Document Detail


Medication discontinuation after curative surgery for sporadic primary hyperparathyroidism.
MedLine Citation:
PMID:  21134541     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although parathyroidectomy (Ptx) for sporadic primary hyperparathyroidism (PH) improves comorbidities and symptoms, routine Ptx for minimally symptomatic PH remains controversial. Whether successful Ptx translates into discontinuation or dose-reduction of prescribed medications is unknown.
METHODS: Consecutive patients undergoing curative Ptx for sporadic PH from January 2007 to April 2009 were compared to patients undergoing thyroidectomy (Tx). We reviewed patient demographics, symptoms, comorbid conditions, and pre- and postoperative medications utilizing the Fisher exact test and t test for comparisons.
RESULTS: Compared to 176 Tx patients, 260 Ptx patients were older (P < .001), more commonly men (P = .006), and had higher preoperative prevalences of every examined PH symptom and comorbid condition. Postoperatively, even minimal PH symptoms improved after Ptx. The mean number of preoperative medications was higher in Ptx patients (4 vs 2.8, P < .001). Discontinuation or dose-reduction of medication occurred in 28 (11%) Ptx patients vs 7 (4%) Tx patients (P = .01). After Ptx, symptom improvement was the predominant reason for beneficial medication changes, and the most common beneficial effect was discontinuation or dose-reduction of chronic analgesics (33%).
CONCLUSION: PH symptoms are numerous and improve after curative Ptx. Medication use for related symptoms can be beneficially reduced by surgery. Drug profiles should be routinely reviewed and adjusted after parathyroidectomy.
Authors:
Adrienne L Melck; Michaele J Armstrong; Michael T Stang; Sally E Carty; Linwah Yip
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  148     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1113-8; discussion 1118-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Section of Endocrine Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anxiety / etiology
Bone Diseases, Metabolic / etiology
Comorbidity / trends
Depression / etiology
Drug Therapy / methods*
Female
Follow-Up Studies
Gastroesophageal Reflux / epidemiology
Humans
Hyperlipidemias / etiology
Hyperparathyroidism, Primary / classification,  drug therapy,  surgery*
Hypertension / etiology
Male
Middle Aged
Osteoporosis / etiology
Prospective Studies
Retrospective Studies
Sex Characteristics
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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