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Fractional Excretion of Sodium

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181. Management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency

. Cortisol is lipophilic, and therefore highly protein bound in the plasma to cortisol- bindingglobulin(60–80%)andalbumin(15–35%).Thefree active fraction is small, usually around 5%. Following uncomplicated major elective surgery there is a proportionateincreaseinpro-in?ammatorycytokines,CRH, ACTHandcortisol.A?ve-foldincreaseinsecretion,toabout 100 mg of cortisol per day, is common. Plasma cortisol concentration typically returns to baseline within 24–48 h [9, 10]. During protracted critical illness (...) that the short-term use of hydrocortisone supplementation during uncomplicated surgery carries minimal risk. There is a reluctance to use glucocorticoid supplementation too liberally for fear of unwanted side- effects. The importance of maintaining peri-operative ?uid balance is increasingly accepted, and thus sodium and waterretentionsecondarytosupplementationisapotential concern.Glycaemiccontrolisdeemedimportantindiabetic patients and glucocorticoid-induced glycaemia is feared, although itcan beeasily

2020 Association of Anaesthetists of GB and Ireland

182. Treatment of Patients with Schizophrenia

fraction of individuals with psychosis will have a shift in diagnosis over time 23 (Bromet et al. 2011). Specialty consultation can be helpful in establishing and clarifying diagnosis (Coulter et al. 2019), particularly if the illness symptoms or course appear to be atypical or if the patient is not responding to treatment. A thorough history is also important to identify the presence of co-occurring psychiatric conditions or physical disorders that need to be addressed in treatment planning (American (...) , or synthetic substances (e.g., "bath salts", K2, Spice). The route by which substances are used (e.g., ingestion, smoking, vaping, intranasal, intravenous) is similarly important to document. Mortality is increased in individuals with schizophrenia (Brown et al. 2000; Fazel et al. 2014; Olfson et al. 2015) and the average lifespan is shortened by a decade or more, with much of this decrease related to increased rates of co-occurring physical conditions (Laursen et al. 2013; Saha et al. 2007; Walker et al

2020 American Psychiatric Association

183. Heart Failure - Systolic Dysfunction

of premature death. Dietary indiscretion in sodium intake and medication noncompliance are common reasons for heart failure decompensation. Progressive pump failure and malignant arrhythmias are the most common causes of death among HF patients. Diagnosis and Surveillance Heart failure with reduced ejection fraction (systolic dysfunction) is a commonly recognized cause of heart failure. Widely available techniques can quantitate the left ventricular ejection fraction and estimate the degree of systolic (...) December, 2016 Ambulatory Clinical Guidelines Oversight Grant Greenberg, MD, MA, MHSA R Van Harrison, PhD Literature search service Taubman Health Sciences Library For more information: 734-936-9771 Heart Failure - Systolic Dysfunction Patient population: Adult patients with left ventricular systolic dysfunction Objectives: 1) To improve mortality and morbidity for patients with heart failure (HF). 2) To present a framework for treating patients with HF. Key Points Diagnosis. ? Ejection fraction (EF

2020 University of Michigan Health System

184. Acute Kidney Injury (AKI)

sulphonamides, acyclovir, triamterene, indinavir and phosphate-rich laxatives. The role of urinary electrolyte measurement in determining the aetiology of an episode of AKI remains unclear. In pre-renal disease (i.e. acute kidney impairment rather than injury) there is increased urinary sodium reabsorption. This should be reflected by a low urine sodium concentration and a low fractional excretion of sodium (FENa, where FENa = (urine Na + x plasma Cr)/(plasma Na + x urine Cr)). However, results should (...) be interpreted with caution. For instance, a raised FENa may be present in patients in the pre-renal phase if concentrating ability is impaired (e.g. in the elderly), those who have received diuretics in the preceding 24 hours, with glycosuria or in those with underlying CKD (because of adaptive changes [7]). In these circumstances, the fractional excretion of urea (FEUrea) has been proposed as a potentially more useful index; in addition, release of anti-diuretic hormone (ADH) in response to rising plasma

2019 Renal Association

186. Hyponatraemia

water excretion fractional excretion of sodium thyroid-stimulating hormone serum cortisol level and/or adrenocorticotrophic hormone test serum lipids and serum protein electrophoresis CT brain, chest, abdomen/pelvis other tests targeted at evaluating the underlying cause Treatment algorithm ACUTE ONGOING Contributors Authors Associate Director Nephrology MedStar Washington Hospital Center Washington DC Disclosures JHV declares that she has no competing interests. Peer reviewers Director Department (...) Hyponatraemia Hyponatraemia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Hyponatraemia Last reviewed: February 2019 Last updated: January 2019 Summary Defined as a serum sodium concentration of <135 mmol/L. Most common electrolyte disorder encountered in clinical practice. Can occur in settings of volume depletion, volume overload, or euvolaemia. Serum osmolality, urine osmolality, and urine sodium concentration

