The use of high dose octreotide in management of neonatal chylothorax: Review

2021 ◽  
pp. 1-5
Author(s):  
M.A. Alhasoon
Keyword(s):  
Side Effects ◽  
Rare Condition ◽  
Optimal Dose ◽  
High Dose ◽  
Term Neonates ◽  
Risk Of Death ◽  
Key Words Neonates ◽  
Octreotide Treatment ◽  
Congenital Chylothorax ◽  
High Doses

BACKGROUND: Being a rare condition, the incidence of chylothorax among neonates is low, but the mortality rate is high. In a dire effort to reduce the risk of death, octreotide treatment is used to effectively treat acquired and congenital chylothorax. Octreotide is proven to effectively treat chylothorax in pre-term and full-term neonates. However, previous studies have not consistently demonstrated the optimal dose of octreotide or the best mode of administration. The objectives of this work were to review previous literature to determine the outcomes of administering high doses of octreotide compared to lower dose regimens in neonates with chylothorax and to determine best practices. METHODS: A literature search was performed using electronic databases using the key words neonates, chylothorax, and octreotide. RESULTS: Octreotide has been administrated in doses ranging from 0.5μg/kg/h to >  20μg/kg/h. Both low- and high-doses of octreotide are effective in resolving chylothorax with little to no side effects. When side effects were reported, neonates experienced side effects that are less significant in nature and scope. CONCLUSIONS: We recommend that the dose of octreotide in neonatal chylothorax can be titrated safely to a maximum of 20μg/kg/h without significant side effects.

scholarly journals Laying hens can convert high doses of folic acid added to the feed into natural folates in eggs providing a novel source of food folate

2008 ◽  
Vol 101 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Leane Hoey ◽  
Helene McNulty ◽  
Elizabeth M. E. McCann ◽  
Kelvin J. McCracken ◽  
John M. Scott ◽  
...  
Keyword(s):  
Folic Acid ◽  
Laying Hens ◽  
Optimal Dose ◽  
Leafy Vegetables ◽  
Natural Food ◽  
High Dose ◽  
Green Leafy Vegetables ◽  
Cost Efficient ◽  
High Doses ◽  
Food Folate

There are few good sources of natural food folates apart from green leafy vegetables and these may have a limited potential to increase folate status because of substantial losses that can occur during cooking. Fortified foods can overcome this but are controversial because of safety concerns regarding chronic exposure to high-dose folic acid (FA; the synthetic form). The aim of the present study was to develop eggs with an enriched natural folate content and minimal unmetabolised FA. Forty-eight, 30-week-old laying hens were randomised to receive the basal feed (formulated to provide 1 mg folate/kg feed) to which had been added one of the following FA levels (0, 2, 4, 8, 16, 32 mg/kg feed). Total folate was measured in eggs collected throughout the 12-week study period and the FA content estimated at 12 weeks. Results showed that the maximal egg folate content was achieved by adding 16 mg FA/kg feed. At this optimal dose, the total folate content per egg was 75 μg (compared with 32 μg in a regular egg) of which FA represented at most 10 %, a level which would probably be converted into natural folates by humans after ingestion. The results demonstrate that it is possible to use synthetic FA at high doses to produce novel animal foods enriched with natural folates in a cost-efficient process. Such foods may be particularly relevant to European populations without access to FA fortification and therefore dependent on natural food folate sources for the primary prevention of folate-related disease.

Role of High-Dose Intravenous Frusemide Therapy in the Management of Chronic Renal Failure

1975 ◽  
Vol 3 (4) ◽  
pp. 245-250
Author(s):  
Mam Chandra ◽  
M K Mitra ◽  
N N Gupta
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Side Effects ◽  
Treated Group ◽  
Fixed Dose ◽  
High Dose ◽  
Dose Regime ◽  
Diuretic Response ◽  
High Doses

The results of using high doses of intravenous frusemide in the management of 28 patients suffering from chronic renal failure are presented. The results are compared with those obtained from 14 patients also suffering from chronic renal failure, who received identical ‘conservative management’ but were not treated with diuretics. Large doses of intravenous frusemide produced a satisfactory diuretic response in a higher percentage of treated patients (71%) compared with controls (36%). It was also observed that in the treated group of patients a significant diuretic response could be obtained in patients with a creatinine clearance below 4 ml per minute. The study also demonstrated that in the group of patients receiving frusemide the response was better in those who were given a progressive-dose regime; 88% of patients improved with this regime compared with 68% of patients who were treated with a fixed dose of frusemide. Transient deafness with tinnitus and vertigo were the only side-effects observed. However these effects were only seen in patients who received 1000 mg or more frusemide in one day, administered over a period of one to two hours. It is concluded that all patients suffering from chronic renal failure should be given a trial of large doses of intravenous frusemide therapy, along with other conventional measures, particularly where facilities for dialysis are not immediately available.

