Dr. Shannon Replies

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 619-619
Author(s):  
Daniel C. Shannon
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Intravenous Administration ◽  
Ductus Arteriosus ◽  
Oral Feeding ◽  
Blood Levels ◽  
Severe Toxicity ◽  
Potential Toxicity ◽  
Nasojejunal Tube ◽  
Rectal Route

Dr. Morens raises questions of potential toxicity of theophylline in the gastrointestinal tract, kidney and ductus arteriosus. Except for vomiting, which has occurred in some infants when blood levels have been excessive (mainly 2Oµg/ml), we have not observed any of these side effects in treating 93 infants. In all infants, treatment was given through a nasogastric or nasojejunal tube until oral feeding was possible. Because acute severe toxicity in children and adults has been related to intravenous administration, we have used this route only when necessary. Because of erratic absorption, we have avoided the rectal route.

scholarly journals Patent ductus arteriosus in preterm infants; experience of a tertiary referral neonatal intensive care unit: prevalence, complications, and management

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Side Effects ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

scholarly journals IV Paracetamol for closure of patent ductus arteriosus in preterm neonates admitted to a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 294 ◽  
Author(s):  
Sunil B. ◽  
Shruthi Patel ◽  
Girish N.
Keyword(s):  
Side Effects ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Tertiary Care ◽  
Current Treatment ◽  
Preterm Neonates ◽  
Tertiary Care Centre ◽  
Vascular Connection ◽  
Intravenous Paracetamol

Background: Ductus arteriosus is a vascular connection between the pulmonary artery and descending aorta. The incidence is inversely related to birth weight and gestational age (GA). In preterm infants it varies between 40% and 60% on the third day of life. At present, the choice of treatment of clinically significant PDA is with either ibuprofen or indomethacin, but they carry many contraindications and potential side effects. Hence it is important to consider that paracetamol may be used as an alternative to other non steroidal anti-inflammatory drugs and is effective in ductal closure with minimal side effects.Methods:Thirty six preterm infants with hemodynamically significant PDA(hs-PDA) were treated with intravenous paracetamol and subsequent closure was evaluated clinically and by follow-up 2D-Echo.Results: PDA closure following intravenous paracetamol was evident in 27 babies (75%). There were no significant side effects noted with paracetamol therapy.Conclusions: This study shows that paracetamol could offer favourable safety profile in comparison to current treatment options. Therefore, paracetamol may be accepted as a first-line drug treatment for PDA in preterm infants. 

scholarly journals Studies on the Metabolic Fate of Flecainide Acetate. (1). Blood Levels, Distribution, Metabolism and Excretion in Rats after Repeated Intravenous Administration.

1999 ◽  
Vol 14 (3) ◽  
pp. 201-213
Author(s):  
Mannen MISHIMA ◽  
Masataka UEDA ◽  
Atsushi TAKAO ◽  
Atsuhiro INABA ◽  
Keiko KAMIYA ◽  
...  
Keyword(s):  
Intravenous Administration ◽  
Blood Levels ◽  
Metabolic Fate ◽  
Flecainide Acetate

scholarly journals Evaluation of the Effect of Shenmai Injection on Chemotherapy Efficacy and Side Effects of Acute Leukemia

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Jianling Qiao ◽  
Xuan Kan ◽  
Fei Qin
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Acute Leukemia ◽  
Control Group ◽  
Blood Levels ◽  
Observation Group ◽  
Impaired Liver Function ◽  
Shenmai Injection ◽  
Before And After ◽  
Bone Marrow Blood

