Maximum daily dose of hydrocodone

2010 ◽  
Vol 67 (19) ◽  
pp. 1588-1589 ◽  
Author(s):  
Dana M. Nerenberg ◽  
Jeffrey Fudin
Keyword(s):  
Maximum Daily Dose ◽  
Daily Dose

A Grave Case of Morphia and Cocaine Habit [Considérations sur un cas grave de morphi-cocaïnomanie]. (Prog. Méd., May 12th, 1900.) Sollier, P

1901 ◽  
Vol 47 (198) ◽  
pp. 603-603
Author(s):  
W. C. Sullivan
Keyword(s):  
Subcutaneous Tissue ◽  
Abdominal Region ◽  
Maximum Daily Dose ◽  
Daily Dose

The patient was a medical man, æt. 40; the morphia habit dated back ten years, the maximum daily dose being 3 grammes; the cocaine habit was more recent. When the case came under Sollier's treatment the intoxication was profound; the patient was emaciated; there was diffuse induration of the subcutaneous tissue, and there were numerous ulcers in the abdominal region where the patient injected the drugs; the urine contained albumen, and severe uræmic symptoms had appeared; the hæmoglobin was reduced to 4·5 per cent., and was shown by the spectroscope to be very imperfectly oxidised. The author specially indicates this blood-state, as he considers that the symptoms of collapse on the withdrawal of morphia are due to asphyxia.

Dosing of valproate in an elderly population with dementia: Evaluation of discontinuations and dose reductions

2012 ◽  
Vol 1 (11) ◽  
pp. 274-276
Author(s):  
Jonathan G. Leung ◽  
Sandra Mullen
Keyword(s):  
Elderly Patients ◽  
Dose Reduction ◽  
Psychiatric Hospitalization ◽  
Psychological Symptoms ◽  
Functional Decline ◽  
Total Daily Dose ◽  
Maximum Daily Dose ◽  
Daily Dose ◽  
Record Review ◽  
Initial Starting

It is estimated that more than half of elderly patients with dementia will develop some degree of behavioral and psychological symptoms of dementia (BPSD). BPSD is associated with significant morbidity, rapid functional decline, and psychiatric hospitalization, and there are currently no medications approved by the Food and Drug Administration (FDA) for its treatment. One treatment option that has been evaluated is the antiepileptic drug valproate. This retrospective medical record review evaluated the tolerability of valproate in elderly patients with dementia. A total of 62 patients met inclusion criteria for this review, which sought to determine whether there was an association either between the initial valproate dose and discontinuation or dose reduction (DCDR) or the maximum valproate dose achieved and DCDR. Both the total daily dose and total daily dose in mg/kg were assessed. For both the maximum daily dose (OR 1.0; 95% CI 0.99, 1.01) and maximum daily mg/kg dose (OR =1.15; 95% CI 0.92, 1.49) there was also no association with DCDR. There was no associated risk of DCDR when evaluating initial daily doses (OR: 1.0; 95% CI: 0.99 – 1.01). However, an association between DCDR and initial daily mg/kg dose was found (OR: 1.92; 95% CI: 1.11–4.02). For both the initial dose and initial mg/kg dose model, African Americans were associated with the need for DCDR (OR 20.75; 95% CI: 1.77–660). Results from this study suggest that higher initial starting doses based on weight may lead to higher rates of side effects necessitating a discontinuation or dose reduction; however, large trials are needed to confirm these results.

Patterns of acetaminophen medication use associated with exceeding the recommended maximum daily dose

2015 ◽  
Vol 24 (9) ◽  
pp. 915-921 ◽  
Author(s):  
Saul Shiffman ◽  
Jeffrey M. Rohay ◽  
Deena Battista ◽  
Judith P. Kelly ◽  
Mary K. Malone ◽  
...  
Keyword(s):  
Medication Use ◽  
Maximum Daily Dose ◽  
Daily Dose

The influence of obesity on hydroxychloroquine blood levels in lupus nephritis patients

Lupus ◽  
2021 ◽  
pp. 096120332098521
Author(s):  
Tatiana Pedrosa ◽  
Léonard de Vinci Kanda Kupa ◽  
Sandra Gofinet Pasoto ◽  
Nádia Emi Aikawa ◽  
Eduardo Ferreira Borba ◽  
...  
Keyword(s):  
Body Weight ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Blood Levels ◽  
Concomitant Treatment ◽  
Obese Patients ◽  
Maximum Daily Dose ◽  
Increased Risk ◽  
Daily Dose ◽  
The Impact

