Prophylactic Uses

For patients with chronic gout, colchicine has established value as a prophylactic agent, especially when there is frequent recurrence of attacks. Prophylactic medication also is indicated upon initiation of long-term medication with allopurinol or the uricosuric agents, because acute attacks often increase in frequency during the early months of such therapy. 

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L-Fohc acid is available as a crystalline dihydrate containing 8% water. Approximately 80% of the commercial production is consumed for feed enrichment in animal nutrition. FoHc acid is being offered by the pharmaceutical industry for therapeutic and prophylactic use (see Pharmaceuticals). Pharmacological doses of fohc acid are commonly used as a rescue dose during cancer chemotherapy, in women using oral contraceptives, and alcohoHcs. Several studies have provided evidence that multivitamins or foHc acid (0.8—4 mg/day) supplementation prevent the majority of neural tube defects (101). 

The cephalosporins also may be used perioperatively, that is, during the preoperative, intraoperative, and postoperative periods, to prevent infection in patients having surgery on a contaminated or potentially contaminated area, such as the gastrointestinal tract or vagina In some instances, a specific drug may be recommended for postoperative prophylactic use only. 

When an antibiotic is ordered for die prevention of a secondary infection (prophylaxis), the nurse observes die patient for signs and symptoms that may indicate die beginning of an infection despite the prophylactic use of die antibiotic. If signs and symptoms of an infection occur, the nurse must report them to the primary health care provider. 

Aiititubercular drug s are used in combination with other aiititubercular dm to treat active tuberculosis. Isoniazid (INH) is the only aiititubercular drug used alone While isoniazid is used in combination with other drains for the treatment of primary tuberculosis, a primary use is in preventive therapy (prophylaxis) against tuberculosis. For example, when a diagnosis of tuberculosis is present, family members of the infected individual must be given prophylactic treatment with isoniazid for 6 months to 1 year. Display 12-1 identifies prophylactic uses for isoniazid. 

The purported prophylactic use of Japanese herbal medicines to combat neuronal ageing has been related to their free-radical scavenging activity (Hiramatsu a al., 1992). Inhibition of the pro-inflammatory effects of cytokine interleukin-1 by recombinant endogenous interleukin-1 receptor antagonist in experimental rats is associated with alleviation of excitotoxic neuronal damage, an action which has also been related to the antiinflammatory effect of lipocortin 1 (Relton and Roth well, 1992). 

What specific agent(s) would you consider for prophylactic use in this patient ... 

The CSFs should not be used routinely for treatment of febrile neutropenia in conjunction with antimicrobial therapy.5 However, the use of CSFs in certain high-risk patients with hypotension, documented fungal infection, pneumonia, or sepsis is reasonable. A recent meta-analysis demonstrated that hospitalization and neutrophil recovery are shortened and that infection-related mortality is marginally improved.14 As with prophylactic use of these agents, cost considerations limit their use to high-risk patients. 

Fludarabine Consider prophylactic use of trimethoprin-sulfamethoxazole Fludarabine 25 mg/M2 IV days 1-5... 

Ari pi prazole, olanzapine, quetiapine, risperidone, and ziprasidone are effective as monotherapy or as add-on therapy to lithium or valproate for acute mania. Prophylactic use of antipsychotics can be needed for some patients with recurrent mania or mixed states, but the risks versus benefits must be weighed in view of long-term side effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). 

When prescribing strong opioids as analgesics for severe pain, it is even recommended to combine the treatment with prophylactic use of laxatives to avoid constipation. The effect of opioids on the bowel is to cause almost no movement at all in the bowels and therefore it is unavoidable to use stimulating laxatives sometimes combined with bulk forming preparations. 

Ml (long-term prophylactic use in patients who have survived the acute phase of MI)- 0 mg twice/day. 

Duration of therapy Continue administration for a minimum of 48 to 72 hours after fever abates or after evidence of bacterial eradication has been obtained. Perioperative prophylaxis Discontinue prophylactic use within 24 hours after the surgical procedure. In surgery where infection may be particularly devastating, prophylactic use may be continued for 3 to 5 days following surgery completion. CEFACLOR ... 

Prophylactic use, surgery - Administer 2 g IV or IM 30 to 60 minutes prior to surgery followed by 2 g every 6 hours after the first dose for no more than 24 hours. 

Prophylactic use, cesarean section - Administer 2 g IV as soon as the umbilical cord is clamped. If a 3-dose regimen is used, give the second and third 2 g dose IV, 4 and 8 hours after the first dose. 

Prophylactic use, transurethral prostatectomy - Adrr n sier 1 g prior to surgery 1 g every 8 hours for up to 5 days. 

Prophylactic use (at least 3 months) - 30 to 40 mg/kg/dose every 6 hours... 

Prophylaxis To prevent postoperative infection in contaminated or potentially contaminated colorectal surgery, the recommended adult dosage is 15 mg/kg infused over 30 to 60 minutes and completed about 1 hour before surgery followed by 7.5 mg/kg infused over 30 to 60 minutes at 6 and 12 hours after the initial dose. Complete administration of the initial preoperative dose about 1 hour before surgery so that adequate drug levels are present in the serum and tissues at the time of initial incision, and administer, if necessary, at 6-hour intervals to maintain effective drug levels. Limit prophylactic use to the day of surgery only. 

Prevention of influenza Safety and efficacy of zanamivir have not been established for prophylactic use to prevent influenza. Use of zanamivir should not affect the evaluation of individuals for annual influenza vaccination in accordance with guidelines of the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices. 

Center for Disease Controls and Prevention Advisory Committee on Immunization Practices. Efficacy of oseltamivir has not been established for prophylactic use to prevent influenza. 

Acute otitis media in children - Acute otitis media in children due to susceptible strains of Haemophilus influenzae or Streptococcus pneumoniae. There are limited data on the safety of repeated use in children younger than 2 years of age. Not indicated for prophylactic use or prolonged administration. 

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