2018 BMJ Best Practice

188. Volume depletion in adults

intestinal obstruction severe pancreatitis crush injuries intra-abdominal bleeding fatigue thirst dry mucous membranes muscle cramps abdominal pain chest pain confusion decreased skin turgor diuretic therapy chronic kidney disease older adult altered mental status high ambient temperature Diagnostic investigations FBC serum electrolytes blood glucose serum urea serum creatinine urinalysis random urine sodium fractional excretion of sodium (FENa) random urine chloride random urine creatinine random urine (...) osmolality rectal examination and faecal occult blood test urine urea/fractional excretion of urea (FEurea) arterial blood gases nasogastric lavage stool cultures abdominal ultrasound abdominal CT scan upper GI endoscopy colonoscopy saliva osmolality Treatment algorithm ACUTE Contributors Authors Research Associate Northwestern University Feinberg School of Medicine Chicago IL Disclosures SKH is an author of a reference cited in this monograph. Professor Division of Nephrology and Hypertension Department

2018 BMJ Best Practice

189. Acute kidney injury

(including urea and creatinine) ratio of serum urea to creatinine urinalysis urine culture full blood count fractional excretion of sodium fractional excretion of urea urinary eosinophil count venous blood gases fluid challenge bladder catheterisation urine osmolality urine sodium concentration renal ultrasound chest x-ray ECG anti-nuclear antibodies anti-DNA complement (C3, C4, CH50) anti-glomerular basement membrane antibodies anti-neutrophil cytoplasmic antibodies acute hepatitis profile HIV serology (...) obstructive symptoms haematuria fever rash arthralgia/arthritis altered mental status signs of uraemia nausea thirst flank pain abdominal distension abdominal bruit livedo reticularis petechiae ecchymoses advanced age underlying renal disease malignant hypertension diabetes mellitus myeloproliferative disorders, such as multiple myeloma connective tissue disease sodium-retaining states (e.g., congestive heart failure, cirrhosis, nephrotic syndrome) radiocontrast exposure to nephrotoxins (e.g

2018 BMJ Best Practice

190. Syndrome of inappropriate antidiuretic hormone

headache seizure coma no hx of recent diuretic use age >50 years pulmonary conditions (e.g., pneumonia) nursing home residence postoperative state malignancy medicine associated with SIADH induction central nervous system (CNS) disorder endurance exercise Diagnostic investigations serum sodium serum osmolality serum urea urine osmolality urine sodium diagnostic trial with normal saline infusion serum uric acid fractional excretion of sodium fractional excretion of urea serum TSH serum cortisol level (...) Syndrome of inappropriate antidiuretic hormone Syndrome of inappropriate antidiuretic hormone - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Syndrome of inappropriate antidiuretic hormone Last reviewed: February 2019 Last updated: March 2018 Summary Syndrome of inappropriate antidiuretic hormone (SIADH) is defined as euvolaemic, hypotonic hyponatraemia secondary to impaired free water excretion, usually from

2018 BMJ Best Practice

191. Iron Deficiency and Anaemia in Adults

preparations contain varying amounts of ferrous iron and the frequency of gastrointestinal side effects related to each different preparation tends to be directly related to the content of ferrous iron. Iron salt Dose Preparation Content of ferrous iron Ferrous sulphate 200mg tablets 65mg Ferrous gluconate 300mg tablets 35mg Sodium feredetate (Sytron) 380mg/ 10mls elixir 55mg Limitations to iron supplements There are several limitations to taking iron supplements. Only a small amount is actually absorbed (...) , and the recycling of iron after red blood cell (RBC) degradation. Under normal physiological conditions, as there is no active iron excretion mechanism, iron homeostasis is strictly controlled at the level of intestinal absorption. Storage of iron In healthy individuals, about 25% of the total body iron (800 to 1,000mg) represents storage iron, mainly as ferritin in the liver and skeletal muscle; consequently, serum ferritin is a useful marker for iron stores. Hepcidin is a naturally occurring protein, secreted

2018 Royal College of Nursing

192. Axicabtagene ciloleucel (Yescarta) - diffuse large B-cell lymphoma (DLBCL); primary mediastinal large B-cell lymphoma (PMBCL)

