Eine Gruppe von Antibiotika antibiotika-wiki.de , zu denen das Natürliche Antibiotikum Lincomycin und sein halbsynthetisches Analogon Clindamycin gehören. Sie haben bakteriostatische oder bakterizide Eigenschaften, abhängig von der Konzentration im Körper und der Empfindlichkeit von Mikroorganismen. Die Wirkung ist auf die Unterdrückung der Proteinsynthese in Bakterienzellen durch Bindung DER 30s-Subeinheit der ribosomalen Membran zurückzuführen. Lincosamide sind resistent gegen die Wirkung von Salzsäure Magensaft. Nach oraler Verabreichung wird schnell absorbiert. Es wird für Infektionen verwendet, die durch Gram-positive Kokken (hauptsächlich als Medikamente der zweiten Reihe) und unvorhersehbare anaerobe Flora verursacht werden. Cuando se vincula un sitio web que vende productos farmacéuticos desde otro sitio - comprar-farmacia.es, como Search Engine Marketing a través del programa AdSense de Google, la degradación resultante puede disminuir drásticamente la cantidad de ingresos publicitarios obtenidos por el sitio web. Lo mismo se aplica a cualquier inclusión pagada. Esencialmente, el servidor de anuncios sirve una página desde su propio dominio. Si la página contiene un banner (es decir, una imagen) del dominio de una marca, la marca recibirá una parte de los ingresos publicitarios.

Name of treatment regimen

University Hospitals/Ireland Cancer Center

Sickle Cell Inpatient Treatment Guidelines

Supportive Care
Sickle Cell Guidelines
• If patient is hypovolemic on admission, hydrate with Normal Saline @ 300 - 500 • If patient is euvolemic on admission or becomes euvolemic after hydration, hydrate with D5W1/2NS at 75-125 ml/hr continuously.
Laboratory/Radiology
All patients on admission should have the following parameters obtained: • CBC with diff and reticulocyte count, basic metabolic and hepatic panels. • Women: urine beta-HCG • Blood cultures, urinalysis with culture if needed
Transfusions
• Transfuse PRBC's if the Hgb drops >3 g below baseline. • Transfuse PRBC's for symptomatic anemia i.e. shortness of breath, dyspnea on exertion or orthostasis. Sickle Cell Crisis is NOT a symptom of anemia.
Pain Medications
• All narcotic bolus doses should be given as IVPB • If there is no IV access, analgesics may be given IM or SQ. • If the patient is on chronic long acting narcotics, continue the same. • For initial pain relief give Morphine 5 - 10 mg IV and repeat every 1 hr prn pain until pain improves or Dilaudid 1 - 2 mg IV and repeat every 2 hr prn pain until pain improves. • When patient has obtained adequate pain relief with bolus narcotics within the first 2 hours of admission begin PCA with morphine at 1 - 2 mg demand or dilaudid at 0.2 - 0.4 mg demand with a 6 min lock out. • If the patient is not on chronic long acting narcotics consider adding a basal rate • Breakthrough pain medications to be given equivalent to a 1 hour demand if needed. Give one time doses. If frequent breakthrough doses needed, increase PCA demand dose. • If no contraindications to NSAID such as renal dysfunction, GI bleed, PUD or GERD may add ketorolac 30 mg IV every 6 hrs x a maximum of 5 day. • Re-assess frequently. Increase PCA doses by 25% if needed. MD Signature: ____________________Printed Name: ____________________Beeper:________ Date order written__________________ University Hospitals/Ireland Cancer Center

Sickle Cell Inpatient Treatment Guidelines

Supportive Care
Sickle Cell Guidelines

Respiratory
• Incentive spirometry at bedside • Routine use of supplemental oxygen is not recommended unless oxygen
Ancillary Medications
• For itching: diphenhydramine 25-50 mg po every 4-6 hrs or hydroxyzine 25-50 • Antibiotics, other home meds as needed as needed.
Chronic Care
• Ferritin concentration if not drawn in the previous 12 months • Echocardiogram if not done in the previous 24 months • Pneumococcal, meningococcal and influenza vaccinations if not previously given • Pulmonary Hypertension consult if needed.
Special Situations
• Acute chest syndrome presenting as new infiltrates, hypoxia, and chest pain may require exchange transfusion and a transfusion medicine consult should be obtained. For mild symptoms PRBC's should be given. MD Signature: ____________________Printed Name: ____________________Beeper:________ Date order written__________________

Source: http://www.cwrumedicine.org/images/current_residents/sicklecellguidelines.pdf