Medical management of ectopic pregnancy
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This document outlines the medical management of ectopic pregnancies. It describes the criteria for using medical management, including gestational sac size and beta HCG levels. The main drug used is methotrexate, which works by depleting folate cofactors and inhibiting trophoblast growth. Methotrexate can be given as a single intramuscular dose or multiple doses over days, monitoring beta HCG levels. Other drugs like potassium chloride, prostaglandins, and hyperosmolar glucose can also be locally injected under ultrasound guidance to terminate the ectopic pregnancy. Contraindications for methotrexate are also listed.
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Proteinuria provides diagnostic and prognostic information about renal disease. It is associated with hypertension, obesity, and vascular disease, and can predict risks of chronic kidney disease progression, cardiovascular disease, and mortality. Monitoring proteinuria is important for assessing treatment response, as protein-lowering therapies may be renoprotective. A thorough history, physical exam, urinalysis, and further tests are needed to determine the type and cause of proteinuria and rule out underlying conditions in order to begin appropriate treatment.Methotrexate 2.pptx
Methotrexate 2.pptxDrPabitraKumar
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This document provides information on methotrexate, including its history, mechanism of action, pharmacokinetics, uses, dosage, interactions, and adverse effects. Methotrexate was initially used to treat childhood leukemias in 1948 and is now approved by the FDA to treat psoriasis. It works by inhibiting dihydrofolate reductase and interfering with DNA synthesis. Its uses include psoriasis, rheumatoid arthritis, and some cancers. Adverse effects include hepatotoxicity, myelosuppression, gastrointestinal upset, and potential teratogenicity.IMMUNOSUPPRESSANTS IN OPHTHALMOLOGY.DP.pptx
IMMUNOSUPPRESSANTS IN OPHTHALMOLOGY.DP.pptxmeenalikarn2
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Ophthmology
Medicine
Immunosuppressant
DiseaseMay 2018 FDA New Drug Approvals
May 2018 FDA New Drug Approvalsadoseofeducation
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Lokelma was approved for treatment of hyperkalemia. Common side effects include edema. Lucemyra was approved to treat opioid withdrawal symptoms. Common side effects include hypotension and bradycardia. Aimovig was approved for preventive treatment of migraines. Common side effects include injection site reactions and constipation. Doptelet was approved to treat thrombocytopenia in patients with liver disease undergoing a procedure. Common side effects include pyrexia and abdominal pain. Palynziq was approved to reduce phenylalanine levels in patients with phenylketonuria. It carries a black box warning for risk of anaphylaxis. Common side effects include injection site reactions and arthralgiadiabetes in pregnancy definition and types .pptx
diabetes in pregnancy definition and types .pptxVigneshT64
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Diabetes in pregnancy can be gestational diabetes or pregestational diabetes. Gestational diabetes is carbohydrate intolerance that begins during pregnancy. Pregestational diabetes includes type 1 and type 2 diabetes that occurs prior to pregnancy. Screening and management of diabetes in pregnancy aims to reduce complications for both mother and baby such as premature delivery, malformations, and growth problems. Treatment involves medical nutrition therapy, blood glucose monitoring, and possibly insulin therapy. After delivery, women with gestational diabetes receive follow-up testing to determine if diabetes persists.Multiple tablet poisoning Toxicology CME MOHANAVEL.pptx
Multiple tablet poisoning Toxicology CME MOHANAVEL.pptxStanCafe
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The child ingested 15 iron tablets containing a total of 975 mg of elemental iron, which is a potentially lethal dose. Diagnostic workup included an abdominal x-ray showing tablets in the stomach and intestine, and serum iron level. Whole bowel irrigation with polyethylene glycol was used for decontamination. The chelating agent desferoxamine was administered at 15 mg/kg/hr due to the large iron ingestion and presence of symptoms. Parameters like anion gap metabolic acidosis, leukocytosis, and hyperglycemia indicate severity. The prognosis depends on the ingested dose, time to treatment, and presence of complications.Acromegaly
Acromegalyagho john
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Acromegaly is a condition caused by excessive growth hormone (GH) secretion after epiphyseal plate closure in adults. It results in enlargement of extremities, soft tissues, and internal organs. The presentation outlines the physiology of GH, epidemiology, etiology as pituitary adenomas in most cases, pathogenesis involving mutations, clinical features, investigations including MRI and biochemical testing, and treatment with surgery, radiation, and medical management to suppress GH and normalize IGF-1 levels. Long term monitoring is needed to manage comorbidities like cardiovascular and respiratory complications. While challenging, a multidisciplinary approach can help reduce mortality and morbidity from acromegaly.anterior pituitary hormone
anterior pituitary hormoneVenuDDon
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This document discusses the hypothalamic-pituitary hormones and their regulation and functions. It summarizes the hormones secreted by the anterior pituitary gland including growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotropic hormone. It then provides more detailed information about growth hormone, prolactin, the gonadotropins, and their regulators and clinical uses.Medical management of ectopic pregnancy
- 1. Medical management of ectopic pregnancy
- 2. Criteria for medical management No hemodynamic instability No tubal rupture Fertility desired Gestational sac < 3.5cm Beta HCG level < 5000mIu/ml No cardiac motion on USG Ability and willingness to comply with follow up.
- 3. Drugs commonly used are: Methotrexate (drug of choice) Potassium chloride Prostaglandin(PGF留) Hyperosmolar glucose
- 4. Methotrexate mechanism of action & regimens MOA: methotrexate depletes tetrahydrofolate cofactors for DNA & RNA synthesis and inhibits rapidly growing trpohoblast of EP. Regimens: 1)Single dose- methotrexate i.m 50mg/m族 of body surface area. o 硫-HCG level on D and D is measured, minimum difference of > 15 percent should be there o Dose to be repeated - if difference is < 15 percent b/w D and D . OR o fetal cardiac activity is present on D. o 硫-HCG level is repeated weekly until undetectable. 2)Multiple dose- methotrexate 1mg/kg i.m on D,D,D,D & lecuovorin 0 .1mg/kg i.m on D,D,D,D o 硫-HCG level is measured every alternate day, Until decreased upto 15 percent in 2 consecutive days o Then weekly 硫-HCG level estimation is done until undetectable.
- 5. Contraindication of methotrexate Hemoperitoneum Breast feeding Immunodeficiency EP > 4cm Alcoholism Hepatic/Renal disease Blood disorder
- 6. Local injection 20 percent potassium chloride 0.5 ml under USG guidance causes asystole & resolution of ectopic Hyperosmolar glucose 1 to 3 ml injected into the sac. PGF留 when injected causes contraction and vasoconstriction thus resolution of pregnancy.
- 7. Oral dose
- 8. THANK YOU