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By L. Hjalte. Aquinas College.

It has been used to commit sexual assaults due to its ability to sedate and incapacitate unsuspecting victims cheap generic levitra with dapoxetine uk. Long-term Consequences of Use Physical and psychological dependence purchase levitra with dapoxetine paypal; cardiovascular collapse purchase 40/60mg levitra with dapoxetine with mastercard; and death and Health Effectsiii Other Health-related Sometimes used as a date rape drug. Issues In Combination with Exaggerated intoxication, severe sedation, unconsciousness, and slowed heart rate Alcohol and breathing, which can lead to death. Headache; muscle pain; extreme anxiety, tension, restlessness, confusion, irritability; Withdrawal Symptoms numbness and tingling of hands or feet; hallucinations, delirium, convulsions, seizures, or shock. More research is needed to determine if behavioral therapies can be used to treat Behavioral Therapies addiction to Rohypnol® or other prescription sedatives. More research is needed to determine if salvia is addictive, but behavioral therapies Behavioral Therapies can be used to treat addiction to dissociative drugs. Kidney damage or failure; liver damage; high blood pressure, enlarged heart, or Long-term changes in cholesterol leading to increased risk of stroke or heart attack, even in Consequences of Use young people; hostility and aggression; extreme mood swings; anger (“roid rage”); and Health Effects paranoid jealousy; extreme irritability; delusions; impaired judgment. Males: shrunken testicles, lowered sperm count, infertility, baldness, development of Other Health-related breasts, increased risk for prostate cancer. Issues Females: facial hair, male-pattern baldness, menstrual cycle changes, enlargement of the clitoris, deepened voice. Alcohol Mood swings; tiredness; restlessness; loss of appetite; insomnia; lowered sex drive; Withdrawal Symptoms depression, sometimes leading to suicide attempts. Medical Use Used to treat conditions caused by low levels of steroid hormones in the body. Treatment Optionsiii Medications Hormone therapy More research is needed to determine if behavioral therapies can be used to treat Behavioral Therapies steroid addiction. Sometimes misleadingly called “synthetic marijuana” and marketed as a “natural,” “safe,” legal alternative to marijuana. More research is needed to determine if behavioral therapies can be used to treat Behavioral Therapies synthetic cannabinoid addiction. Long-term Consequences of Use Breakdown of skeletal muscle tissue, kidney failure, psychosis, and death. Alcohol Withdrawal Symptoms Depression, anxiety, problems sleeping, tremors, paranoia. Title 21 code of federal regulations: Part 1308 — Schedules of controlled substances. Effects of initiating moderate alcohol intake on cardiometabolic risk in adults with type 2 diabetes: A 2-year randomized, controlled trial. A systematic review and meta-analysis of alcohol consumption and all-cause mortality. Moderate alcohol use and reduced mortality risk: Systematic error in prospective studies. This document was developed through a collaborative effort between some of the best minds in addiction care today and will help you make wise decisions, ensuring that medications you may be prescribed and incidental exposure to alcohol do not threaten your hard won recovery. This guide is divided into three sections and is based on the drug classifcation system developed nearly 20 years ago by Dr. Avoiding these products will decrease the likelihood you will absorb or ingest small quantities of alcohol that could sensitize your system and threaten recovery. Please remember that this guide is only intended as a quick reference and never as a substitute for the advice of your own personal physician. It is essential that you inform all of your personal physicians, dentists and other health care providers of your chemical dependency history so that medications can be prescribed safely and appro- priately when they are deemed necessary. Never discontinue or make any changes in the doses of medication that you may have been prescribed. Doing so may result in unexpected problems such as withdrawal reactions, which in some cases can be life-threatening. The bottom line is that a recovering addict or alcoholic needs to become a good consumer. The danger is not always that a recovering addict may develop a new addiction (though this certainly can happen), but that one can be led back into dependence on their drug of choice. The latest scientifc research has proven that all the dependence- producing drugs act on the brain in the same way to produce addiction, despite having different effects or a differ- ent kind of “high” when taken. In addition, if urine drug screening is part of the recovering person’s continuing treatment program, use of many types of medications can result in falsely positive tests for the more highly addictive classes of drugs, resulting in negative consequences. Therefore, it is very important for a recovering person to learn about the different types of medications and drugs, as well as which ones present a special risk to continuing recovery and sobriety. The com- monly available medications and drugs are divided into three classes – A, B and C – to indicate three levels of risk. Class A drugs must be avoided completely, as they are well known to produce addiction and are the most dan- gerous of all. Only under very unusual conditions can Class A drugs be taken by a recovering addict or alcoholic, and only when given by a physician or dentist and with the consent of the addiction medicine physician that follows your care. These exceptional circumstances can include severe illness and injuries, including major surgery, car ac- cidents and other trauma, and tests or procedures that can only be done under sedation or anesthesia. Medication treatments for certain psychiatric conditions are in this category as are medications used for drug detoxifcation. The medications in Class B are also potentially dangerous, especially when taken by recovering persons without the guidance of a physician or another health care professional. However, under certain circumstances, the Class B group can be taken safely under a physician’s care. We strongly urge you to have an addiction medicine specialist follow your treatment when you are prescribed these medications. Class C medications are generally safe from the point of view of addiction recovery. However, overuse of any medication, even the common over-the-counter remedies, can result in unwanted side effects. People who have struggled with drug addiction or alcoholism must remain aware of the tendency to look for external solutions for internal problems and should avoid taking any of these medications on their own in order to medicate emotions and feelings. The tools of recovery, including participation at 12-Step fellowship meetings, working the Steps, or talking with a sponsor, counselor or doctor, provide safe and healthy ways to deal with the strong feelings that can come up at any time in early sobriety. The three classes of medications that appear on the following pages include both the brand name (i. On the following pages, look for the brand name listed frst, followed by the (generic name) in parentheses. For street drugs, the common name is listed frst, and the chemical name or street name is in parentheses. For each drug group in Class A and B, there is also a brief explanation of the dangers associated with taking the medication or street drug. Please note that there is a variety of cough and cold preparations that contain alcohol and that medications which can be taken in tablet form will not contain ethyl alcohol. Certain topical products, soft-gels and capsules contain ethyl alcohol and should be avoided. Please refer to the table at the end of the document for a list of alcohol-containing products to avoid. These medications bind to opiate receptors in the central nervous system, altering the perception of and response to pain and produce generalized central nervous system depression and may alter mood or cause sedation.

The frequency of A1C testing (83% non-Hispanic whites) with type 1 purchase levitra with dapoxetine 40/60 mg visa, agement of Diabetes in Pregnancy purchase levitra with dapoxetine overnight delivery. The use of point-of-care A1C c A reasonable A1C goal for many cose levels at premeal purchase genuine levitra with dapoxetine line, postmeal, and testing may provide an opportunity for nonpregnant adults is ,7% (53 bedtime associated with specified A1C more timely treatment changes during mmol/mol). Other measures of average gly- have also demonstrated higher A1C levels and effective doses of multiple cemia such as fructosamine and 1,5- in African Amercans than in whites (33). B but their