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Warfarin reversal management
لماذا لا ينبغي حقن المضاد الحيوي فانكومايسين بسرعة عبر الوريد؟

» الجواب: ⬇️

يسبب الإعطاء السريع عبر الوريد لهذا المضاد الحيوي حدوث متلازمة الرجل الأحمر Red Man Syndrome وهي رد فعل تحسسي أتى اسمها من الطفح الأحمر الذي يتطور على الوجه، والرقبة، والجذع. يوصى هنا بإعطاء هذا الدواء وريدياً ببطء لتجنب فرط التحسس هذا.
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Group "F"- Internship
Photo
هذا من Davidson's
8 Cs of clubbing

#باطنة
Thrombosis in cancer, also known as cancer-associated thrombosis, can be caused by various factors. Some of the common causes include:

1. Activation of blood coagulation: Cancer cells can trigger the activation of blood coagulation pathways, leading to the formation of blood clots.

2. Compression of blood vessels: Tumors can compress blood vessels, causing disruption in the flow of blood and increasing the risk of clot formation.

3. Chemotherapy and other cancer treatments: Some cancer treatments, such as chemotherapy, can damage the blood vessels, making them more prone to clot formation.

4. Immobility: Cancer patients may experience long periods of immobility, either due to the disease itself or as a side effect of treatment, which can contribute to the development of blood clots.

5. Increased levels of certain clotting factors: Some types of cancer can lead to an increase in the levels of clotting factors in the blood, making clot formation more likely.

6. Inflammation: Cancer-induced inflammation can promote the activation of the coagulation cascade, increasing the risk of thrombosis.

7. Endothelial dysfunction: Cancer cells can disrupt the function of the endothelial cells lining the blood vessels, leading to a pro-thrombotic state.

8. Tumor-related factors: Some tumors release substances that promote blood clotting, leading to an increased risk of thrombosis.

It is important for cancer patients to be aware of the risk of thrombosis and for healthcare providers to monitor and manage this risk through appropriate measures such as anticoagulant therapy and lifestyle modifications.

#باطنة
Necrotizing pneumonia ?

#باطنة
🛑Hepa Merz :
contains L-ornithine-L-aspartate ( LOLA ), Nicotinamide, and Riboflavin sodium phosphate. 

Hepa Merz is a hepatoprotective which is used in:-
Acute and chronic hepatitis,
Jaundice,
Fatty degeneration of liver Cirrhosis,
Liver damage due to alcohol hepatotoxic drugs,
Anorexia and indigestion.

L-ornithine L-aspartate is amino acids that reduces the accumulation of ammonia in patients with poor liver function and relieve symptoms of abnormal ammonia metabolism.

Nicotinamide is a form of vitamin B3 (niacin) and is used to prevent and treat niacin deficiency.
Riboflavin sodium phosphate involved in oxidation-reduction reactions in many metabolic pathways, and in energy production in the mitochondrial respiratory chain.
🛑 Dosage  :

is available both as an infusion concentrate (mainly for inpatients in hospitals) and as granules.

♦️The granules are packed in portions in small bags and can be dissolved e.g. in a glass of water, tea or juice and taken with or after meals.

Hepa-Merz granules are available in two dosages:
Hepa-Merz Granules 3000 contain 3 grams of L-ornithine L-aspartate per sachet.

Recommended dosage: up to 3x daily 1 – 2 sachets
packs of 30, 50 and 100 bags

Hepa-Merz Granules 6000 contain 6 grams of L-ornithine L-aspartate per sachet.

Recommended dosage: up to 3x daily 1 sachet
packs of 50 and 100 bags

♦️Hepa-Merz Infusion concentrate
Package sizes: 5x 10ml or 10x 10ml.

1 ampoule of 10ml concentrate contains 5g of LOLA in water for solution in 500ml NaCl.

Unless otherwise prescribed up to 4 amps/day pre-coma or coma: up to 8 amp/24 h, depending on severity of condition.

Infusion rate: 1 ampoule (5g LOLA) per hour

#باطنة
💊Pentoxifylline improves the flow of blood through blood vessels.
( Improves blood flow by decreasing blood viscosity and increasing red blood cell (RBC) flexibility )

May increase tissues oxygenation through enhanced blood flow

It is used to reduce leg pain caused by poor blood circulation. Pentoxifylline makes it possible to walk farther before having to rest because of leg cramps. 

Effects may be seen within 2-4 weeks; recommended to continue treatment for at least 8 weeks

- Dosage:-
400 mg PO TID with meals

Digestive or CNS side effects: Decrease dose to 400 mg BID; discontinue if adverse effects persist

Renal impairment (CrCl <30 mL/min): Decrease dose to 400 mg/day

#باطنة
Ventilator-associated pneumonia (VAP) results from the invasion of the lower respiratory tract and lung parenchyma by microorganisms. Intubation compromises the integrity of the oropharynx and trachea and allows oral and gastric secretions to enter the lower airways

Artificial airways become colonized with pathogenic bacteria soon after intubation or tracheostomy, and the major pathogens include both gram-positive and gram-negative bacteria: S. aureus (including MRSA), P. aeruginosa, and Klebsiella and Enterobacter specie, E coli.

#باطنة
Legionella pneumophila is a cause of community-acquired pneumonia that also induces electrolyte disorders, such as hyponatremia, hypokalemia, and hypophosphatemia. However, the mechanisms of these electrolyte disorders have not yet been clarified.

#باطنة
Reversible causes of Cardiac Arrest

#ER
H's and T's of ACLS
Signs and treatment

#ER