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Augmented Renal Clearance
In pharmacology, augmented renal clearance (ARC) is a phenomenon where certain critically ill patients may display increased clearance of a medication through the kidneys. In many cases, it is observed as a measured creatinine clearance above that which is expected given the patient's age, sex, and other factors. The phenomenon is most commonly observed in patients with neurologic damage, sepsis, major trauma, or burns. Augmented renal clearance can be caused by increased fluid administration, certain medications, and critical illnesses. It can lead to failure of treatment in people due to a decrease in drug concentrations, increase in clearance, or shorter half life. Many medications require adjustment to account for the changed clearance in people with ARC, notably some antibiotics. History Normal kidney function measured by creatinine clearance varies in different populations based on age, gender, race, fluid balance, and other factors, but also can be affected by diseases the ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Clearance (pharmacology)
In pharmacology, clearance (Cl_\text) is a pharmacokinetic parameter representing the efficiency of drug elimination. This is the rate of elimination of a substance divided by its concentration. The parameter also indicates the theoretical volume of plasma from which a substance would be completely removed per unit time. Usually, clearance is measured in L/h or mL/min. Excretion, on the other hand, is a measurement of the amount of a substance removed from the body per unit time (e.g., mg/min, μg/min, etc.). While clearance and excretion of a substance are related, they are not the same thing. The concept of clearance was described by Thomas Addis, a graduate of the University of Edinburgh Medical School. Substances in the body can be cleared by various organs, including the kidneys, liver, lungs, etc. Thus, total body clearance is equal to the sum clearance of the substance by each organ (e.g., renal clearance + hepatic clearance + pulmonary clearance = total body clearance). F ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Vasopressors
An antihypotensive, also known as a vasopressor, is an agent that raises blood pressure by constricting blood vessels, thereby increasing systemic vascular resistance. This is different from inotropes which increase the force of cardiac contraction. Some substances do both (e.g. dopamine, dobutamine). If low blood pressure is due to blood loss, then preparations increasing volume of blood circulation—plasma-substituting solutions such as colloid and crystalloid solutions (salt solutions)—will raise the blood pressure without any direct vasopressor activity. Packed red blood cells, plasma or whole blood should not be used solely for volume expansion or to increase oncotic pressure of circulating blood. Blood products should only be used if reduced oxygen carrying capacity or coagulopathy is present. Other causes of either absolute (dehydration, loss of plasma via wound/burns) or relative ( third space losses) vascular volume depletion also respond, although blood products a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intensive Care Unit
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine. An intensive care unit (ICU) was defined by the task force of the World Federation of Societies of Intensive and Critical Care Medicine as "an organized system for the provision of care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency." Patients may be referred directly from an emergency department or from a ward if they rapidly deteriorate, or immediately after surgery if the surgery is very invasive and the patient is at high risk of complications. History In 1854, Florence Nightingale left for the Crimean War, where triage was used ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Levetiracetam
Levetiracetam, sold under the brand name Keppra among others, is a novel antiepileptic drug. (medication) used to treat epilepsy. It is used for Focal seizure, partial-onset, Myoclonic epilepsy, myoclonic, or tonic–clonic seizures, and is taken either Oral administration, by mouth as an immediate release, immediate or extended release formulation or by intravenous, injection into a vein. Levetiracetam was discovered in 1992 through screening in audiogenic seizure susceptible mice and, 3 years later, was reported to exhibit saturable, stereospecific binding in brain to a approximately 90 kDa protein, later identified as the ubiquitous synaptic vesicle glycoprotein SV2A." The discovery process identifying levetiracetam's antiepileptic potential was unique because it challenged several dogmas of antiepileptic drug discovery, and thereby encountered skepticism from the epilepsy community. Common side effects of levetiracetam include sleepiness, dizziness, feeling tired, and ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Vancomycin
Vancomycin is a glycopeptide antibiotic medication used to treat certain bacterial infections. It is administered intravenously ( injection into a vein) to treat complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, and meningitis caused by methicillin-resistant ''Staphylococcus aureus''. Blood levels may be measured to determine the correct dose. Vancomycin is also taken orally (by mouth) to treat ''Clostridioides difficile'' infections. When taken orally, it is poorly absorbed. Common side effects include pain in the area of injection and allergic reactions. Occasionally, hearing loss, low blood pressure, or bone marrow suppression occur. Safety in pregnancy is not clear, but no evidence of harm has been found, and it is likely safe for use when breastfeeding. It is a type of glycopeptide antibiotic and works by blocking the construction of a cell wall. Vancomycin was approved for medical use in the United States in 1 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fluoroquinolone
