Hello James! You will be taking a drug called Digoxin. You are probably familiar with this drug because you were on this drug while you were in the hospital. We have however, adjusted the dosage of the drug so that it doesn’t cause more harm on your kidney function. The strength of the digoxin tablet you will be taking is 0.125 mg. Digoxin is indicated for the use in relieving the symptoms of congestive heart failure and/or atrial fibrillation. It is a drug that will help a weakened heart to function properly by increasing the strength of the heart muscle and maintaining the normal heart rhythm. Take one tablet by mouth with a glass of water. It is best to take digoxin on an empty stomach or one to two hours after meals. If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. There are several medicines (OTC and prescription) that can interact with digoxin.
These include antacids, beta-blockers, barbiturates, certain hormones, antibiotics, cold and flu medicines and herbal supplements and many more. Tell your doctor if you stop or start any new medication. Do not treat yourself with non-prescription medicines for pain, allergies, coughs or colds, without advice from your physician. Side effects that you should report to your doctor immediately include: changes in vision, confusion, diarrhea or constipation, fainting spells, fast or slow heartbeat, headaches, loss of appetite, nausea, weakness or tiredness. Side effects that do not require medical attention (unless it continues or are bothersome) are breast enlargement in men and women. It will be important that you visit your physician for regular check ups on your progress. It is advisable that you check your own progress by checking your pulse and blood pressure regularly while you are taking digoxin.
The Essay on Congestive Heart Failure In Pediatrics
Congestive Heart Failure is not a disease, but a condition in which the heart is unable to pump enough blood needed to meet the cardiac demands of the body and facilitate systemic circulation. Congestive Heart Failure can be right or left-sided, and is mainly a fluid issue, in which there is a decreased amount of blood to the kidneys. In children, CHF can be long term and is most common in ...
Case Summary As a group, we assessed the case to look at the appropriateness of each medication that the patient was on and the cause of the impeding renal failure. Upon closer look at the Gentamicin peak and trough concentrations, we discovered the trough concentrations were above the normal therapeutic level. Gentamicin may cause nephrotoxicity when trough concentrations exceed 2.0 mcg/ml. It was apparent that the above normal gentamicin concentration was the leading cause of the decreased creatinine clearance in the patient. Other adverse effects included cardiovascular effects and edema. We discontinued the patient off gentamicin and piperacillin because of the risk for nephrotoxicity and him on Cipro IV 200 mg every 12 hours for the Serratia infection. We also discontinued the patient off Meperidine, an opiate analgesic the patient was on for pain.
Meperidine is contraindicated for patients’ with renal failure and there is a risk for possible interaction with diuretics. Morphine sulfate 8mg/ml every 4 hours as needed was a better alternative for the management of pain in this patient. By closely reviewing the patients’ drug regimen for efficacy, we were able to eliminate the medications that had no present indication or medications that were causing drug-drug or drug-disease interaction. The last drug we discontinued form the patients’ drug regimen was the ranitidine. This drug is indicated for the use in peptic ulcer disease, hypersecretory conditions. The patients’ medical history showed no current indication for the use of this medication. The medications that we kept the patient on during the hospital stay were Coalce, Prazosin, Furosemide, Digoxin, Allopurinol and Insulin. We made no dosagechanges to the colace, a stool softner. Prazosin (alpha-1 antagonist) was being used to treat hypertension and coronary heart failure was also dosed appropriately.
The Essay on United State Marijuana Patients Drug
Should the use of marijuana for medicinal purposes be legalized? Wouldn't it be simple to provide a simple black or white answer to this question? Across the nation there is much debate on this very topic, one that I don't believe can be solved so easily with a yes or no. There are so many activists that have strong opinions on this subject and go to the fullest extent to ensure they are heard. As ...
The patient had been on furosemide (loop diuretics) for two days to reduce volume overload. Furosemide has a wide variety of dosages, (40 mg-400mg every 24 hrs) and a dosage increase was indicated because the start dose of 40 mg IV Q 12 hr has not been very effective in decreasing patient volume. The allopurinol was being used for gout and the patient is on the lowest dose available because of renal insufficiency. Finally, digoxin was being used to relieve symptoms of congestive heart failure and the dosage needed to be decreased in patients’ with renal insufficiency. Digoxin is available in two strengths 0.25mg and 0.125 mg. The switched the patient form the higher strength to the lower strength to maintain normal renal function.
In addition to modifying patients’ drug therapy, it is just as important to monitor patients’ progress on the new drug therapy according to set therapeutic goals and outcomes. Our main goal in this case is to increase renal function (increased creatinine clearance and decreasing BUN), increasing urine outcome and return patient to normal weight. Additional monitoring included continuing to monitor BUN and serum creatinine every other day and continue to monitor input, and weight everyday. Monitoring for adverse events: check for hyperuricemia due to furosemide, ask patient if vomiting and for cardiac effects due to digoxin.
According to the case authors, cause of the acute renal failure was due to the gentamicin trough concentrations. The authors recommended that the patient’s fluid intake be restricted to one liter a day. The dosages of the following medicines should also be adjusted: increase furosemide, and decrease digoxin and ranitidine. The monitoring parameters included weight, BUN and urine analysis.
Overall, in my opinion, it was necessary to get the patient off gentamicin because it appeared to be the leading cause of the acute renal failure in this case. It also became necessary to reduce the doses of some of the medications the patient was on to adjust the doses according to his renal function (GFR).
The Essay on Cocaine Why Increased Dosages Of Coca
Why use cocaine This is a question that perplexes many doctors of medicine and psychology. As an ex user, I feel that this topic is one that I have a personal interest in. I will start by defining what cocaine is. Cocaine is a colorless or white crystalline powder extracted from coca leaves, occasionally used in medicine as a local anesthetic especially for the eyes, nose, or throat and widely ...
Additional parameters I would have included as for monitoring the patient post-discharge: blood test for digoxin concentrations and electrocardiogram for heart rhythms.
