I am professionally pharmacist. These slides for clinical subject. Especially for pharmacy department students. I hope these students get more benefits about it.
Gentamicin 40 mg per ml injection smpc taj pharmaceuticalsTaj Pharma
Gentamicin - Drug Information - Taj Pharma, Gentamicin dose Taj pharmaceuticals Gentamicin interactions, Taj Pharmaceutical Gentamicin contraindications, Gentamicin price, Gentamicin Taj Pharma Gentamicin 40 mg/ml Injection SMPC- Taj Pharma . Stay connected to all updated on Gentamicin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Management Of Nephrotic Syndrome
Objectives
To briefly review the definition & etiology of nephroticsyndrome.
To understand the terminology pertaining to clinical course of nephroticsyndrome.
To understand the management of nephroticsyndrome:Specific management & Supportive care and management of complications
Management of congenital nephrotic syndrome
This presentation was presented to pharmacy students and faculty. The topic of discussion was supportive care in cancer treatment and combating emesis. The presentation looks into the pathophysiology, treatment priniciples and regimes for chemotherapy induced emesis.
Deflazacort 6mg tablets smpc taj pharmaceuticalsTaj Pharma
Deflazacort Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Deflazacort Dosage & Rx Info | Deflazacort Uses, Side Effects -: Indications, Side Effects, Warnings, Deflazacort - Drug Information - Taj Pharma, Deflazacort dose Taj pharmaceuticals Deflazacort interactions, Taj Pharmaceutical Deflazacort contraindications, Deflazacort price, Deflazacort Taj Pharma Deflazacort 6mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Deflazacort Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Gentamicin 40 mg per ml injection smpc taj pharmaceuticalsTaj Pharma
Gentamicin - Drug Information - Taj Pharma, Gentamicin dose Taj pharmaceuticals Gentamicin interactions, Taj Pharmaceutical Gentamicin contraindications, Gentamicin price, Gentamicin Taj Pharma Gentamicin 40 mg/ml Injection SMPC- Taj Pharma . Stay connected to all updated on Gentamicin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Management Of Nephrotic Syndrome
Objectives
To briefly review the definition & etiology of nephroticsyndrome.
To understand the terminology pertaining to clinical course of nephroticsyndrome.
To understand the management of nephroticsyndrome:Specific management & Supportive care and management of complications
Management of congenital nephrotic syndrome
This presentation was presented to pharmacy students and faculty. The topic of discussion was supportive care in cancer treatment and combating emesis. The presentation looks into the pathophysiology, treatment priniciples and regimes for chemotherapy induced emesis.
Deflazacort 6mg tablets smpc taj pharmaceuticalsTaj Pharma
Deflazacort Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Deflazacort Dosage & Rx Info | Deflazacort Uses, Side Effects -: Indications, Side Effects, Warnings, Deflazacort - Drug Information - Taj Pharma, Deflazacort dose Taj pharmaceuticals Deflazacort interactions, Taj Pharmaceutical Deflazacort contraindications, Deflazacort price, Deflazacort Taj Pharma Deflazacort 6mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Deflazacort Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
1. Gentamicin
• Clinical use
• The spectrum of activity of gentamicin is
similar to other aminoglycosides but its
most significant activity is against
Psuedomonas aeruginosa.
• It is still regarded by many as first choice for
this type of infection.
2. • Therapeutic range
• Gentamicin has a low therapeutic index, producing dose related side
effects of nephro- and ototoxicity.
• The use of TDM to aid dose adjustment if these toxic effects which appear
to be related to peak and trough plasma levels are to be avoided.
• It is generally accepted that the peak level (drawn 1 h post-dose after an
intravenous bolus or intramuscular injection) should not exceed 12 mg/L
and the trough level (drawn immediately pre-dose) should not exceed 2
mg/L.
• The above recommendations relate to multiple daily dosing of
gentamicin. If once daily dosing is used, then different monitoring and
interpretation parameters may apply.
3.
4. • Distribution
• Gentamicin is relatively polar and distributes primarily into
extracellular fluid.
• Thus, the apparent volume of distribution is only 0.3 L/kg.
• Gentamicin follows a two-compartment model with
distribution being complete within 1 h.
• Elimination
• Elimination is by renal excretion of the unchanged drug.
