Don’t routinely prescribe benzodiazepines or Z -drugs in elderly patients in case of insomnia as first choice treatment. Physicians should always recommend intermittent use of these drugs.In case of chronic use, evaluate both the indications and the possible occurrence of side effects
Several studies show an increased risk of falls and hip fracture in elderly patients taking benzodiazepines or Z-drugs (zolpidem, zopiclone, zaleplon). This risk also exists for safer protocols (i.e. short-term therapies with low-dose and short half-life drugs). The...
Don’t prescribe therapies with anti-inflammatory drugs (NSAIDs) without initial and periodical assessment in each patient of the actual clinical indications and of the side effects risk at that time.
NSAIDs are used primarily in chronic therapies, as analgesic drugs and are burdened with significant side effects, especially at gastrointestinal, renal and cardiovascular level. The available studies suggest caution by the physicians both at the moment of initial...
Don’t routinely prescribe Proton Pump Inhibitors (PPI) in patients without risk factors for ulcer disease. In gastroesophageal reflux disease prescribe the lowest dose that can control symptoms and educate the patient to desirable withdrawal periods.
PPI are usually prescribed to avoid drug induced gastropathy. This procedure showed to be effective for NSAIDs, but not for steroids, anticoagulants, antineoplastic agents, antibiotics. PPI intake is related to an increased risk of intestinal and lung infections in...
Don’t routinely prescribe antibiotics for acute upper airway infections. Assess the opportunity in patients at risk of lower respiratory tract infection or in case of clinical worsening after a few days
Upper respiratory tract infections (including acute otitis media) are usually caused by viruses and recover spontaneously in a few days. The routine use of antibiotics raises the risk of bacterial resistance and side effects. Patients at risk of lower respiratory...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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