Quinolone antibiotics constitute a large group of broad-spectrum bacteriocidals that share a bicyclic core structure related to the substance 4-quinolone. They are used in human and veterinary medicine to treat bacterial infections, as well as in animal husbandry, specifically poultry production. Quinolone antibiotics are classified into four generations based on their spectrum of activity and chemical modifications. The first-generation quinolones, such as nalidixic acid, primarily target Gram-negative bacteria and are mainly used for urinary tract infections. Second-generation quinolones introduced fluorine atoms into their structure, creating fluoroquinolones, which significantly expanded their antibacterial activity to include some Gram-positive bacteria. Third-generation fluoroquinolones further improved Gram-positive coverage, while fourth-generation fluoroquinolones offer broad-spectrum activity, including anaerobic bacteria. Only quinolone antibiotics in generati ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Aminoglycoside
Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar). The term can also refer more generally to any organic molecule that contains amino sugar substructures. Aminoglycoside antibiotics display bactericidal activity against Gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen but generally not against Gram-positive and anaerobic Gram-negative bacteria.ME Levison, MD, 2012, Aminoglycosides, The Merck Manua accessed 22 February 2014. Streptomycin is the first-in-class aminoglycoside antibiotic. It is derived from ''Streptomyces griseus'' and is the earliest modern agent used against tuberculosis. Streptomycin lacks the common 2-deoxystreptamine moiety (image right, below) present in most other members of this class. Other examples of aminoglycosides include the deoxystreptamine-containin ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
SOFA Score
The sequential organ failure assessment score (SOFA score), previously known as the sepsis-related organ failure assessment score, is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems. The score tables below only describe points-giving conditions. In cases where the physiological parameters do not match any row, zero points are given. In cases where the physiological parameters match more than one row, the row with most points is picked. The quick SOFA score (qSOFA) assists health care providers in estimating the risk of morbidity and mortality due to sepsis. Medical use The SOFA scoring system is useful in predicting the clinical outcomes of critically ill patients. According to an observational study at an Intensive Care Unit (ICU ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
APACHE III
APACHE II ("Acute Physiology and Chronic Health Evaluation II") is a severity-of-disease classification system, one of several ICU scoring systems. It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death. The first APACHE model was presented by Knaus et al. in 1981. Application APACHE II was designed to measure the severity of disease for adult patients admitted to intensive care units. It has not been validated for use in children or young people aged under 16. This scoring system is used in many ways which include: # Some procedures or some medicine is only given to patients with a certain APACHE II score # APACHE II score can be used to describe the morbidity of a patient when comparing the outcome with other patients. # Predicted mortalities are averaged for groups of patients in order to spec ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Serum Creatinine
Creatinine (; ) is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass). Biological relevance Serum creatinine (a blood measurement) is an important indicator of kidney function, because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys. Creatinine itself is produced via a biological system involving creatine, phosphocreatine (also known as creatine phosphate), and adenosine triphosphate (ATP, the body's immediate energy supply). Creatine is synthesized primarily in the liver by methylation of glycocyamine (guanidino acetate, synthesized in the kidney from the amino acids arginine and glycine) by S-adenosyl methionine. It is then transported in the blood to other organs, muscles, and the brain, where it is phosphorylated to phosphocreatine, a high-energy compound. Creatine conversion to phosphocreatine is catalysed by creatine ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hematologic Cancer
Tumors of the hematopoietic and lymphoid tissues (American English) or tumours of the haematopoietic and lymphoid tissues (British English) are tumors that affect the blood, bone marrow, lymph, and lymphatic system. Because these tissues are all intimately connected through both the circulatory system and the immune system, a disease affecting one will often affect the others as well, making aplasia, myeloproliferation and lymphoproliferation (and thus the leukemias, myelomas, and the lymphomas) closely related and often overlapping problems. While uncommon in solid tumors, chromosomal translocations are a common cause of these diseases. This commonly leads to a different approach in diagnosis and treatment of hematological malignancies. Hematological malignancies are malignant neoplasms ("cancer"), and they are generally treated by specialists in hematology and/or oncology. In some centers "hematology/oncology" is a single subspecialty of internal medicine while in others they ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