scholarly journals Factors associated with outcomes of septic shock patients receiving high dose noradrenaline according to three primary infection sites

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987454
Author(s):  
Kang-song Wu ◽  
Dan-yan Gu ◽  
Ting-ting Wang ◽  
Bu-wen Yu ◽  
Kong-han Pan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Primary Infection ◽  
Medical Information ◽  
Respiratory Infections ◽  
High Dose ◽  
Do Not Resuscitate ◽  
Factors Associated ◽  
Risk Of Death ◽  
Urinary Infections ◽  
High Doses

Objective To identify factors associated with outcome of septic shock patients receiving high dose noradrenaline according to three primary infection sites. Methods This retrospective study was based on data from a publicly available ICU database (Medical Information Mart for Intensive Care [MIMIC] III. Septic shock patients receiving high dose (≥1 μg/kg per min) noradrenaline and ≥18 years were identified and their characteristics and outcomes were compared according to three primary infection sites (abdominal, respiratory and urinary tract). Results 154 septic shock patients who received high doses of noradrenaline were identified; (89 [58%] had a respiratory infection, 41 [27%] an abdominal infection and 24 [16%] a urinary infection). There were no differences among the three infection groups in duration/maximum dosage of noradrenaline, length of stay in the ICU/hospital, do not resuscitate (DNR) rates, hypertension and adequate antimicrobial therapy. Patients with urinary infections had a lower risk of death at 28-days compared with those with abdominal or respiratory infections. Conclusions The prognosis for septic shock patients receiving high dose noradrenaline is poor. Patients with abdominal or respiratory infections are at higher risk of death compared with those with urinary infections.

Investigation of Effects of Silymarin in 5-Fluorouracil Hepatotoxicity and Nephrotoxicity in Mice

2021 ◽  
Author(s):  
Emin Sengul ◽  
Volkan Gelen ◽  
Serkan Yildirim ◽  
Esra Senturk ◽  
Yusuf Dag ◽  
...  
Keyword(s):  
Dna Damage ◽  
Side Effects ◽  
Total Bilirubin ◽  
Control Group ◽  
High Dose ◽  
Liver And Kidney ◽  
Group 5 ◽  
High Doses ◽  
Kidney Functions ◽  
Liver And Kidney Damage

Abstract Hepatotoxicity and nephrotoxicity are common side effects of 5-Fluorouracil (5-FU). The present study aimed to investigate the effects of Silymarin (SLY) on 5-FU induced hepatotoxicity and nephrotoxicity in mice. In our study, 10 mice in each group were randomly divided into four groups as the control group, 5-FU, SLY50+5-FU, and SLY100+5-FU group. SLY50+5-FU and SLY100+5-FU groups were administered at a dose of 50 and 100 mg/kg for seven days, respectively. 5-FU was administered at a dose of 400 mg/kg intraperitoneally on the fourth day. After the applications, the mice were decapitated under anesthesia. The liver and kidney functions which urea, creatinine, AST, ALT, and total bilirubin levels were analyzed in serum. In liver and renal tissues, MDA and GSH levels, SOD, CAT, and GR activity were determined. Also, histopathological and immunohistochemical changes were examined in liver and kidney sections. Urea, creatinine, ALT, AST, and total bilirubin levels increased 5-FU group according to control and prevented to this increases the especially high dose of SLY. 5-FU also causes histopathological and immunohistochemical changes such as degeneration, necrosis, hyperemia, DNA damage, and IL-6 increase in kidney and liver tissue. High doses of SLY prevented these changes caused by 5-FU. As a result of this study, it was determined that SLY has hepatoprotective and nephroprotective effects on 5-FU-induced liver and kidney damage in mice.

