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Nutritional and Dietary Supplementation during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Among 55 infants exposed to lansoprazole during the first trimester, the frequency of congenital anomalies was not increased. In the same investigation, the frequency of congenital anomalies among infants exposed to pantoprazole during the first trimester was no greater than controls (Diav-Citrin et al., 2005). The Swedish Registry reported 975 infants exposed to lansoprazole during organogenesis during the first trimester, and the frequency of congenital anomalies was not increased (Kallen, 2019).
Principles of Intraoperative Management of Early-Onset Scoliosis
Published in Alaaeldin (Alaa) Azmi Ahmad, Aakash Agarwal, Early-Onset Scoliosis, 2021
Ashok N. Johari, Rashid Anjum, Vrushali Ponde
Dexamethasone along with ondansetron is generally enough to address the issue. Pantoprazole avoids the gastric irritation, which may set in from taking NSAIDS. Opioids can increase the incidence explaining the importance of a multimodal approach.
Stomas
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
John R.T. Monson, Iain Andrew Hunter
The stomach will secrete about 1.5 to 2 L a day. This volume can be reduced either with a proton pump inhibitor or a H2 receptor antagonist. The use of acid suppression can be titrated to stoma output pH, which should be maintained above six. Lansoprazole Fastabs at a dose of 30–60 mg a day can be employed. In a very short gut, intravenous pantoprazole may be required.
Fedratinib, the first selective JAK2 inhibitor approved for treatment of myelofibrosis – an option beyond ruxolitinib
Published in Expert Review of Hematology, 2022
Fedratinib is rapidly absorbed following single oral dose with peak plasma concentration achieved 2 to 4 hours following the administration of Fedratinib 400 mg once daily. The pharmacokinetic (PK) studies show a first-order absorption incorporating a lag time and first-order elimination [15,32,33]. Plasma Fedratinib levels reached steady state within 15 days of once-daily dosing [30]. Fedratinib is metabolized by cytochrome P450 enzymes [15] (CYP3A4, CYP2C19) and, hence, dose reductions, even in some cases, avoiding co-administration of cytochrome P450 inhibitors may be necessary [34]. Fedratinib is a weak inhibitor of CYP2D6, and a moderate inhibitor of CYP2C19 and CYP3A4 [35]. Gastric acid suppression by co-administration of pantoprazole did not affect Fedratinib pharmacokinetics significantly [36]. Fedratinib is mainly excreted in feces [37], and the half-life was found to be 41 hours [15]. PK is not significantly affected by age (between 20 and 95 years), sex, race (White and Asian), body weight (between 40 and 135 kg), mild to moderate liver dysfunction, or mild renal dysfunction [15]. However, moderate (creatinine clearance 30–59 mL/min) or severe (creatinine clearance 15–29 mL/min) renal impairment increases Fedratinib exposure significantly, mandating a dose reduction for severe renal impairment [15,38].
Commercialized fecal microbiota transplantation provides efficacious treatment of Clostridium difficile infection
Published in Infectious Diseases, 2018
Chad Martinez, Jonathan Edwards, Ali Hassoun
Standardized antibiotic conditioning was not used prior to cFMT therapy. Rather, individual antibiotic regimens for recurrent CDI were discontinued for at least 48 hours prior to treatment. Informed consent was received prior to cFMT. For capsule administration, pantoprazole (40 mg) was administered in two doses: one dose the night previous to and another in the morning of oral cFMT. A clear liquid diet was started at midnight before therapy. Food and fluids were restricted two hours prior to treatment. One placebo capsule was given to evaluate for capability of successful ingestion. Patients then took 30 cFMT capsules (FMT Capsule DE, OpenBiome, Massachusetts) with clear liquids over a 90 minute period. Regular diets were continued one hour after treatment. Patients receiving cFMT via colonoscopy were given four liters of polyethylene glycol as a single dose bowel preparation one day prior to treatment. Food and fluids were restricted after midnight and 250 mL of cFMT was instilled during the procedure. Regular diets were resumed no sooner than one hour after colonoscopy and as tolerated per patient.
Black esophagus: a case series and literature review of acute esophageal necrosis
Published in Scandinavian Journal of Gastroenterology, 2018
C. R. Lamers, W. G. N. Mares, D. J. Bac
A 24-year-old male presented to our emergency department with nausea, vomiting and progressive retrosternal pain. Physical examination revealed epigastric tenderness. Laboratory analysis revealed hemoglobin of 9.8 mmol/L—decreased to 8.2 mmol/L the next day—white blood cell count of 17.4/nL, serum creatinine of 87 μmol/L, urea of 9.6 mmol/L, glucose of 6.9 mmol/L, and albumin of 55 g/L. EGD showed a circumferential necrotizing esophagitis with edema, ulcerations, and purulent exudates involving the distal half of the esophagus and abruptly stopping at the gastro-esophageal junction (Figure 1.2). Biopsies of the esophageal mucosa revealed severe necrotizing inflammation. Additional tests for CMV and fungi were negative. Abdominal ultrasound was unremarkable. Patient was treated with pantoprazole. The next day the patient felt much better and he was discharged. Six months after discharge, a repeat EGD showed an unremarkable esophagus.