translation into average glu- in children with type 1 diabetes found a cose levels and their prognostic signifi- highly statistically significant correlation A1C and Microvascular Complications cance are not as clear as for A1C (see between A1C and mean blood glucose, Hyperglycemia defines diabetes, and Section 2 “Classification and Diagnosis although the correlation (r 5 0. A1C may ferent interpretations of the clinical gression of microvascular (retinopathy also confirm the accuracy of the pa- meaning of given levels of A1C in those [37] anddiabetickidneydisease) andneu- tient’s meter (or the patient’s reported populations. Given the substantially in- long as significant hypoglycemia does ished and disappeared during follow-up. These analyses also However, on the basis of physician judgment with those previously randomized to the S52 Glycemic Targets Diabetes Care Volume 40, Supplement 1, January 2017 standard arm (48). The benefitofintensive increased mortality rate in the intensive Many factors, including patient prefer- glycemic control in this cohort with type 1 compared with the standard treatment ences, should be taken into account when diabetes has been shown to persist for arm (1. Heterogeneity of mor- Recommended glycemic targets for 10 yearsofobservationalfollow-up,those tality effects across studies was noted, many nonpregnant adults are shown in originally randomized to intensive glyce- which may reflect differences in glycemic Table 6. All three duration of diabetes, a known history of prandial glucose to be a cardiovascular trials were conducted in relatively older hypoglycemia, advanced atherosclerosis, risk factor independent of A1C. In sub- participants with longer known duration or advanced age/frailty may benefitfrom jects with diabetes, surrogate measures of diabetes (mean duration 8–11 years) less aggressive targets (56,57). The target A1C among intensive venting hypoglycemia in patients with postprandial hyperglycemia. Postprandial glucose measurements The glycemic control comparison in should be made 1–2 h after the beginning of the meal, generally peak levels in patients with diabetes. E c Insulin-treated patients with hypo- glycemia unawareness or an episode of clinically significant hypoglyce- mia should be advised to raise their glycemic targets to strictly avoid hypoglycemia for at least several weeks in order to par- tially reverse hypoglycemia un- awareness and reduce risk of future episodes. A c Ongoing assessment of cognitive function is suggested with in- creased vigilance for hypoglycemia by the clinician, patient, and care- givers if low cognition or declining cognition is found. B Hypoglycemia is the major limiting fac- tor in the glycemic management of type 1 and type 2 diabetes. Char- dations from the International Hypogly- acteristics and predicaments toward the left justify more stringent efforts to lower A1C; those toward caemia Study Group regarding the the right suggest less stringent efforts. C cose compared with those targeting glycemia that should be included in c Glucose (15–20 g) is the preferred preprandial glucose (60). Therefore, it is reports of clinical trials of glucose-lowering treatment for the conscious individu- reasonable for postprandial testing to be drugs for the treatment of diabetes al with hypoglycemia (glucose alert recommended for individuals who have (61). Measuring tant for therapeutic dose adjustment of that contains glucose may be used. Severe hypoglycemia is de- mia, the treatment should be re- plasma glucose values to ,180 mg/dL fined as severe cognitive impairment peated. E tes and 147 with type 2 diabetes) found but are not limited to, shakiness, irritabil- c Glucagon should be prescribed for that actual average glucose levels associ- ity, confusion, tachycardia, and hunger. Caregivers, school per- laxed without undermining overall glycemic consciousness, seizure, coma, or death. Patients hypoglycemia was associated with greater patients titrating glucose-lowering drugs should understand situations that in- risk of dementia (63). Hypoglycemia significantly associated with subsequent patients to treat hypoglycemia with may increase the risk of harm to self or episodes of severe hypoglycemia (64). Hypoglycemia treat- use and carbohydrate intake and exer- with type 1 diabetes, found no associa- ment requires ingestionofglucose-orcar- cise are necessary, but these strategies tion between frequency