Dialysis therapy for lactic acidosis caused by metformin intoxication: presentation of two cases

2011 ◽  
Vol 30 (12) ◽  
pp. 1995-1997 ◽  
Author(s):  
Yasemin Usul Soyoral ◽  
Huseyin Begenik ◽  
Habib Emre ◽  
Enver Aytemiz ◽  
Mustafa Ozturk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Side Effects ◽  
Lactic Acidosis ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
High Dose ◽  
Type Ii ◽  
Dialysis Therapy ◽  
Oral Antidiabetic ◽  
High Doses

Metformin is an oral antidiabetic, which is frequently used in the treatment of type II diabetes mellitus. Serious side effects may be seen during the administration of high doses of metformin. Two cases of lactic acidosis due to ingestion of high dose metformin for suicidal purposes have been presented here; in both cases, clinical improvement was seen with bicarbonate hemodialysis.

scholarly journals Systemic Minoxidil Accidental Exposure in a Paediatric Population: A Case Series Study of Cutaneous and Systemic Side Effects

2021 ◽  
Vol 10 (18) ◽  
pp. 4257
Author(s):  
Manuel Sánchez-Díaz ◽  
David López-Delgado ◽  
Trinidad Montero-Vílchez ◽  
Luis Salvador-Rodríguez ◽  
Alejandro Molina-Leyva ◽  
...  
Keyword(s):  
Side Effects ◽  
Treatment Time ◽  
Case Series ◽  
Paediatric Population ◽  
High Dose ◽  
Retrospective Case ◽  
Case Series Study ◽  
High Doses ◽  
Initial Zone ◽  
Series Study

Oral minoxidil is an approved treatment for high blood pressure which is also used as an off-label drug for alopecia. Knowledge about the effects of systemic minoxidil in the paediatric population is limited. A retrospective case series study of paediatric patients with history of systemic minoxidil intake due to contaminated sets of omeprazole was performed to describe side effects of high dose oral minoxidil intake in children. Twenty patients aged between 2 months and 13 years joined the study. They had received high doses of oral minoxidil (mean dose 0.90 mg/kg/day) during a mean time of 38.3 days. Hypertrichosis appeared in 65%, with a mean latency time of 24.31 days. Treatment time was associated with the appearance of hypertrichosis (p < 0.05). Most common initial zone of hypertrichosis was the face. Systemic effects developed in 15%, with no cases of severe disorders. The present study shows a novel insight into the side effects of high doses of oral minoxidil in children.

scholarly journals Application of polymeric nanoparticles in oral delivery of recombinant human erythropoietin: A review

2019 ◽  
Vol 9 (1-s) ◽  
pp. 403-407
Author(s):  
Pankaj Rajendra Dhapake ◽  
Jasmine G Avari
Keyword(s):  
Side Effects ◽  
Drug Release ◽  
Oral Delivery ◽  
Recombinant Human Erythropoietin ◽  
Dosage Form ◽  
The Body ◽  
High Dose ◽  
Risk Of Death ◽  
Human Erythropoietin ◽  
Increased Risk

Recombinant Human Erythropoietin drugs are known as erythropoietin stimulating agents which stimulate the bone marrow to produce more red blood cells in the body. It is used an antianemic in the treatment of renal anemia and chemotherapy induced anemia. It also use in treatment of HIV, cerebral malaria and neurological disease like schizophrenia. The recombinant human erythropoietin dosage form currently available in the market is parenteral dosage form that is ready for injection liquid vial (syringe), which is usually administered 2-3 times weekly. To achieve a therapeutic effect of parenterally administered EPO, cumulative doses are required that significantly exceed levels of endogenous EPO. These high serum levels result in prolonged circulation times of EPO and unspecific binding to non-targeted tissue, which may lead to severe undesired side effects i.e. growth of tumor and also increased risk of death. By using the nanotechnology, side effects and toxicity related to high dose of erythropoietin should be reduces and prolong drug release. this will achieve by reducing administration frequency and lowering dosage of erythropoietin. Keywords: Recombinant Human Erythropoietin, Nanoparticle, Prolong drug release, Anemia

scholarly journals Effects of rhBMP-2 Loaded Hydroxyapatite Granules/beta-Tricalcium Phosphate Hydrogel (HA/β-TCP hydrogel) Composite on a Rat Model of Coccygeal Intervertebral Fusion.

