Patient doses

In elderly or debilitated patients doses may be instituted at 1A> to Vs the recommended dose for younger adults and increased more gradually than dose increases in younger adults... 

Radiopharmaceuticals are prescribed in units of radioactivity, and the actual dispensing of the patient dose involves calculating how much radiopharmaceu-... 

From these data, it can be estimated that chlorphenoxamine (11.24, R = 4-C1, R = Me) should hydrolyze ca. 17 times faster than diphenhydramine. This decreased stability appears sufficient to drive formation of detectable amounts of the benzhydrol metabolite (11.25, R = 4-C1, R = Me) in the stomach of patients dosed with chlorphenoxamine. Indeed, ether bond cleavage to form this and derived metabolites was a major pathway in humans [49], Whether the reaction was entirely nonenzymatic or resulted in part from oxidative O-dealkylation (Chapt. 7 in [50]) remains unknown. 

To further illustrate the diversity of hydrolytic opening reactions, we turn our attention to an isothiazole ring as found in the antipsychotic agent ziprasidone (11.129). This drug is subject to various reactions of oxidation and reduction, but also undergoes hydrolytic cleavage of the C=N bond of the isothiazole ring. Evidence for this reaction was afforded by detection of radioactive metabolite 11.130, a sulfonamide, in the urine of patients dosed... 

In general, the lowest effective dose of the drug should be used, particularly in elderly patients. Dose titration should be undertaken slowly. Similarly, on discontinuation of a drug, the dose should be reduced slowly, the rate of decrease being decided by the elimination half-life of the drug. Some psychotropic drugs produce a discontinuation syndrome that can usually be avoided by slow withdrawal. In particular, sedatives, anxiolytics and antidepressants can cause withdrawal effects. 

Q87 For this patient, dose by rectum of paracetamol suppositories is ... 

Nonvirilized patient - Dosing may be initiated with 2.5 mg system nightly. 

Drugs with thyroid hormone activity, alone or with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. 

Hepatically impaired patients Dose hepatically impaired patients with caution and monitor hepatic function at regular intervals. 

For long-term suppressive therapy in pediatric patients, doses as low as 1 mg/kg per 24 hours, given in a single dose or in 2 divided doses, may be adequate. 

Special risk patients Dose may need reduction in patients with CHF, peripheral edema, orthostatic hypotension, or impaired renal function. 

In patients unable to take the capsules, therapy may be initiated with the injection. Administer the initial dose no sooner than 6 hours after transplantation. The recommended starting dose is 0.03 to 0.05 mg/kg/day as a continuous IV infusion. Give adult patients doses at the lower end of the dosing range. Concomitant adrenal corticosteroid therapy is recommended early posttransplantation. Proceed with continuous IV infusion only until the patient can tolerate oral administration. 

If signs and symptoms do not improve after 2 days, reevaluate the patient. Dosing may be reduced, but advise patients not to discontinue therapy prematurely. In chronic conditions, withdraw treatment by gradually decreasing the frequency of applications. 

Rishin and colleagues have recently reported results of a phase I trial of conventional fractionated radiotherapy with concurrent tirapazamine (290 mg/m2), cisplatin (75 mg/m2) wk 1, 4, and 7, and tirapazemine alone (160 mg/m2, three times per wk) wk 2, 3, 5, and 6 for untreated stage IV HNC patients (86). The cohort was small at 20 patients. Dose... 

In summary, most data are available on the influence of CYP genes on the pharmacokinetics of antidepressants. Genotype-adjusted dose escalation schemes have already been put forward and should be especially useful in TCA treatment. It has to be noted, though, that all studies concerning dose escalation and response have been performed in depressed patients. Dose-response relationships may, however, be different in patients with anxiety disorders, so that further studies are warranted. 

It is an anionic detergent which softens the stool by water accumulation in intestinal lumen and emulsifies the colon contents. It is indicated in obstetric, habitual, geriatric, paediatric constipation or when straining is to be avoided (recent myocardial infarction, severe hypertension, post-operative cases, abdominal hernia), fissures, haemorrhoids and bed ridden patients. Dose 100-200 mg/day. 

Group of Patients Dose (pg) Volume (ml) Dose (pg) Volume (ml) ... 

Dibenzodiazepine Clozapine May benefit treatment-resistant patients little extrapyramidal toxicity May cause agranulocytosis in up to 2% of patients dose-related lowering of seizure threshold... 

When dealing with a short-lived radionuclide generator, an infusion system will be needed for elution of the generator, recording of patient dose, and administration of the activity. The effective utilization of 76 sec Rb-82 will depend on its rapid extraction from the generator. Thus, the foremost feature of an infusion system will be the attainment of a high and uniform flow... 

Dosage should be individualized according to patient, dosing formulation, and disease state... 

A review of trials has suggested that vasopressin is more likely to cause adverse effects at doses of 0.04 U/minute or more when it is used to treat septic shock mesenteric ischemia and cardiac dysfunction and ischemia were particularly associated with high doses (30). The authors suggested that limiting the dosage to 0.03 U/minute may minimize these effects. This suggestion has been supported by a retrospective audit of the effects of continuous vasopressin infusion in septic shock in 102 men and women, mean age 53 years (31). There were adverse events that may have been linked to vasopressin in 18 patients cardiac arrest (n = 9) ischemic/mottled digits (n = 8) myocardial infarction (n = 1) and hyponatremia (n = 1). Adverse events occurred with doses of vasopressin of 0.04 units/minute and over, except in one patient (dose not stated). 

Since oxidative stress is related to the risk of chronic diseases, lower levels of oxidative stress are considered consistent with lower risk of these diseases. A few studies have also measured biochemical and pathobiological markers of cancer in patients after lycopene intervention (Kucuk et al., 2001). However, the levels of lycopene used in these studies were based on preliminary studies investigating the absorption and oxidative stress status in healthy and at risk for cancer patients. Dose-response studies have not been undertaken. 

These studies were multiple-dose, ascending-dose tolerance studies with three patients per cohort, except at the MTD where usually six or more patients were enrolled. In the event of a DLT, the cohort was to be expanded up to six patients. Dose escalation was to proceed until the MTD was identified, with MTD being defined as the highest dose at which less than two of six patients experienced DLT during, or as a consequence of, treatment with tasidotin. Toxicity was analyzed according to the National Cancer Institute Common Toxicity Criteria, version 2.0... 

Trial (reference) Target population Number of patients Dose regimen Results... 

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