Antibiotic dosing for renal function disorders and continuous renal replacement therapy.

[Antibiotic dosing for renal function disorders and continuous renal replacement therapy]. Anaesthesist. 2015 Mar 27; Authors: Michael E, Kindgen-Milles D Abstract For patients with acute kidney injury (AKI) and continuous renal replacement therapy, it is essential that the dosing of antibiotics is adequately adjusted in order to achieve an effective drug level above the minimum inhibition concentration but avoiding toxic side effects. In the selection of substances, preference should be given to antibiotics with a broad therapeutic spectrum, low incidence of side effects and, as far as possible, extrarenal elimination. Determination of serum levels should always be carried out, when this is possible. In any case, a sufficiently high loading dose should be included. An accurate as possible estimation of residual renal function and calculation of the mechanical clearance allows determination of the necessary maintenance dosage, which is acceptably accurate for clinical needs. Recent studies have shown that under modern continuous renal replacement therapy, the extent of elimination of antibiotics is regularly underestimated so that nowadays, the risk of antibiotic underdosing is higher than toxicity due to overdosing. PMID: 25812546 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

Related Links:

Med-botics, a firm based in Colorado Springs, won FDA Breakthrough Device status for its Oxalert EPO (Enhanced Pulse Oximeter), a device developed to prevent respiratory arrest from opioid overdoses. Post-op patients and others on heavy opioid the...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Critical Care Emergency Medicine Surgery Source Type: blogs
From 2015 to 2017, number of opioid - involved overdose deaths increased for nearly all racial/ethnic groups
Source: The Doctors Lounge - Psychiatry - Category: Psychiatry Tags: Family Medicine, Internal Medicine, Emergency Medicine, Pharmacy, Psychiatry, Surgery, Anesthesiology & amp; Pain, Journal, Source Type: news
Overdose deaths involving fentanyl or cocaine higher in regions east of Mississippi River
Source: The Doctors Lounge - Psychiatry - Category: Psychiatry Tags: Family Medicine, Internal Medicine, Emergency Medicine, Pharmacy, Psychiatry, Surgery, Anesthesiology & amp; Pain, Journal, Source Type: news
In 1819, a soon-to-be-knighted John Herschel (1792 to 1871) discovered that hyposulfite of soda could “fix” or make photographic images permanent by dissolving away unexposed and otherwise insoluble silver salts. This British genius soon coined terms for his astronomical or botanical images as “negatives” or “positives” and for the art as “photography.” Even after it was renamed sodi um thiosulfate, hyposulfite of soda retained photographers’ nickname for it: “hypo.” An antidote for cyanide poisoning, sodium thiosulfate was supplied in ampoules to physicians...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
This article provides a concise overview of local anesthetic systemic toxicity, its history, mechanisms, risk factors, prevention, clinical presentation, and treatment, with a special emphasis on issues specific to the geriatric population. The authors used MEDLINE, Scopus, and Google Scholar to search for original research articles (human and animal studies), registries data, case reports, review articles, and pertinent online publications using the combinations of the following search terms: local anesthetics, local anesthetic systemic toxicity, intralipid, lipid emulsion, Exparel, ultrasound-guidance, regional anesthesi...
Source: Drugs and Aging - Category: Geriatrics Source Type: research
Jeffrey A. SingerThe Drug Enforcement Administration, having virtually eliminated the diversion of prescription pain relievers into the underground market for nonmedical users, appears to be setting its sights on regulating the medical management of pain, a mission not suited for law enforcement. Acting under the authority of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), the DEA  announced a proposal to reduce, once again, the national production quotas for fentanyl, morphine, hydromorphone (Dilaudid), oxycodone, and oxymorphone, ...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs
AbstractGlobally, chronic pain is a major therapeutic challenge and affects more than 15% of the population. As patients with painful terminal diseases may face unbearable pain, there is a need for more potent analgesics. Although opioid-based therapeutic agents received attention to manage severe pain, their adverse drug effects and mortality rate associated with opioids overdose are the major concerns. Evidences from clinical trials showed therapeutic benefits of cannabis, especially delta-9-tetrahydrocannabinol and cannabinoids reduced neuropathic pain intensity in various conditions. Also, there are reports on using co...
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
Back in May, Bruce Schoneboom wrapped up his appointment to the HHS Pain Management Best Practices Inter-Agency Task Force. The group determined best practices for managing chronic and acute pain—and addressed judicious prescribing of opioids. If you didn’t know: The CDC reports there are 192 overdose deaths in the U.S. every day. Forty percent of The post Dr. Bruce Schoneboom and the HHS Pain Task Force appeared first on Johns Hopkins Nursing Magazine.
Source: Nursing Blogs at Johns Hopkins University - Category: Nursing Authors: Tags: New On the Pulse DNP nurse anesthesiology nurse anesthetist pain month Source Type: blogs
Authors: Singh P, Maita M, Lacci J, Boies B, Revere AS, Sirak ET, Seifi A Abstract OBJECTIVES: The purpose of this study was to identify the incidence of anesthetic errors per discharges in the United States within these errors, the incidence of death. A secondary aim was to identify any association between the mortality and patient comorbidities. METHODS: A retrospective analysis of the hospitals in the United States using the Nationwide Inpatient Sample (NIS) database during 2007-2014 was performed. The study population consisted of patients who were recorded as inpatient discharges who experienced complicati...
Source: Southern Medical Journal - Category: General Medicine Tags: South Med J Source Type: research
In conclusion, Swiss Rolls might be desirable for a wider assessment of the intestine, as it allows large segments to be analyzed at once, while Strips are better suited when detailed evaluation of each villus is intended. PMID: 31465765 [PubMed - as supplied by publisher]
Source: Experimental and Molecular Pathology - Category: Pathology Authors: Tags: Exp Mol Pathol Source Type: research
More News: Anesthesia | Anesthesiology | Overdose | Study | Toxicology | Urology & Nephrology