2021 ◽  
Author(s):  
Shinichi Nakagawa ◽  
Rintaro Okada ◽  
Junichi Kushioka ◽  
Joe Kodama ◽  
Hiroyuki Tsukazaki ◽  
...  
Keyword(s):  
Side Effects ◽  
Tricalcium Phosphate ◽  
Posterior Lumbar Interbody Fusion ◽  
High Dose ◽  
Fusion Model ◽  
Intervertebral Fusion ◽  
Beta Tricalcium Phosphate ◽  
Morphogenetic Protein ◽  
Ectopic Bone ◽  
High Doses

Abstract The effects and inflammation-related side effects of bone morphogenetic protein (BMP)-2 on posterior lumbar interbody fusion are controversial. One of the potential causes for the inconsistent results is the uncontrolled release of BMP-2 from the collagen carrier. Therefore, BMP delivery systems which support effective bone regeneration while attenuating side effects are strongly sought for. We developed NOVOSIS putty (NP), a novel composite material of hydroxyapatite (HA), beta-tricalcium phosphate (β-TCP)-hydrogel, and BMP-2, which can sustainably release BMP-2 over two weeks. This study investigated the effects and side effects of NP compared with those of collagen sponge (CS) containing BMP-2 using a rat coccygeal intervertebral fusion model. The fusion rates of NP with low and high doses of BMP-2 were significantly higher than those of an iliac bone (IB) graft, but those of CS with low and high doses of BMP-2 were not different from those of the IB graft. Furthermore, the incidences of ectopic bone formation and soft tissue swelling were significantly lower in the NP group than in the CS group. The HA/β-TCP hydrogel carrier enabled superior bone induction with low-dose BMP-2 and decreased the incidence of side effects caused by high-dose BMP-2 compared with that of the collagen carrier.

Acute cerebellar toxicity induced by high dose of cytarabine (HiDAC): A case report

2020 ◽  
Vol 26 (6) ◽  
pp. 1492-1494 ◽  
Author(s):  
Hamid Rahmani ◽  
Mojan Radmehr ◽  
Molouk Hadjibabaie ◽  
Mohammad Solduzian
Keyword(s):  
Acute Myeloid Leukemia ◽  
Case Report ◽  
Side Effects ◽  
Myeloid Leukemia ◽  
High Dose ◽  
High Dose Cytarabine ◽  
Pyrimidine Analogue ◽  
High Doses ◽  
Different Doses ◽  
Acute Myeloid

Cytarabine is a pyrimidine analogue that is used for the treatment of acute myeloid leukemia at different doses. Standard doses of cytarabine are used for induction therapy, while high doses are used for post-remission (consolidation) and relapsed/refractory treatment. One of the major side effects of its high doses is acute cerebellar toxicity occurring in 10 to 25% of patients. We report a case that developed this side effect after receiving two doses of high-dose cytarabine. The patient’s symptoms improved after withholding the drug. Thereafter, the patient tolerated treatment continuation with lower doses.

scholarly journals Myocardial dissection complicating left sinus of Valsalva aneurysm in silent takayasu arteritis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Astri Astuti ◽  
Achmad Hafiedz Azis Kartamihardja ◽  
Muhammad Adniel Ilhamy ◽  
Muhammad Dinnar Fahlavi ◽  
Nuraini Yasmin Kusumawardhani ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Rare Condition ◽  
Optimal Dose ◽  
High Dose ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Clinical Criteria ◽  
Satisfactory Outcome ◽  
History Of ◽  
Left Sinus Of Valsalva

Abstract Background Myocardial dissection (MD) in a left sinus of Valsalva aneurysm (LSVA) is a rare condition that may lead to a fatal complication. Determining the MD etiology is challenging because of various possibilities ranging from congenital to acquired diseases. Here, we discuss an approach for determining the etiology of MD complicating LSVA in Takayasu arteritis (TA) and its treatment. Case presentation A 41-year-old man presented with dyspnea on heavy activities and a history of consciousness loss at the age of 24 years. He was diagnosed with dilated cardiomyopathy and MD complicating LSVA in TA based on combined clinical and pathognomonic diagnostic criteria of TA evaluated using vascular Doppler and computed tomography angiography of the aorta. The patient refused to undergo surgery and received an optimal dose of chronic heart failure therapy, a high-dose steroid, and azathioprine. The patient experienced some improvements in clinical condition, functional outcome, and inflammatory markers at 1-year follow-up. Conclusions Clinical criteria and various imaging modalities may be used to determine the etiology of MD complicating LSVA in silent TA. As an alternative to surgery, the optimal medical treatment might result in a satisfactory outcome.

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