Objective: To study the effect of Shenmai injection on the efficacy and side effects of chemotherapy in acute leukemia. Methods: Sixty-two patients with acute leukemia admitted to the hospital between February 2018 and June 2019 were enrolled in this study. All patients were divided into observation and control groups according to different treatment methods in chemotherapy. The control group was treated with chemotherapy alone. The observation group was treated Shenmai injection combined with chemotherapy. The treatment effect of the two groups was compared, and the incidence of bone marrow blood and side effects before and after treatment were compared. Results: The therapeutic effect of the observation group was 93.55% which was much higher than that of the control group of 74.19%, P<0.05. The bone marrow blood levels of WBC, PLT and Hb in the observation group before and after treatment were 23.97±3.05, 6.76±1.27, 69.01±8.15, 66.96±9.46, 91.07±8.15, 89.35±7.46, respectively, compared with the control group. The difference in the situation after treatment was found to be significant. The incidence of toxic side effects such as nausea and vomiting, impaired liver function and renal dysfunction in the observation group was 9.68%, which was lower than that of the control group (32.26%, P<0.05). Conclusion: Shemai injection has significant effects on the efficacy and side effects of chemotherapy in acute leukemia and effectively improves the effect of chemotherapy.

Side Effects of Sugar Substitutes during Intravenous Administration

1975 ◽  
Vol 18 (1) ◽  
pp. 227-241 ◽  
Author(s):  
D.W. Thomas ◽  
J.B. Edwards ◽  
R.G. Edwards
Keyword(s):  
Side Effects ◽  
Intravenous Administration ◽  
Sugar Substitutes

In Reply: Cerebral Blood Flow

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 1013-1014
Author(s):  
RAUL BEJAR
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gastrointestinal Tract ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Blood Flows ◽  
Before And After ◽  
Regional Blood Flows ◽  
Left Ventricular Output ◽  
Patent Ductus

Baylen and Emmanouilides give the impression that their abstract was misquoted in our commentary. We would like to explain our interpretation of their data. In the abstract, Baylen et al indicate that they measured regional blood flows (RBF) in premature fetal lambs, expressing them as a percentage of the left ventricular output (LVO) before and after patent ductus arteriosus (PDA) closure. Their results (percent of LVO) before and after PDA closure were: lung, 42.7% vs 8.4% (P &lt; .01); carcass, 35% vs 55% (P &lt; .01); heart, 5.5% vs 10.2% (P &lt; .05); gastrointestinal tract, 5.1% vs 9.3% (P &lt; .05); brain, 2.7% vs 3.4% (P = NS); kidney, 2.2% vs 3.3% (P = NS); liver, 3.2% vs 5.7% (P = NS).

Effect of Vitamin E and Selenium (Se) Supplementation on Biochemical Parameters and Expression of Metallothionein (MT-2) in Heavy Metals Exposed Buffaloes

2021 ◽  
Author(s):  
Himalaya Bhardwaj ◽  
Chanchal Singh ◽  
Shashi Nayyar ◽  
Sandeep Sodhi ◽  
Rajesh Jindal
Keyword(s):  
Heavy Metals ◽  
Heavy Metal ◽  
Vitamin E ◽  
Metal Binding ◽  
Biochemical Parameters ◽  
Lactic Dehydrogenase ◽  
Oral Feeding ◽  
Farm Animals ◽  
Blood Levels ◽  
Plasma Vitamin

Background: Farm animals may serve as bio-indicators of environmental pollution. Environmental heavy metals may disrupt the normal physiological and biochemical profile of the animals. The present study was planned to reduce the stress caused by heavy metal pollution by oral feeding of vitamin E and Selenium in heavy metals exposed buffaloes.Methods: Twenty buffaloes were selected on the basis of blood levels of heavy metals and divided into exposed and non-exposed groups. Exposed animals (n=10) were orally supplemented with 20 ml/day of Cargill E care Se® containing vitamin E, 100mg/ml and Se 0.5mg/ml for 30 days. Antioxidants, biochemical parameters and the expression of metallothionein-2 were analyzed after supplementation on 0, 15 and 30 days.Result: The levels of heavy metal were found to be elevated even after 30 days of supplementation. No significant alterations were observed in activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) after 30 days of supplementation. There was significantly (p less than 0.05) higher activity of blood glutathione and plasma Vitamin E. In supplemented group, plasma glucose, total cholesterol, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), lactic dehydrogenase (LDH), creatine kinase (CK) and total Immunoglobulin were found to be significantly reduced in supplemented group. Expression of metal binding protein, metallothionein-2 was found to be elevated in exposed animals despite supplementation with Vitamin E and Se for 30 days.

