Hemodialysis frequency

TABLE 49-6 Dosing Recommendations for Adult Patients with Reduced Renal Function and for Adult Patients Receiving Hemodialysis Recommended Dose and Frequency for Change in Patients with Creatinine Clearance <30 mL/min ... 

Diallyl isophthalate (DAIP), 2 258, 261 physical properties of, 2 258t thermoset molding properties of, 2 262t Diallyl phthalates (DAP), 2 258-263 20 110 copolymerization, 2 259-260 Diallyl terephthalate (DATP), 2 259 DIALOG file, 18 246 DIALOG OneSearch, 18 244 -dial suffix, 2 58 Dialysate, 26 814, 815 composition of, 26 817 Dialysis. See also Hemodialysis alternative modes of, 26 832-833 requirements for adequate, 26 821-822 treatment time and frequency of, 26 833-834... 

Mechanism of Action An antispasmodic that exhibits potent antimuscarinic activity by interceding via cholinergic muscarinic receptors, thereby inhibiting urinary bladder contraction. Therapeutic Effect Decreases urinary frequency, urgency. Pharmacohinetics Rapidly and well absorbed after PO administration. Protein binding 96%. Extensively metabolized in the liver to active metabolite. Primarily excreted in urine. Unknown if removed by hemodialysis. Half-life 1.9-3.7 hr. 

Salicylism and death have occurred following topical application. In an adult, 1 g of a topically applied 6% salicylic acid preparation will raise the serum salicylate level not more than 0.5 mg/dL of plasma the threshold for toxicity is 30-50 mg/dL. Higher serum levels are possible in children, who are therefore at a greater risk for salicylism. In cases of severe intoxication, hemodialysis is the treatment of choice (see Chapter 58). It is advisable to limit both the total amount of salicylic acid applied and the frequency of application. Urticarial, anaphylactic, and erythema multiforme reactions may occur in patients who are allergic to salicylates. Topical use may be associated with local irritation, acute inflammation, and even ulceration with the use of high concentrations of salicylic acid. Particular care must be exercised when using the drug on the extremities of patients with diabetes or peripheral vascular disease. 

Drug Change in Frequency Recommended Dose and Frequency for Patients with Creatinine Clearance < M) mL/min or for Patients Receiving Hemodialysis... 

C. Adjustment for hemodialysis. To offset loss of fomepizole during dialysis, increase the frequency of dosing to every 4 hours. 

DDS has been treated either by addition of osmotically active solute (glucose, glycerol, albumin, urea, fructose, NaQ, mannitol) to the dialysate, or by intravenous infusion of mannitol or glycerol. With the technique of pure ultrafiltration the patient is subjected to ultrafiltration without dialysis. The net result is loss of fluid without the patient undergoing dialysis. Ultrafiltration followed by dialysis does not appear to be associated with DDS (Ronco et al., 1998). Additionally, DDS can be prevented by decreasing the time on dialysis and inCTeasing the frequency of dialysis at the initiation of hemodialysis in patients. Mannitol infusion accompanying the initial... 

While current therapy is believed to be effective in the clearance of small solutes such as urea, improved removal of middle molecules and protein-bound solutes is desirable. Henderson et al. (2001) point to the importance of quantifying the removal of larger toxic solutes in the fight of increasing evidence that shows a positive correlation between survival and middle molecule clearance in hemodialysis patients. A number of studies are underway to enhance the removal of middle molecules. These studies include (1) variations in modes of dialysis, (2) changes in dialyzer design to improve internal filtration, (3) targeted removal of specific molecules, and (4) increased frequency of dialysis. 

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