• Gentamicin clearance is approximately equal to creatinine
clearance.
5. • Practical implications
• Therapeutic range is based on peak (1 h
post-dose to allow for distribution) and
trough (pre-dose) concentrations,
6. • Initial dosage. This may be based on the
patient's physiological parameters.
Gentamicin clearance may be determined
directly from creatinine clearance.
• The volume of distribution may be
determined from ideal body weight.
7. Single dose (STAT) and Once
daily (OD) gentamicin regimen
• 5mg/kg once daily
• Dose: 5mg/kg OD (Maximum daily dose: 480mg)
• Administration: in100ml normal saline or glucose 5%
infused over 60mins
• Advantages
• high peaks are more effective in achieving bacterial kill
• Long post antibiotic effect therefore not necessary to have
levels above the mean inhibitory concentration (MIC) all
day
• Reduced risk of nephrotoxicity due to washout period
allowed by infrequent dosing
• No greater risk of ototoxicity.
• Monitoring of levels is simpler
• Less nursing time required to administer the antibiotic
8. • Indications for OD Regimen
• Severe sepsis of unknown cause and/or oliguria
• Intra-abdominal sepsis
• Urological sepsis
• Hospital acquired pneumonia
• Exclusion of OD Regimen
• Significant renal impairment
• Pregnant patients
• Endocarditis
• Patients with cystic fibrosis
• Patients with severe burns
9. • However
• A second dose MAY be given after a 24 hour Interval if there
is no clinical improvement, and providing the renal function
has not become impaired.
• Should once daily gentamicin be required for more than two
doses, this should be guided by serum trough levels.
• Unless for specific conditions i.e infective endocarditis and
neutropenic sepsis, gentamicin should not be given > 5
days as this increase the risk of toxicity.
10.
11. • Once daily dosing. There are theoretical arguments for once
daily dosing of gentamicin, since aminoglycosides display
concentration-dependent bacterial killing, and a high enough
concentration to minimum inhibitory concentration (MIC) ratio
may not be achieved with multiple dosing.
• Furthermore, aminoglycosides have a long post-antibiotic effect.
• Aminoglycosides also accumulate in the kidneys, and once daily
dosing could reduce renal tissue accumulation.
12. • There have been a number of clinical trials
comparing once daily administration of
aminoglycosides with conventional
administration.
• A small number of these trials have shown less
nephrotoxicity, no difference in ototoxicity, and
similar efficacy with once daily administration.
13. Initial dosage for a once daily regimen is 5–7 mg/kg/day for
patients with a creatinine clearance of >60 mL/min.
• This is subsequently adjusted on the basis of blood levels.
However, monitoring of once daily dosing of gentamicin is
different to multiple dosing.
• One approach is to take a blood sample 6–14 h after the first
dose and plot the time and result on a standard
concentration-time plot (the Hartford nomogram, Nicolau et
al., 1995).
14. • Once daily dosing of gentamicin has not been
well studied in pregnant or breastfeeding
women, patients with major burns, renal failure,
endocarditis or cystic fibrosis.
• Therefore, it cannot b recommended in these
groups and multiple daily dosing should be
used
15. Once Daily Dose in Renal
Impairment
• Dose: 3 mg/kg OD
• Administration: In 100ml normal saline or
glucose 5% infused over 60mins
• In patients receiving ≥ 2 doses, a post
dose gentamicin level should be
collected 18 –24 hours after the last dose
(i.e., a pre-dose level)
16. Monitoring for Once Daily
Regimen
• Aim for a pre-dose (trough) level of < 1mg/L.
• Take a pre-dose level (18-24hours) before giving the next dose.
• Clearly mark on the request form how many hours after the dose
the sample has been taken.
• Unless patients are at risk of nephrotoxicity due to pre-existing
renal impairment or are receiving multiple nephrotoxic agents
(e.g some chemotherapy agents).
• Do not wait for the result to come back before giving the next
dose, adjust the regimen around the next and subsequent dose if
applicable
17. • Post dose (peak) levels are not required.
• When the first dose of gentamicin has been given in the evening or night,
the level should be taken by 1500hr the following day if this falls within
18-24 hour window and sent for analysis immediately.
• Renally Impaired
• Await assay result and give dose when level <1mg/L.
