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Case Conference 4 Section C - Group 5 Mendoza, T., Mindanao, A., Miranda, M.C., Molina, M., Monzon, J.,Morales, A., Musni, M., Nallas, A., Naval, A., Nepomuceno,

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Presentation on theme: "Case Conference 4 Section C - Group 5 Mendoza, T., Mindanao, A., Miranda, M.C., Molina, M., Monzon, J.,Morales, A., Musni, M., Nallas, A., Naval, A., Nepomuceno,"— Presentation transcript:

1 Case Conference 4 Section C - Group 5 Mendoza, T., Mindanao, A., Miranda, M.C., Molina, M., Monzon, J.,Morales, A., Musni, M., Nallas, A., Naval, A., Nepomuceno, J., Nerpiol, C., Ng, C., Ng, P., Niere, J

2 Recommended Dosage for Initial Treatment of Tuberculosis in Adults: DrugDOSAGE Daily doseThrice-weekly dose Isoniazid5 mg/kg, max 300 mg 15 mg/kg, max 900 mg Rifampicin10 mg/kg, max 600 mg Pyrazinamide mg/kg, max 2 g mg/kg, max 3 g Ethambutol15-20 mg/kg25-30 mg/kg

3 Recommended Antituberculosis Treatment Regimen : IndicationInitial PhaseContinuation Phase Duration, monthsDrugsDuration, monthsDrugs New smear or culture positive case 2HRZE4HR New culture negative cases 2HRZE7HR Pregnancy2HRE2HR Failure and relapse---- Resistance (or tolerance) to H Throughout (6)RZE Resistance to H + RThroughout (12-18)ZEQ + S (or another injectable agent) Resistance to all first-line drugs Throughout (4) 1 injectable agent + 3 of these 4: ethionamide, cycloserine, Q, PAS Standardized re-treatment (susceptibility testing unavailable) 3HRZES5HRE Intolerance to RThroughout (12)HZE Intolerance to Z2HRE7HR

4 Criteria for ARDS Acute in onset Oxygenation: A partial pressure of arterial oxygen to fractional inspired oxygen concentration ratio < 200 mm per Hg (regardless of positive end-expiratory pressure. ) Bilateral pulmonary infiltrates on chest radiograph Pulmonary artery wedge pressure < 18 mm Hg or no clinical evidence of left atrial hypertension Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med Mar;149(3 Pt 1): Harrisons Principle of Internal Medicaine 17 th Edition

5 Clinical Conditions Associated with Development of Acute Respiratory Distress Syndrome Direct lung injuryIndirect lung injury Pneumonia Aspiration of gastric contents Toxic Inhalation injury Near drowning Pulmonary contusion Fat embolism Reperfusion pulmonary edema post lung transplantation or pulmonary embolectomy Sepsis Severe trauma – Multiple bone fractures – Flail chest – Head Trauma – Burns pancreatitis Post-Cardiopulmonary bypass Massive transfusions Drug overdose Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med 2000;342:1338. Harrisons Principle of Internal Medicaine 17 th Edition


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