Cirrhosis aminoglycosides

Cirrhosis Peritoneal Cefotaxime Regimen based on organism isolated 1. Add clindamycin or metronidazole if anaerobes are suspected 2. Other third-generation cephalosporins, extended-spectrum penicillins, aztreonam, and imipenem as alternatives 3. Aminoglycoside with antipseudomonal penicillin... 

Uses Edema, HTN, CHF, h atic cirrhosis Action Loop diuretic -1- reabsorption of Na Cr in ascending loop of Henle distal tubule Dose 5-20 mg/d PO or IV 200 mg/d max Caution [B, ] Contra Sulfonylurea sensitivity Disp Tabs, inj SE Orthostatic -1- BP, HA, dizziness, photosens, electrolyte imbalance, blurred vision, renal impair Notes 20 mg torsemide = 40 mg furosemide Interactions t Risk of ototox W/ aminoglycosides, cisplatin t effects W/ thiazides t effects OF anticoagulants, antih5rpCTtensives, Li, salicylates X effects IT/barbiturates, carbamaz ine, cholestyramine, NSAIDs, phenytoin, phenobarbital, probenecid, dandehon EMS t Effects of anticoagulants monitor for S/Sxs tinnitus, monitor ECG for hypokalemia (flattened T waves) OD May cause HA, hypotension, hypovolemia, and hypokalemia give IV fluids symptomatic and supportive... 

Accumulated evidence suggests that liver disease is an important dinical risk factor for aminoglycoside nephrotoxicity [32]. This is particularly true of patients with biliary obstruction or cholangitis as distinct from other causes of liver disease such as alcoholic cirrhosis [33]. When hver disease is defined as any three of six criteria consisting of, AST > 2 times normal, total bi-hrubin > 2.5 pg/dl, albumin < 3 g/dl, elevated aUca-hne phosphatase, prothrombin time > 15 seconds or... 

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