ordinator: Course Co-ordinator Heather Draper Objectives To produce a better understanding of a wide range of contemporary issues in health care ethics To introduce students to ethical theory and philosophical reasoning To enable students to improve their skills of argument To enable students to evaluate critically the ethical issues they face in their professional lives To enable students to keep abreast of developments once the course is finished Content Foundation in Health Care Ethics and Law Introduction to Health Care Ethics Consent, confidentiality, paternalism and surrogate decision-making, truth-telling, lying and deception, conscience, culture and belief, resource issues and formulae, European Convention on Human Rights in Biomedicine. Introduction to Medical Law A basic introduction to the English legal system and the following areas of medical law: that relating to consent and negligence; confidentiality; reproduction, abortion, contraception, and new reproductive technologies; those who are unable to consent for themselves; death and dying; human experimentation; channels of redress and complaint. Students will also look at the Hart Devlin debate and have an opportunity to apply case law to cases under supervision. Moral Philosophy and Ethical Thought The nature of moral reasoning and the main ethical theories and principles, which will be illustrated with examples drawn from clinical practice, notions of autonomy, duty, justice and equality, truth and rights; deontological, consequential, virtue, social contract and feminist theories of ethics; and the normative dimensions of concepts of illness, disease and health. Reproductive Responsibilities and Reproductive Technologies Abortion, foetal experiments and use of foetal tissue, antenatal screening, genetics, assisted reproduction and commercial surrogacy, place and mode of confinement, forced Caesarean Sections, in utero therapies, and parental responsibilities. Ethics in Community Care Explores some of the ethical issues raised by care in the community. It includes care of the mentally ill and disabled, abuse of the vulnerable, care of the elderly, care of the chronically and terminally ill, problems from general practice, issues in equity and the responsibility for care, and health promotion and education. It will also look at the ethical responsibilities of commissioners and purchasers. Medical Technology and Ethics Explores the increasingly technical and invasive nature of medical practice and asks whether the use of technology is always consistent with the aims and goals of health care. Examples include: intensive care, organ and tissue transplantation, intervention in self-killing, doctor-assisted death.

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2004 Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, which is solely responsible for the contents. The opinions expressed in this publication do not necessarily reflect those of the publisher or any of its educational sponsors, but rather are those of the author based on the available scientific literature. Publisher: SNELL Medical Communication Inc. in cooperation with Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto. TMEndocrinology Scientific Update is a Trade Mark of SNELL Medical Communication Inc. All rights reserved. The administration of any therapies discussed or referred to in Endocrinology Scientific Update should always be consistent with the recognized prescribing information in Canada. SNELL Medical Communication Inc. is committed to the development of superior Continuing Medical Education. 218-008 and zyrtec. Emergency contraception regimen.5, 6 In a prospective, randomized trial of 834 subjects, Ho and Kwan found the efficacy of levonorgestrel to be similar to that of the combined estrogen progestin regimen.5 Failure rates were 2.7% in the combination group and 2.4% in the levonorgestrel group, a non-statistically significant difference. The larger WHO trial involving 1055 women showed greater effectiveness in the levonorgestrel group where the pregnancy rate was 1.1% compared to 3.2% in the combined estrogen progestin group.6 The proportion of pregnancies prevented was 85% with levonorgestrel compared to only 57% with the combination hormonal regimen. Side Effects In both randomized clinical trials, levonorgestrel was found to be better tolerated than combined estrogen progestin.5, 6 Nausea 23.1% vs. 50.5% ; , vomiting 5.6% vs. 18.8% ; , dizziness 11.2% vs. 16.7% ; and fatigue 11.2% vs. 28.5% ; were all significantly less common among women who received levonorgestrel.6 The relatively high incidence of GI side-effects may result in low acceptability and contribute to lower efficacy because of vomiting.7 It has been suggested that the side-effect profile of combined hormonal emergency contraception may be improved by administering antiemetics before both doses or taking the pill with a snack, although there is no data to support this practice.3, 8 Contraindications Six cases of serious venous and arterial thrombosis have been linked to the use of combined estrogen progestin emergency contraception in the United Kingdom, where it has been used on more than 4 million occasions.8 Although the incidence of thrombosis is very low for the combined hormonal regimen, it is considered to be even less frequent for an estrogen-free method. Women who experience active migraine with focal neurologic deficit should not use combination estrogen-progestin; migraine is not a contraindication for progestin-only emergency contraception.2, 9 Progestin-only oral contraceptives are contraindicated in conditions of unexplained vaginal bleeding and porphyria.1 Conclusions Levonorgestrel has been shown to be equal or superior to combined hormonal emergency contraception with a significantly lower incidence of. The drug of choice in older adults with diabetes with less than optimal ldl levels is a statin and abilify.

