– See: – diabetic foot menu – amputation menu – osteomyelitis in the diabetic patient – Discussion: – amputation should be considered for any diabetic patient w/ advanced changes (Charcot joints, multiple ulcers, vascular pathology) who has who has undergone a surgical debridement which could not logically leave the patient w/ a functional foot; – vascular considerations: … Read more
– for short term management of of CHF if patient to respond to Digitalis, Diuretics, and vasodilators; – used for patients w/ severe CHF refractory to diuretics, vasodilators, and conventional inotropic agents. – potent inotropes and vasodilators; – amrinone & milrinone decr systemic, pulmonary, & coronary vascular resistance; – this effect can lead to decreases … Read more
– for treatment of recurrent Ventricular Fibrillation or hemodynamically unstable ventricular Tachycardia; – Adult: Loading: 800-1600 mg/day for 1-3 weeks; – Maintenance dose: 600-800 mg/day for 1 month, then 200-400 mg/day; – Peds: 10 mg/kg/day divided q12hr PO for 7-10 days then reduce to 5 mg/kg/day divided q12hr if effective; – Average half life of … Read more
– Tricyclics – for depression, peripheral neuropathy, chronic pain adjunct; – Adult: begin 50-100mg PO qhs; can increase to 300mg qhs; – Strong anticholenergic effects, urinary retension, sedation; – Contraindicated with hypersensitivity, concomitant use of MAO inhibitors, disulfiram, use during acute recovery phase of MI, use of ETOH or other CNS depressants; – use with … Read more
– Discussion: – long acting calcium channel blocking agent; – indicated for the prevention of angina and HTN; – initial dose is 5 mg PO qd and maximum dose is 10 mg PO qd
– for endogenous depression; – initially 150mg PO hs or 50mg PO tid; increase to 300mg daily; – reduce dose in elderly, taper dose if d/c ing -Side Effects: Sedation: +; Insomnia: ++; Anticholinergic: +; Orthostatic Hypotension: ++; Nausea: 0
– for severe systemic fungal infections; – dose: 0.25mg/kg IV over 6hrs initially (infusion .1mg/ml); – gradually increase dose as tolerated up to 1-1.5mg/kg/24hrIV over 6hr; – note hypersensitivity, caution with nephrotoxic/antineoplastic agents; – monitor blood, liver, and renal function, – discontinue therapy if BUN >40mg/dl, Creatinine >3.0mg/dl, or if liver function test abnormalities are … Read more
– See: – aminoglycosides – for short term Rx of serious infections from Gm Neg aerobes and penicillinase producing Staph; – Adult: 15 mg/kg/24hr divided over q8-12 hours; – with clearance < 50 ml/min. give dose over 12-18hr; – w/ clearance < 30 give dose over 24-36 hr; – Peds: … Read more
– for HTN – possibly indicated in reperusion injury to protect against calcium paradox in crushed skeletal muscles; – massive simultaneous volume replacement would be needed to prevent additional depletion of intravascular volume by these agents. – K+ sparing diuretic; – Adult: 5mg PO qd; increase to 10mg if needed
– amicar may be harmful in disseminated intravascular coagulation, and this disorder should be reasonable r/o out before administration of this agent; – consider 3 – 5 gm IV load and 1 gm IV q1hr times 5 hours