of severe hypo- bohydrate-containing foods. Pure glucose awareness (or hypoglycemia-associated Severe hypoglycemia was associated is the preferred treatment, but any form of autonomic failure) can severely compro- withmortalityinparticipantsinboththe carbohydrate that contains glucose will mise stringent diabetes control and qual- standard and the intensive glycemia arms raise blood glucose. Ongoing insulin activity or insulin release, especially in older adults, and a treatment intensity were not straightfor- secretagogues may lead to recurrent hypo- diminished autonomic response, which ward. An association of severe hypoglyce- glycemia unless further food is ingested af- both are risk factors for, and caused by, mia with mortality was also found in the ter recovery. An association be- normal, the individual should be counseled cycle” is that several weeks of avoidance tween self-reported severe hypoglycemia to eat a meal or snack to prevent recurrent of hypoglycemia has been demonstrated and 5-year mortality has also been report- hypoglycemia. Hence, patients with one or more The use of glucagon is indicated for the and the elderly are noted as particularly episodes of clinically significant hypogly- treatment of hypoglycemia in people un- vulnerable to clinically significant hypo- cemia may benefit from at least short- able or unwilling to consume carbohy- glycemia because of their reduced ability term relaxation of glycemic targets. Those in close contact to recognize hypoglycemicsymptoms and with, or having custodial care of, people effectively communicate their needs. Impact reduces severe hypoglycemia in hypoglycemia- panied by ketosis, vomiting, or alteration in of self monitoring of blood glucose in the man- unaware patients with type 1 diabetes. Diabetes agement of patients with non-insulin treated Care 2013;36:4160–4162 the level of consciousness, marked hyper- diabetes: open parallel group randomised trial. Adequate fluid and 1174–1177 insulin-pump interruption for reduction of hy- caloric intake must be ensured. N Engl J Med 2013;369:224–232 dehydration is more likely to necessitate Farmer A; Diabetes Glycaemic Education and 26. Cost effectiveness of Safety of a hybrid closed-loop insulin delivery self monitoring of blood glucose in patients system in patients with type 1 diabetes. A ofbloodglucose inpatientswithtype 2diabetes clinical trial of continuous subcutaneous insulin and the hyperglycemic nonketotic hyper- mellitus who are not using insulin. Juvenile Diabetes Research Foundation Con- 28:1568–1573 in Adult Patients With Diabetes” (69). Continuous glu- Diabetes Control and Complications Trial/ cose monitoring and intensive treatment of type 1 Epidemiology of Diabetes Interventions and References diabetes. As- strong association between frequency of self- guided pump therapy in type 1 diabetes: a rand- sociation of glycaemia with macrovascular and monitoring of blood glucose and hemoglobin omised controlled trial. Frequent monitoring of A1C during nificantly reduces A1C levels in poorly con- T1D Exchange clinic registry. Diabetes Care 2008;31:1473–1478 test strips in veterans with type 2 diabetes mel- 2014;51:845–851 33. Diabe- tients who self-monitor blood glucose and their glucose monitoring on hypoglycemia in type 1 tes Care 2016;39:1462–1467 unused testing results. Choosing wisely [Internet], Continuous Glucose Monitoring Study Group, glucose concentrations in children with type 1 2013. Accessed 18 ousglucose monitoringinwell-controlledtype 1 cose determinations by sensors. Sustained benefitof betes screening with hemoglobin A1c versus fast- detemir with insulin glargine when adminis- continuous glucose monitoring on A1C, glucose ing plasma glucose in a multiethnic middle-school tered as add-on to glucose-lowering drugs in profiles, and hypoglycemia in adults with type 1 cohort. Treat-to-target trials: uses, inter- parative effectiveness and safety of methods cose in children with type 1 diabetes. Diabetes of insulin delivery and glucose monitoring for Care 2010;33:1025–1027 Obes Metab 2014;16:193–205 diabetes mellitus: a systematic review and 37. Acta Diabetol 2016;53:57–62 time continuous glucose monitoring significantly gression of diabetic retinopathy in patients with S56 Glycemic Targets Diabetes Care Volume 40, Supplement 1, January 2017 type 1 diabetes: 18 years of follow-up in the cardiovascular disease in patients with type 1 58.