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IN VIVO 90, 180, 360 mg kg day No direct drug-related ECG changes or changes in heart sounds or heart rates. ECG changes sinus bradycardia, prolongation of PR interval, prolongation of QT interval, and prolongation of QRS complex ; were considered secondary to severe clinical toxicity emesis, minimal to marked reductions in food consumption, and body weight loss ; and not a direct drug effect.

Economic Type of surgery: analysis: Cost1. Total hip effectiveness replacement Mean age: NR M F: Study design: 2. Total knee Decision replacement analysis Mean age: NR based on M F: established 3. Hip fracture model Mean age: NR Sullivan M F: NR 2003 ; Pre-existing riskfactors: NR Time horizon: 5 years Discount rates: Costs 3% Effects NR and accolate and zestoretic, for instance, zestoreti side effects.
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L. DI RIENZO BUSINCO, A. DI RIENZO BUSINCO, M. D'EMILIA, M. LAURIELLO1, G. COEN TIRELLI Otorhinolaryngology Unit, S. Eugenio Hospital, Rome; 1 Department of Experimental Medicine, University of L'Aquila, L'Aquila, Italy and accutane.

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Isaac 2 , isaac 2 1 department of pharmacology, school of pharmacy, university of georgia, athens, ga 30602 2 department of psychology, university of georgia, athens, ga 30602 * correspondence to reigle, department of pharmacology, school of pharmacy special issue in recognition of professor david grant's outstanding contributions to the pharmaceutical sciences, for example, side effects of zestoretic. Diltiazem ext. rel. * CARDIZEM CD $$$$ CARDIAC GLYCOSIDES digoxin * LANOXIN $ DIURETICS Loop Diuretics furosemide * LASIX $ bumetanide * BUMEX $$ Potassium Sparing Diuretics spironolactone * ALDACTONE $ triamterene hctz * DYAZIDE $ triamterene hctz * MAXZIDE $ Thiazide and Related Diuretics chlorthalidone * HYGROTON $ 25mg and 50mg only ; hydrochlorothiazide * HYDRODIURIL $ metolazone * ZAROXOLYN $$ Combination Products atenolol chlorthalidone * TENORETIC $$ lisinopril hctz * ZESTORETIC $$ bisoprolol hctz * ZIAC $$$ captopril hctz * CAPOZIDE $$$ NITRATES Oral isosorbide dinitrate oral * ISORDIL $ nitroglycerin ext. rel. * $ nitroglycerin sublingual * NITROSTAT $ Transdermal nitroglycerin ointment * $ nitroglycerin transdermal NITREK $$ patch * nitroglycerin transdermal NITRO-DUR $$ SYMPATHOLYTICS clonidine * tablets only ; CATAPRES $ methyldopa * ALDOMET $ guanfacine * TENEX $$ VASODILATORS hydralazine * $ minoxidil * LONITEN $$$$ ORTHOSTATIC HYPOTENSIVES fludrocortisone acetate * FLORINEF $$$ CENTRAL NERVOUS SYSTEM ALCOHOL ABUSE DETERRANTS disulfiram ANTABUSE $ ALZHEIMER'S AGENTS donepezil ARICEPT PA ; $$$$ rivastigmine EXELON PA ; $$$$ memantine NAMENDA PA ; $$$$ galantamine REMINYL PA ; $$$$ Current MMSE required ANALGESICS NSAIDs Propionic Acid Derivatives ibuprofen * rx strengths ; MOTRIN $ naproxen * NAPROSYN $$ Acetic Acid Derivatives indomethacin * INDOCIN $ diclofenac sodium ext.rel. * VOLTAREN $$ 5 and zestril.

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