Each bag of YESCARTA contains 300 mg sodium. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Dispersion for infusion. A clear to opaque, white to red dispersion. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications YESCARTA is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL), after two or more lines of systemic therapy. 4.2 Posology and method (...) not be used. • Central venous access is recommended for the administration of YESCARTA. • The patient’s identity must be verified again to match the patient identifiers on the YESCARTA bag. • The tubing should be primed with 0.9% sodium chloride solution (0.154 mmol sodium per ml) prior to infusion. • Entire contents of the YESCARTA bag should be infused within 30 minutes by either gravity or a peristaltic pump. YESCARTA is stable at room temperature for up to 3 hours after thaw. • The bag should

2018 European Medicines Agency - EPARs

193. Handbook on tuberculosis laboratory diagnostic methods in the European Union

Sodium dodecyl sulfate SNP Single nucleotide polymorphism SOP Standard operating procedures TB Tuberculosis TST Tuberculin skin test UKAS United Kingdom Accreditation Service UK NEQAS UKAS accredited proficiency testing provider No. 4715 VNTR Variable number tandem repeat ZN Ziehl-Neelsen (staining method) Handbook on tuberculosis laboratory diagnostic methods in the European Union – Updated 2018 TECHNICAL REPORT 6 Background and introduction Francis Drobniewski Tuberculosis (TB) is a major cause

2018 European Centre for Disease Prevention and Control - Technical Guidance

194. Management of Cardiovascular Diseases during Pregnancy Full Text available with Trip Pro

Calcium channel blocker CI Confidence interval CO Cardiac output CoA Coarctation of the aorta CPG Committee for Practice Guidelines CT Computed tomography CVD Cardiovascular disease DBP Diastolic blood pressure DCM Dilated cardiomyopathy DES Drug-eluting stent DVT Deep vein/venous thrombosis ECG Electrocardiogram EF Ejection fraction ESC European Society of Cardiology FDA US Food and Drug Administration HCM Hypertrophic cardiomyopathy HF Heart failure HFrEF Heart failure with reduced ejection fraction (...) 5-HT1A 5-hydroxytryptamine (serotonin) HTAD Heritable thoracic aortic disease ICD Implantable cardioverter-defibrillator ICU Intensive care unit IE Infective endocarditis INR International normalized ratio i.v. Intravenous KLH Keyhole limpet haemocyanin LMWH Low molecular weight heparin LQTS Long QT syndrome LV Left ventricular LVEF Left ventricular ejection fraction MCS Mechanical circulatory support mGy Milligray MI Myocardial infarction MR Mitral regurgitation MRA Mineralocorticoid receptor

2018 European Society of Cardiology

195. Nitisinone (Nityr) - Tyrosinemias

Page 4/42 CYP1A2 Cytochrome P450 1A2 CYP2C19 Cytochrome P450 2C19 CYP2D6 Cytochrome P450 2D6 CYP3A4 Cytochrome P450 3A4 D Dose EC50 Concentration of drug producing 50% of Emax Emax Maximum effect a drug produces Et or Ec Extent of effect a drug produces at time t or at concentration c EU European Union F Absolute bioavailability fe Fraction of the systemically available drug excreted into the urine Fr Relative bioavailability FT Fourrier Transform fu Unbound fraction of drug in plasma GC Gas (...) 38 2.6. Pharmacovigilance 40 2.7. Product information 40 2.7.1. User consultation 40 2.7.2. Labelling exemptions 40 3. Benefit-risk balance 40 4. Recommendation 41 Assessment report EMA/413721/2018 Page 3/42 List of abbreviations Ae,t Cumulative amount of unchanged drug excreted into the urine until time t Ae 8 Cumulative amount of unchanged drug excreted into the urine in infinite time Ae-INF Cumulative amount of unchanged drug excreted into the urine in infinite time AeT Cumulative amount

2018 European Medicines Agency - EPARs

196. ESC/ESH Management of Arterial Hypertension Full Text available with Trip Pro

and diastolic blood pressure treatment targets3052 7.3.2 Blood pressure targets in specific subgroups of hypertensive patients3052 7.4 Treatment of hypertension3054 7.4.1 Lifestyle changes3054 7.4.2 Dietary sodium restriction3054 7.4.3 Moderation of alcohol consumption3055 7.4.4 Other dietary changes3055 7.4.5 Weight reduction3055 7.4.6 Regular physical activity3056 7.4.7 Smoking cessation3056 7.5. Pharmacological therapy for hypertension3056 7.5.1 Drugs for the treatment of hypertension3056 7.5.2 (...) Electrocardiogram eGFR Estimated glomerular filtration rate ELSA European Lacidipine Study on Atherosclerosis ENaC Epithelial sodium channel ESC European Society of Cardiology ESH European Society of Hypertension FEVER Felodipine Event Reduction HAS-BLED Hypertension, Abnormal renal/liver function (1 point each), Stroke, Bleeding history or predisposition, Labile INR, Elderly (>65), Drugs/alcohol concomitantly (1 point each) HbA1c Haemoglobin A1c HBPM Home blood pressure monitoring HDL-C HDL cholesterol HELLP