Introduction In 2016 the American Academy of Ophthalmology(2016-AAO) recommended a maximum daily HCQ use of 5.0 mg/kg real body weight(RBW) taking into consideration minimizing eye toxicity. Retinopathy in systemic lupus erythematosus(SLE) patients was recently associated with obesity and this condition is progressively more common in these patients. However, the impact of obesity in HCQ blood levels remains controversial. Objective To determine if the 2016-AAO recommendation based on RBW with and without maximum daily dose restriction results in adequate and safe blood levels in obese lupus nephritis(LN) patients. Methods A cross-sectional study was performed with 108 LN patients under the prescribed 2016-AAO dose for at least 3 months. LN patients were assessed for demographic characteristics, body mass index(BMI), disease parameters, HCQ dose, concomitant treatment and HCQ blood levels measured by liquid chromatography-tandem mass spectrometry. Obesity was defined as BMI ≥30kg/m2. Results Obesity was identified in 35/108(32%) LN patients. The calculation of HCQ daily dosage revealed that obese patients were under a lower prescribed daily dose according to the real body weight (RBW) [4.4(2.9-5.4) vs. 4.9(4-5.5)mg/Kg/day, p < 0.001] due to the maximum limit used. Regardless of that the median of HCQ blood levels was significantly higher in obese compared to non-obese patients (1562 ± 548.6 vs. 1208 ± 448.9 ng/mL, p = 0.002). Further analysis of patients under the 20016-AAO recommendation by RBW without the restriction of maximum daily dose confirmed that in spite of comparable daily dose in 14 obese patients and 61 non-obese patients [4.8 (4.5-5.4) vs. 5.0(4.5-5.5) mg/kg, p = 0.312], the median of HCQ blood levels was significantly higher in obese patients than in non-obese (1734 ± 457.3 vs. 1189 ± 449.4 ng/mL, p < 0.001). Conclusion Obese patients under the 2016-AAO prescribed dose of HCQ based on RBW with and without maximum daily dose restriction have a very high HCQ blood levels compared to non-obese patients, with a potential increased risk of ocular toxicity. The use of 2016-AAO dose of HCQ according to the ideal body weight for this group of patients should be considered.Clinicaltrials.gov #NCT0312243.

scholarly journals Retrospective Observational Study of Daytime Add-On Administration of Zopiclone to Difficult-to-Treat Psychiatric Inpatients With Unpredictable Aggressive Behavior, With or Without EEG Dysrhythmia

2021 ◽  
Vol 12 ◽  
Author(s):  
Alfonso Ceccherini-Nelli ◽  
Elena Bucuci ◽  
Lisa Burback ◽  
Daniel Li ◽  
Maryam Alikouzehgaran ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Violent Behavior ◽  
Psychiatric Inpatients ◽  
Pharmacological Interventions ◽  
Maximum Daily Dose ◽  
Daily Dose ◽  
Index Value ◽  
Age Range

Managing violent behavior is a particularly challenging aspect of hospital psychiatric care. Available pharmacological interventions are often unsatisfactory.Aim: To assess the effectiveness and safety of daytime zopiclone add-on administration in violent and difficult-to-treat psychiatric inpatients.Methods: Chart review of inpatients treated with daytime zopiclone, between 2014 and 2018, with up to 12 weeks follow-up. Effectiveness was retrospectively assessed with the Clinical Global Impression rating scale (CGI) and the frequency and severity of aggressive incidents recorded with the Staff Observation Aggression Scale-Revised (SOAS-R).Results: Forty-five (30 male, 15 female) cases, 18–69 years age range, average (SD) baseline CGI-S score of 5.4 (1.0), and a variety of diagnoses. Sixty-nine percent showed CGI-S improvement of any degree. For patients with at least one aggressive incident within 7 days prior to initiation of zopiclone (N = 22), average (SD) SOAS-R-Severity LOCF to baseline change was −3.5 (2.7) P &lt; 0.0001. Most patients reported no side effects; 24% reported one or more side effects, and 11% discontinued zopiclone due to sedation (4), insomnia (1) or slurred speech (1). No SAEs were recorded. Zopiclone maximum daily dose correlated with CGI-S baseline-to-LOCF change (rho = −0.5, P = 0.0003). The ROC AUC of zopiclone maximum daily dose and improvement on CGI-S was 0.84 (95% CI 0.70–0.93, P &lt; 0.0001). The ROC AUC of zopiclone maximum daily dose and SOAS-R-N improvement was 0.80 (95% CI 0.58–0.92; P = 0.0008) and maximum Youden's index value was achieved at a dose of &gt;30 mg.Conclusions: Zopiclone doses &gt;30 mg daily achieved the best anti-aggressive effect.

scholarly journals A rational approach to opioid dose reduction in the treatment of bone pain. Clinical discussion