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For cigarettes smokers order levitra with dapoxetine canada, you should ask how many cigarettes or packs they smoke (or smoked) per day generic 40/60mg levitra with dapoxetine fast delivery. It is necessary to ask specific questions buy discount levitra with dapoxetine line, because although one drink is tech- nically considered to be 12 ounces of beer, 5 ounces of wine, or 1. It will help if you are straightforward and nonjudgmental when asking about illicit substance use. One way to ask this question is, “Do you currently take, or have you taken in the past, any illicit drugs? It includes the presence of any symptom, even one that the patient may not have deemed to be significant or may have forgotten because of his or her focus on the chief complaint. Additionally, pharmacists may also be part of a medical team, and therefore should be aware of all of the components of a patient interview even if they are not the ones ask- ing the questions. Prior to starting this part of the interview, let the patient know that you will be asking several questions to assess any potential symptoms he or she may be experiencing. Oftentimes, some of these systems may be addressed concurrently with another part of the interview. For example, after checking the patient’s blood pressure, you may ask if the patient has had any dizziness or palpitations. They are taught to develop their own systematic approach to ensure a thorough and accurate physical exam. The comprehensive physical exam includes measurement of vital signs such as height, weight, temperature, blood pressure, and pulse, as well as the observation, inspection, and palpation of the patient’s body from head to toe. Although physicians often complete this part of the patient assessment, pharmacists are also skilled at completing parts of the physical exam. These parts include, but are not lim- ited to, measuring vital signs and inspecting and palpating parts of the body related to the patient’s complaint. For example, a pharmacist may assess the severity of lower leg edema by inspecting and palpating the area of swelling. Additionally, pharmacists may conduct mental status examinations or assess the effects of a stroke by examining the patient for facial droop, arm drift or strength, and speech abnormalities. The medication history provides insight into the patient’s current and past medications, adverse drug reactions or allergies, adherence, the patient’s own understanding about his or her medications, and any other concerns a patient may have regarding his or her medications. Asking 9 pertinent questions with a systematic approach, utilizing appropriate technique, and actively listening to the patient will enable you to collect a thorough and accurate medication history. This, in turn, will enable you to identify, prevent, and/or resolve any active or potential drug-related problems. For example, a patient who is taking warfarin may also tell you she is taking ibu- profen 200 mg twice daily for arthritis pain. This information provides you with an opportunity to assess the patient’s arthritis pain and inquire about what other agents have been tried to treat the pain. After evaluating the patient, you may determine that acetaminophen is the more appropriate drug for this patient. You would then counsel regarding the increased risk of bleeding associated with concomitant warfarin and ibuprofen use, as well as recommend acetaminophen, being sure to include all the components of self-care counseling described later in this chapter. You should know all the questions that need to be asked, the various ways in which the questions may be asked, the appropriate use of interview techniques, and the many sources of information that should be utilized. This section provides examples of how to ask the questions related to the medication history along with the explanation of each component; however, it is important to realize that these examples demonstrate just one way to ask questions, and you might find that your own communication style lends itself to a different way of asking the questions. You must find a way of having a natural discussion with the patient that works for you, and this will take a lot of practice. Introduction Prior to starting the medication history, you should introduce yourself by telling the patient and/or caregiver your name and title. Be sure to confirm the patient’s identity with at least one patient identifier, such as the patient’s birthday, telephone number, or home address. Additionally, you should describe the purpose of the medication history, tell the patient the amount of time you expect that it will take to conduct the medication history, and obtain permission to collect the information. The following is a sample dialogue for the introduction: “Hello, my name is Shaan Smith, and I am a pharmacy student. Before we get started, I would like to make sure I am