Clinical Evaluation of High Weekly Intravenous Doses of Methotrexate in Advanced Oropharyngeal Carcinoma

1970 ◽  
Vol 56 (5) ◽  
pp. 259-268 ◽  
Author(s):  
Giuseppe M. de Palo ◽  
Mario De Lena ◽  
Roberto Molinari ◽  
Antonio Cunsolo ◽  
Silvio Monfardini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Intravenous Administration ◽  
Renal Toxicity ◽  
Severe Depression ◽  
Response To Treatment ◽  
Oropharyngeal Carcinoma ◽  
Intraarterial Infusion ◽  
Intravenous Injections ◽  
Duration Of Response

Methotrexate (MTX) was given by weekly rapid intravenous injections to 27 patients with inoperable oropharyngeal carcinoma. 9 cases were untreated while 18 had received radiotherapy or chemotherapy before administration of MTX. In 20 cases the dose was 40 mg/m2/week (patients over 50 years) and in 7 cases 60 mg/m2/week (table 1). In responsive patients, maintenance treatment was given at the dose of 15 mg/m2 every 4 days either orally or intramuscularly. 23 cases were adequately evaluable, i.e. they received treatment for a minimum of 3 weeks. Response to treatment was evaluated according to Karnofsky's scale. Considering only category 1 regressions, 11/16 (75%) patients adequately treated with 40 mg/m2 showed objective improvement and respectively 4/7 (57%) given 60 mg/m*. 8 out of 15 cases (41%) with category 1 response showed a regression greater than 50%. The mean duration of response for category 1 patients was 3.5 months, while the longest regression lasted 9 months (table 2). 18 patients had one or more side effects: 9 had oral lesions or gastroenteritis, 12 bone marrow depression, 3 hepatic and 1 renal toxicity. One patient died from hepatic and renal toxicity; in the remaining cases the side effects were quickly reversible (table 3). The percent regression rate for category 1 response and its average duration obtained with intravenous MTX seems comparable to intraarterial infusion (table 4). Systemic toxicity seems also comparable (table 5). Furthermore, intravenous administration obviates the typical local complications occurring with intra-arterial treatment and therapy can be given also at outpatients. For this reason, intravenous administration of MTX is preferred to intra-arterial infusion in the control of primary inoperable oropharyngeal carcinomas, provided no severe depression of liver, kidney and bone marrow is present.

Review of normal gastrointestinal tract, ulcerative colitis, proctitis and rectal medication adherence

2020 ◽  
Vol 29 (14) ◽  
pp. 805-811
Author(s):  
Pineshwari Naeck-Boolauky ◽  
Jitka Adio ◽  
Jennie Burch
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Gastrointestinal Tract ◽  
Side Effects ◽  
Rectal Mucosa ◽  
Gi Tract ◽  
Therapeutic Outcomes ◽  
Rectal Medication ◽  
Inflammatory Bowel

The gastrointestinal (GI) tract has a number of functions—ingestion, digestion, absorption and elimination. When the GI tract is working normally, it is efficient. However, this can change when disease, such as inflammatory bowel disease (IBD) occurs. IBD is a long-term relapsing and remitting autoimmune disease; it incorporates ulcerative colitis (UC). In UC, part or all the mucosa lining the rectum and colon becomes inflamed and ulcerated. UC that affects the rectum only is called proctitis. Effective treatment is essential. It is better to target the rectal mucosa directly in proctitis, using topical rectal medications in enemas or suppositories, as these have fewer side-effects and resolve symptoms more quickly than systemic drugs. However, patients may not feel clear about aspects of their IBD care and can find it difficult to initiate and comply with treatment and maintenance regimens. Nurses need to educate and support them to achieve optimal therapeutic outcomes in both the immediate and long terms.

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