2020 ◽  
pp. 118-122
Author(s):  
S. A. Rozengard ◽  
A. A. Ryazankina ◽  
D. Kh. Latipova ◽  
A. Yu. Malygin ◽  
B. S. Kasparov
Keyword(s):  
Bone Metastases ◽  
Pain Syndrome ◽  
Rational Approach ◽  
Astrocyte Activation ◽  
Case Patient ◽  
Opioid Dose ◽  
Analgesic Effects ◽  
Maximum Daily Dose ◽  
Daily Dose ◽  
Narcotic Drugs

Narcotic drugs have become more available for use, but it is obvious that monotherapy of pain syndrome with narcotic drugs is not always effective. Patients sometimes change prescribed opiates to NSAIDs on their own, because it is more effective despite the high risk of complications. In this case patient has a grade 2 pain syndrome associated with bone metastases despite taking the maximum daily dose of tramadol complicated by nausea. Treatment was successfully changed with medium doses of tramadol and dexketoprophen. We consider the combination of narcotic drugs and NSAIDs as opiate-sparing and suggest that dexketoprophen is effective for treatment of pain associated with bone metastases because of the effect on neuropathiс and central components of pain syndrome. We have analyzed the main mechanisms and options for systemic pharmacotherapy of pain syndrome in bone metastases. Some NSAIDs are known to have central analgesic effects. For example, the analgesic effect of ketorolac after an injury of sciatic nerve is explained by its ability to inhibit the synthesis of algogenic peptides in the posterior horns of the spinal cord and the decrease in astrocyte activation. However, it is the dexketoprofen/tramadol combination that is recognized as the most effective in the world.

Phenoxybenzamine in the treatment of causalgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1263-1268 ◽  
Author(s):  
Salim Y. Ghostine ◽  
Youssef G. Comair ◽  
Donn M. Turner ◽  
Neal F. Kassell ◽  
Camille G. Azar
Keyword(s):  
Cauda Equina ◽  
Blocking Agent ◽  
Nerve Injuries ◽  
Duration Of Treatment ◽  
Content Type ◽  
Maximum Daily Dose ◽  
Greater Occipital Nerve ◽  
Daily Dose ◽  
Fine Print

✓ Forty consecutive cases of causalgia treated during a 7-year period are presented. The patients ranged in age between 17 and 55 years, and all patients were males who received their nerve injuries from missile or shrapnel wounds. The greater occipital nerve was involved in two cases, median nerve in 10, sciatic nerve in 12, brachial plexus in seven, cauda equina in five, and multiple nerves in four cases. Each patient was treated with phenoxybenzamine, a postsynaptic α1-blocker and presynaptic α2-blocking agent. The drug was given orally in gradually increasing increments until a maximum daily dose of 40 to 120 mg was reached. Duration of treatment was usually 6 to 8 weeks. Total resolution of pain was achieved in all cases. The follow-up period ranged between 6 months and 6 years. Side effects of phenoxybenzamine were minimal and transient, consisting primarily of mild orthostatic hypotension and ejaculatory problems. We conclude that oral phenoxybenzamine is a simple, safe, and effective treatment of causalgia.

Effect of renin angiotensin system blockade following transcatheter aortic valve replacement is dose dependent

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Ledwoch ◽  
I Olbrich ◽  
F Poch ◽  
R Thalmann ◽  
C Fellner ◽  
...  
Keyword(s):  
Transcatheter Aortic Valve Replacement ◽  
Renin Angiotensin System ◽  
Left Ventricular ◽  
Angiotensin System ◽  
Transcatheter Aortic Valve ◽  
Maximum Daily Dose ◽  
Lv Remodeling ◽  
All Cause Mortality ◽  
Daily Dose ◽  
Dose Dependent

Abstract Background There is growing body of evidence from retrospective studies that inhibition of the renin angiotensin system (RAS) improves outcome after transcatheter aortic valve replacement (TAVR). However, it remains unknown whether the effect of RAS blockade treatment on survival and left ventricular (LV) remodeling after TAVR is dose dependent. Purpose To assess clinical outcome and remodeling dependent on different RAS doses after TAVR. Methods Patients who were enrolled into our observational TAVR study at our institution were retrospectively assessed according to different dosed of RAS blockade: Group1 (no RAS blockade), group 2 (25% of the maximum daily dose), group 3 (50% of the maximum daily dose) and group 4 (100% of the maximum daily dose). Results A total of 323 patients between January 2015 and September 2019 were included. Patients with higher doses of RAS blockade showed a trend towards lower all-cause mortality at 3-year follow-up (56% with no RAS blockade vs. 66% with the 25% dose vs. 79% with the 50% dose vs. 78% with the full dose; p=0.063). After adjustment for baseline characteristics the difference in survival was significant (p=0.042). Besides NYHA class ≥ III and left ventricular ejection fraction (LV-EF) RAS blockade dose was identified as independent predictor for all-cause mortality (HR 0.72 [95% CI 0.54–0.97]; p=0.03). With respect to regression of LV mass index after TAVR the only significant change was observed in patients receiving the full dose. Conclusion The present study showed for the first time that the impact of RAS blockade treatment on clinical outcome and LV remodeling after TAVR is dose dependent. Survival dependent on RAS dosis Funding Acknowledgement Type of funding source: None