speaking with the right person. This means that I will be ask- ing you questions about all the medications you are currently taking and get some information about medications you may have taken in the past and any side effects or allergies you may have. For each medication, you will need to determine the product’s name, strength, dose, indication, frequency, timing of administration, duration of use, and the pre- scribing physician. The information can be gathered in a number of different ways, and the method you use may depend on the clinical setting. The best way to obtain this information in a planned encounter is via the “brown bag” method. During the meeting, ask about the dose, indication, frequency, timing of administration, and dura- tion of the use. By looking at the bottles, you will already know the name and strength of the medication as well as the prescribing physician. Even though the directions are written on the label, you should ask the patient how he or she is taking a particular medication, because there may be discrepancies between the written directions and how the patient actually takes the medication. Another method is to look at a written list of medications that is either kept by the patient or found in the medical chart. Sometimes a patient may say, “I am tak- ing everything that you have on your list” when you start asking them questions about their medications. For example, you could tell the patient, “Although I do have the medications listed in my chart, it would be good to go through each medication one by one to ensure that my list is accurate and truly shows what you are taking now. Unfortunately, patients do not always remember the names, doses, or how they are taking their medication; accordingly, this method may not produce the most medication history 23 complete medication history. With the patient’s permission, you can call the patient’s pharmacy or primary care physician to obtain the most current medication list, or you can even call the patient’s home to speak with someone who can read the information from the medication bottles. If a patient is presenting to the emergency room or is in a hospital where it is not possible to look at the patient’s medical chart, you should ask the patient, family member, or caregiver if he or she has a written list. If such a list is not available, obtain permission to call the pharmacy, primary care physician, and/or the patient’s home, as discussed previously. Regardless of the method utilized to complete a medication history, the informa- tion that needs to be collected is the same. One way to obtain this information is to ask, “What are the names of the medications that you are currently taking? For example, if a patient states that he or she is taking metoprolol, you must determine if it is tartrate or succinate. With regard to generic versus brand name, for some medications with narrow therapeutic indexes, such as levothyroxine or warfarin, changing between manufacturers may cause fluc- tuations in drug levels in the blood; therefore, including manufacturer information is beneficial.

Although xerostomia is common in elderly patients iis frequently noassessed and managed on time order 40/60mg levitra with dapoxetine mastercard. Due to serious complications of dry mouth which afects oral and general health the qua- lity of life of these patients is decreased levitra with dapoxetine 40/60 mg generic. Therefore purchase generic levitra with dapoxetine on line, the assessmenof salivary gland hypo-function, early recognition, prevention and treatmenof xerostomia and its complications will need to be incorporad into everyday clinical dental practice. Epidermal growth factor inplasma and saliva of patients with active breascancer and breascancer patients in follow-up compared with healthy women. Salivary biomarkers for the dection of malig- nantumors thaare remo from the oral cavity. Oral diagnostic sting for decting human immune-defciency virus-1 antibodies: A chnology whose time has come. Serum amylase isoenzymes in patients undergoing operation for ruptured and non-rup- tured abdominal aortic aneurysm. Measuring change in dry-mouth symptoms over time using the Xero- stomia Inventory. Minor gland saliva fow ra and proins in subjects with hyposalivation due to Sjogren�s syndrome and radiation therapy. Oral dryness examinations: use of an oral moisture checking device and a modifed coton method. Longitudinal analysis of parotid and submandibular salivary fow ras in healthy, diferent-aged adults. Dry Mouth (Xerostomia): Diagnosis, Causes, Complications and TreatmenResearch Review. A follow-up study of minimally invasive lip biopsy in the diag- nosis of Sjogren�s syndrome. An alrnative perspec- tive to the immune response in autoimmune exocrinopathy: induction of functional quiescence rather than destructive autoaggression. Xerostomia and chronic oral complications among patients tread with haematopoietic sm cell transplantation. Major salivary gland function in patients with radiation-induced xerostomia: fow ras and sialochemistry. Parotid gland function during and fol- lowing radiotherapy of malignanciewsin the head and neck: a consecutive study of salivary fow and patients disomfort. Xerostomia afer radiotherapy and its efecon quality of life in head and neck cancer patients. Prosthodontic managemenof radiation in- duced xerostomic patienusing fexible dentures. Hyperglycemia and xerostomia are key derminants of tooth de- cay in type 1diabetic mice. The efecof low level lasertherapy on sali- vary glands in patients with xerostomia. