Headache with hemodialysis

Indications for use of parenteral iron, e.g. as fer-rioxidesaccharate or iron dextran, are in patients on hemodialysis and patients with a disease which prevents absorption from the gastrointestinal tract, in patients who are on long term parenteral nutrition and sometimes in patients with inflammatory bowel disease. Parenteral iron does not raise the hemoglobin level significantly faster than oral therapy and carries a risk of severe adverse reactions. Reactions to intravenous iron include headache, malaise, fever, arthralgias, urticaria and in rare cases anaphylactic reactions, which may be fatal. 

Geriatric Considerations-Summary Levetiracetam is associated with few drug interactions and low incidence of cognitive impairment. Tremor and headache are more prevalent in older adults as compared to adults < 65 years of age. Hemodialysis reduces plasma concentrations. 

The most common complications that occur during the hemodialysis procedure include hypotension, cramps, nausea and vomiting, headache, chest pain, hack pain, and fever or chiUs. Table 45-3 hsts these comphcations and the etiology with predisposing factors... 

Horowitz BZ Bromism from excessive cola consumption. J Toxicol Clin Toxicol 1997 35 (3) 315-320. [PMID 9140329J (Chronic consumption ol 2-4 L of cola containing brominated vegetable oil resulted in headache, fatigue, ataxia, and memory loss, with a measured serum Br level of 3180 mg/L. Hemodialysis was effective in reversing toxicity.)... 

Toxicity specific information regarding the toxicity of aprepitant has not been fully investigated. Single doses of up to 600 mg of aprepitant are well tolerated by healthy subjects with no subjective or objective side effects noted. This is also seen when 375 mg of aprepitant was administered daily for up to 42 days. Drowsiness and headache were reported in one patient who ingested 1440 mg of aprepitant. In the event of overdose, aprepitant should be discontinued and supportive treatment provided. Due to the antiemetic effect of aprepitant, drug-induced emesis may not be effective. Aprepitant cannot be removed by hemodialysis. 

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