Dose increases in patients with chronic myeloid leukemia (CML) treated with imatinib mesylate (IM): Estimated using administrative claims data in a US managed care population

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16014-16014
Author(s):  
C. C. Davis ◽  
P. Hines ◽  
G. Devercelli ◽  
S. Ray ◽  
S. Cheng ◽  
...  
Keyword(s):  
Managed Care ◽  
Median Time ◽  
Primary Objective ◽  
Administrative Claims ◽  
Dose Increase ◽  
Maximum Daily Dose ◽  
Starting Dose ◽  
Daily Dose ◽  
One Year

16014 Background: Dose increase is often the first step when resistance is encountered in CML patients treated with IM. The primary objective of this study is to determine the proportion of CML patients who experienced a dose increase from their starting dose within one year after initiation of IM therapy. Methods: Patients ≥18 years of age diagnosed with CML (ICD-9-CM code = 205.1) between 2001 and 2003 and treated with IM were identified in the Pharmetrics Integrated Claims Database which covers a US managed care population. Eligible patients had at least two claims for IM and were continuously enrolled for at least six months following their first IM prescription. Follow-up was one year after their first IM prescription. Results: A total of 113 CML patients using IM were identified. Eighty-four percent of these patients started IM at 400 mg/day; eight percent started at doses ≥ 600 mg/day; remaining started at doses < 400 mg/day The mean daily dose of IM used by the study group was 419 mg (SD = 91). Nineteen percent of users required at least one dose increase from their starting dose within one year. The first dose increase was most frequently 200 mg/day (mean daily dose = 574 mg (SD = 199). The median maximum daily dose reached by patients experiencing dose increases was 600 mg/day (25th– 75th percentile: 500, 750 mg). The median ending dose in these patients was 600 mg/day (25th–75th percentile: 400, 600 mg). Median time to first dose increase was 5.8 (25th–75th percentile: 2.0, 7.4 months). Median time to maximum dose from initial IM dose was 6.5 (25th–75th percentile: 2.7, 7.4 months). Conclusions: Nearly 20% of all IM-treated CML patients required a dose increase of approximately 200 mg/day within one year. Of those dose increases, 50% occurred within the first 6 months. No significant financial relationships to disclose.

scholarly journals Pregabalin Prescription for Neuropathic Pain and Fibromyalgia: A Descriptive Study Using Administrative Database in Japan

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Mikito Hirakata ◽  
Satomi Yoshida ◽  
Sachiko Tanaka-Mizuno ◽  
Aki Kuwauchi ◽  
Koji Kawakami
Keyword(s):  
Neuropathic Pain ◽  
Descriptive Study ◽  
Medical Data ◽  
Administrative Database ◽  
Physical Status ◽  
Spinal Disorders ◽  
Maximum Daily Dose ◽  
Daily Dose ◽  
The Usa ◽  
The Mean

Objective. To assess dose, characteristics, and coprescribed analgesics in patients newly prescribed pregabalin for neuropathic pain and fibromyalgia in Japan. Methods. Based on the medical and prescription information present in the Medical Data Vision database, we analyzed the initial and maximum daily doses, prescription period, coprescribed analgesics, and neuropathic pain-related disorders of patients newly prescribed pregabalin between 01 July 2010 and 31 December 2013. Results. A total of 45,331 patients (mean age 66.8 years, 48.7% men) were newly prescribed pregabalin during this period. The mean initial and maximum daily doses were 97.3 mg and 127.8 mg, respectively, and decreased yearly. The duration of the prescription period was 111.9 (mean) and 53 (median) days, and the frequently coprescribed analgesics included NSAIDs, opioids, and Neurotropin®. About one half of the patients had spinal disorders. Conclusion. In Japan during the period examined, the number of newly prescribed pregabalin users increased, but the initial and maximum daily doses decreased yearly after pregabalin went on the market. The maximum daily dose in Japan was lower than those reported in the USA and Europe. These differences might be associated with patient age and physical status and with anxiety about possible adverse events.

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