• Always monitor renal function carefully by checking urine output daily
and serum creatinine levels 2 –3 times per week, especially for courses
longer than 5 days duration.
• Risk of toxicity increases when duration of the treatment course exceeds
5 days.
• Prolonged courses of gentamicin must only be given only when there is a
clear clinical need e.g. endocarditis.
18. Multiple daily dose synergistic
regimen for infective endocarditis
• All cases of infective endocarditis must be
referred to a cardiologist
• Dose:1mg/kg every 12 hours (Max 240mg/day)
• Administration: IV injection in 10-20ml saline or
glucose 5% over at 3–5 mins IV infusion in 50ml
normal saline or glucose 5% infused slowly over
20mins –30mins
19. • Gentamicin is given in low doses primarily for its
synergistic effect with beta-lactam antibiotics.
• Regular monitoring of serum levels is important to ensure
that there is enough drug is present throughout a 24-hour
period to act with the beta-lactam.
• Because gentamicin may be given for several weeks in this
context, it is also important to ensure that the drug is being
adequately renally excreted.
• Baseline audiometry is recommended for patients who
require extended treatment (>2 weeks) with this agent
20. Monitoring
• Take pre-dose (trough level) sample before giving the 3rd or
4th dose after commencement.
• This should also be the case after any dose adjustment.
• Post-dose (peak level) should be taken ONE HOUR after the
end of the infusion.
• For streptococcal/enterococcal endocarditis infections aim
for:
• Pre-dose levels: <1mg/L
• Post-dose levels: 3-5mg/L
21. Serum levels Actions
Pre-dose level <1mg/L
Post-dose level around 3-5mg/L
Continue current regimen
Re-check levels after a further 3 or 4
doses
Pre-dose level >2mg/L
Post dose level 5mg/L or above
Omit further doses until level <1mg/L
Increase the dosing interval to 24-hourly
Re-check levels after a further 3 or 4
doses
Pre-dose level <1mg/L
Post dose level <3mg/L
Increase dose and remain on 12
-hourly dosing interval
Re-check levels after a further 3 or 4
doses
22. Conventional Multiple Dose
Regimen
• Multiple daily doses therapeutic regimen has largely been
superseded by once daily gentamicin regimen and is
generally not recommended
• Except for pregnant patients, patients with cystic fibrosis or
severe burns
• Dose: 3-5mg/kg in divided doses (8 -12 hourly)
• Administration: IV injection in 10-20ml saline or glucose 5%
over at 3–5 mins IV infusion in 50ml normal saline or
glucose 5% infused slowly over 20mins –30mins
23. Monitoring
• Both pre and post dose levels are required.
• Take pre-dose (trough level) sample before giving the 3rd or 4th
dose after commencement.
• This should also be the case after any dose adjustment.
• Pre-dose (trough level) should be taken 8 or 12 hours after the
previous dose for tds and bd regimens respectively
• Post-dose (peak level) should be taken ONE HOUR after the end
of the infusion.
• Aim for pre-dose (trough) level < 2mg/L
• For most infections, aim for post-dose level of 5 –10mg/L
24. Pre-dose
Level
Action
< 2mg/L Continue current regimen.
Ensure the patient is responding clinically.
Further pre-dose level to be monitored twice weekly so long
renal function is stable
2 – 3 mg/L Increase dosing interval i.e. from tds to bd provided renal
function is unchanged.
> 3 mg/L Further gentamicin doses should be withheld until level
<1mg/L.
If further doses are required, re-start with increased
interval/decreased dose.
25. Post-dose
Level
Action
Below Target Check previous dose(s) have been given as prescribed.
If the low post-dose level appears genuine, gentamicin is sub-
therapeutic. Consider increasing the dose
High Levels Ensure level is not taken via an intravenous catheter that is
used for the administration of the antibiotic as this will give
false high level.
Consider reducing the dose (and the dose frequency). Final
action dependent on trough level also.
26. Post-dose Level Action
Pre-dose level < 2mg/L
(normal)
Post dose level is above target
range
Reduce the Dose
Both pre-dose and post-dose
levels are above target range
Omit next dose
Review need for further gentamicin
Consider increasing the interval between
doses
Restart gentamicin when pre-dose level
<2mg/L