Intravenous drugs

After intravenous drug administration, a log-convex concentration decline points to a multi-exponential function. For the most frequent case, a bi-exponential equation with the inter-compartment rate constants (k 2) and (k21) can be fitted. 

CmC, a preservative in commercial preparations of some intravenous drugs, activates CICR in a way similar to that of caffeine. 4-CmC is more potent than caffeine and shows isoform-dependent activation profiles it is much less effective in RyR3 than RyRl or RyR2. 

Warner RM, Srinivasan JR (2004) Protean manifestations of intravenous drug use. Surgeon 2(3) 137-140... 

Another approaeh to the problem of providing an intravenous drug additive serviee is to add the drug to a small-volume (50-100 ml) infusion in a eollapsible plastie eontainer and store the preparation at -20°C in a freezer. The infusion ean be removed when required and thawed rapidly by microwave. Many antibiotics are stable for several months when stored in minibags at -20° C and are unaffected by the thawing process in a suitable microwave oven. Other antibiotics, e.g. ampieillin, are degraded when frozen. 

NEEDLE SHARING AMONG INTRAVENOUS DRUG ABUSERS NATIONAL AND INTERNATIONAL PERSPECTIVES. Robert J. Battjes, D.S.W., and Roy W. Pickens, Ph.D., eds. 

Administer intravenous drugs by rapid bolus followed with a 20 mL flush of intravenous fluid and extremity elevation for 10-20 s if peripheral venous access is utilized during resuscitation. 

FIGURE 6-5. Decision algorithm for ventricular rate control using intravenous drug therapy for patients presenting with the first detected episode or an episode of persistent atrial fibrillation that is hemody-namically stable. 

Drugs used for the termination of hemodynamically stable VT are presented in Table 6-11. Intravenous drug administration... 

Cocaine and intravenous drug use Low socioeconomic status Increased hematocrit Sickle cell disease... 

Infection with one or more strains of viral hepatitis often causes acute inflammation of the liver, while chronic infection with hepatitis B or C can lead to cirrhosis. Hepatitis B and C are common in intravenous drug users and can also be transmitted through sexual contact, but many cases of hepatitis C are idiopathic.5,6 Hepatitis C is a more common cause of cirrhosis than hepatitis B in the United States while hepatitis B is more common in the rest of the world.7 See Chapter 21 on viral hepatitis for a complete discussion of infectious hepatitis. 

Individuals may minimize their risk of acquiring both hepatitis B and C infection by avoiding contaminated blood products and not indulging in high-risk behavior such as intravenous drug use. 

Intravenous drug users using unsterilized needles Workers involved with non-human primates Food service handlers Patients with clotting factor disorders Individuals residing in health care institutions Hepatitis B and Hepatitis D Men having sex with other men Individuals with multiple heterosexual partners Intravenous drug users using unsterilized needles Recipients of blood products... 

Prior to routine screening of blood products in the early 1990s, the primary route of transmission of the HCV was blood transfusions, when the risk was 0.02% per unit transfused. Since then, the risk has decreased significantly (0.001% per unit transfused).13 Today, intravenous drug users utilizing contaminated paraphernalia are responsible for most HCV transmission. Other populations at risk for acquiring HCV are listed in Table 21-1. Approximately 10% of the individuals infected with HCV have no identifiable risk factors. 

The most likely modes of transmitting the HDV are similar to those of HBV, including intravenous drug users using unsterilized needles and recipients of contaminated blood products. Sexual and perinatal transmission are rare for HDV.16 Individuals at greatest risk of acquiring HDV are similar to those seen in HBV (Table 21-1). 

Infective endocarditis (IE) is a serious infection affecting the lining and valves of the heart. While this disease is mostly associated with infection of the heart valves, the septal defects may become involved as well. Infections also occur in patients with prosthetic or mechanical devices, such as mechanical heart valves or who are intravenous drug users (IVDUs). Bacteria is the primary cause of IE however, fungi and atypical organisms also can be responsible pathogens. 

IVDUs intravenous drug users MIC minimum inhibitory concentration... 

Single, one daughter. He works as an undercover agent and just returned from an operation in Cambodia. He denies smoking or intravenous drug use. He had a 20-year history of alcohol abuse but has been sober for 10 years. 

Works as a truck driver reports distant history of intravenous drug use in his 20s drinks alcohol occasionally... 

HCV Hepatitis C virus IVDA Intravenous drug abuse... 

A post-mortem examination and a rectal temperature of 41°C (106°F) were recorded. He had needle marks typical of intravenous drug abuse and pulmonary and cerebral edema. Abrasions and contusions of the ankles and wrists were evident from his struggling. Lidocaine was not administered to the victim during the resuscitative attempts. The clinical presentation of cocaine delirium... 

Finally, intravenous drug administration and the sharing of needles and syringes is common among opiate addicts this creates a serious risk of cross-infection. Many studies have shown a high incidence of HIV and hepatitis B and C among heroin addicts. This risk is somewhat reduced in medically controlled narcotic prescription... 

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