2018 European Society of Cardiology

197. Neratinib (Nerlynx) - Breast cancer, breast neoplasms

epidermal growth factor receptor HERA study HERceptin Adjuvant study HR hazard ratio HRc hormone receptor IC50 half-maximal inhibitory concentration iDFS invasive disease-free survival IDMC independent data monitoring committee I-SPY study Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and moLecular Analysis study ITT intent-to-treat IV intravenous LVEF left ventricular ejection fraction M3 pyridine N-oxide Assessment report EMA/CHMP/525204/2018 Page 5/169 M6 N

2018 European Medicines Agency - EPARs

198. Ocrelizumab (Ocrevus) - multiple sclerosis

Ultracentrifugation C Constant Domain CaM Comparability and Monitoring CCI Container Closure Integrity CDC Complement-Dependent Cytotoxicity CDR Complementarity Determining Region CE Capillary Electrophoresis; CE-LIF Capillary Electrophoresis With Laser Induced Fluorescence Detection; CE-SDS Capillary Electrophoresis - Sodium Dodecylsulfate CEX Cation-Exchange CFU Colony-Forming Unit CHO Chinese hamster ovary CHOP Chinese Hamster Ovary Cell Protein CI Confidence Interval CIP Clean in place CPA Corrected Peak Area (...) Target Product Profile RA Rheumatoid Arthritis RDG Roche Diagnostics GmbH RH relative humidity RMS Relapsing Multiple Sclerosis RP-UHPLC Reversed-Phase Ultra High-Performance Liquid Chromatography; RRF Risk Ranking and Filtering RVLP Retrovirus-Like Particles SDS-PAGE Sodium Dodecyl Sulfate - Polyacrylamide Gel Electrophoresis SE-HPLC Size-Exclusion High-Performance Liquid Chromatography; SOP Standard Operating Procedure SSF South San Francisco STB Seed Train Bioreactor SV40 Simian Virus type 40 TI

2018 European Medicines Agency - EPARs

199. Letermovir (Prevymis) - to prevent illness caused by cytomegalovirus (CMV) in adults having an allogeneic haematopoietic stem cell transplant

of the product that could not be solved within the timeframe of accelerated assessment. The applicant was required to prepare a plan to further evaluate and develop a terminal sterilisation process for the product. 2.2. Quality aspects 2.2.1. Introduction The finished product is presented as: A. Film-coated tablets containing 240 mg or 480 mg of letermovir as active substance. Other ingredients are: Tablet core: Microcrystalline cellulose (E460), Croscarmellose sodium (E468), Povidone (E1201), Colloidal (...) substance. Other ingredients are: hydroxypropylbetadex, sodium chloride, sodium hydroxide (E524), water for injections. The concentrate for solution for infusion is available in a pack size of one Type I (30 ml) clear glass vial with a 20 mm fluorocoated chlorobutyl stopper with aluminium flip-off cap containing 12 mL (medium green cap) or 24 mL (dark blue cap) of solution, as described in section 6.5 of the SmPC. 2.2.2. Active Substance General information The chemical name of letermovir is (4S)-2-{8

2018 European Medicines Agency - EPARs

200. Bictegravir / emtricitabine / tenofovir alafenamide / fumarate (Biktarvy) - HIV Infections

the concentration versus time curve over the dosing interval B/F/TAF bictegravir/emtricitabine/tenofovir alafenamide (coformulated) BCS Biopharmaceutics Classification System BIC bictegravir BIC Bictegravir sodium BLQ below the limit of quantitation BMD bone mineral density BMI body mass index CHB chronic hepatitis B CI confidence interval Clast last observed quantifiable concentration of the drug Cmax maximum observed concentration of drug CMH Cochran-Mantel-Haenszel COBI cobicistat (Tybost) CPK creatine (...) statistical analysis plan SBR stay on baseline regimen SD standard deviation SDS Sodium dodecyl sulfate SmPC Summary of Product Characteristics t1/2 estimate of the terminal elimination half-life of the drug TAF tenofovir alafenamide (Vemlidy) TAF Tenofovir alafenamide TDF tenofovir disoproxil fumarate (Viread) TFV tenofovir Tmax time (observed time point) of Cmax TSH thyroid-stimulating hormone UGT1A1 uridine diphosphate glucuronosyltransferase 1A1 ULN upper limit of normal UPLC Ultra performance liquid

2018 European Medicines Agency - EPARs

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