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Evaluation of the clinical ef- cacy of a mouthwash and oral gel containing the antimicrobial proins lactoper- oxidase, lysozyme and lactoferrin in elderly patients with dry mouth--a pilostudy. Efects of hy- droxychloroquine on salivary fow ras and oral complaints of Sjogren patients: a prospective sample study. A sysm- atic review of salivary gland hypofunction and xerostomia induced by cancer therapies: managemenstragies and economic impact. A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoi- etic sm cell transplantation. Long-rm Clinical Observationof Dental Caries in Salivary Hypofunction Patients Using a Supersaturad Calcium-Phospha Remineralizing Rinse. Antifungal efecof supersaturad solu- tion of calcium and phospha (artifcial saliva) in xerostomia. Mravak-Stipetic: Xerostomia - diagnostics and treatmenSazetak Kserostomija � dijagnostika i lijecenje Kserostomija je subjektivan osjecaj suhoce usta koji nastaje zbog smanjenog lucenje sline ili hiposalivacije. Smanjeno lucenje sline je posljedica oscenja zlijezda slinovnica koje uzrokuju odredeni sustavni poremecaji, brojni lijekovi i lijecenje zracenjem tumora u podrucju glave i vrata. Raznolikosuzroka hiposalivacije, stupanj oscenja slinovnica po- pratni oralni morbiditi kao komplikacije suhoce usta, cine rapiju kserostomije slozenom, a cesto i refraktornom. Lijecenje kserostomije ovisi o uzroku i stupnju oscenja slinovnica i obuhvaca simp- tomatsko lijecenje, lokalnu i sustavnu stimulaciju zlijezda slinovnica i prevenciju komplika- cija. U osoba u kojih je funkcija slinovnica ocuvana, provodi se stimulativna rapija dok se u osoba u kojih su slinovnice ireverzibilno oscene i koji nemaju sline provodi nadomjesno lijecenje umjet- nom slinom i simptomatsko lijecenje. Kserostomija je jedna od prvih i skih komplikacija lijecenja zracenjem raka glave i vrata i kemorapije. Prevencija kserostomije obuhvaca djelovanje na uzrok kserostomije i odrzavanje sa- livarne funkcije i prevenciju komplikacija. U prevenciji radijacijske kserostomije razvijeno je nekoliko stragija lijecenja koje ukljucuju sofsticirane kirurske hnike, citoproktivna sredstva i posebne hnike ozracivanja pri cemu se sdi tkivo slinovnica a istodobno ne ugrozava onkolosko lijecenje. Medutim, ovi preventivni postupci ne mogu se primjeniti u svih pacijenata pa u konacnici jedini izbor je lijecenje suhoce usta. Dostupni nacini lijecenja kserostomije obuhvacaju vise kagorija, a izbor rapijskog postupka ovisi o tome da li sli- novnice mogu stvarati slinu ili ne. U nemogucnosti stvaranja sline primjenjuju se nadomjest- ci sline i umjetna slina. Kljucne rijeci: suhoca usta; kserostomija; hiposalivacija; sijalometrija; kserostomija/oral- ne komplikacije; kserostomija/etiologija; kserostomija/prevencija; kserostomija/lijecenje; umjetna slina; prezasicena remineralizirajuca otopinakalcija i fosfata. The firsone consisd of 482 pharmacy-based hypernsive patients from Oulu and Tampere in Finland. The second study population of 1561 medically tread and 220 medically untread patients were drawn from the Finnish national study of hypernsive patients in primary health care in 1996. The patients were identified during one week in November followed up with a health examination. Logistic regression analyses were used to study the associations between variables in both study populations. In addition, factor, reliability and inrnal validity analyses were used to identify patient-perceived problems in the second study population. Iturned outhaalmosall medically tread hypernsive patients (98%) had patient- perceived problems and each patienhad an average of five problems. The moscommon problem was the perceived lack of follow-up by the health centre (72%). Two-thirds of patients had difficulties to accepbeing hypernsive patienand showed a careless attitude towards their hypernsion. High levels of patient-perceived problems in the cagories of everyday life relad problems, health care sysm relad problems and patient-relad problems were associad with multiple risks of inntional non-compliance with antihypernsive medication. Furthermore, patient- perceived everyday life relad problems, a hopeless attitude towards hypernsion and frustration with treatmenwere associad with poor outcomes of antihypernsive drug therapy.