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1 Haziran 2023

Stedman's Electronic Medical Dictionary, v6.0: Features, Benefits, and Alternatives

since last week, you may haveread about a young motherwhose unbornchild, who was developingtwin embryos, had premature laborthat forced doctors to remove themfrom her womb. the mother,27, developed a conditionwhere the placenta went on a rampage,locating and slashing 20 times. in all the chaos, the newborn girls heartbeat was alsodetected. after three days ofintensive care in a neonatal unit,both babies made very good recoveriesand were finally released to thefamily. the mother needed thousands of dollars in medical debt, but was able to pay off most of itthrough the generous gifts of her awesomemothers. both mothers, having the same condition, were fortunate thatthey were diagnosed at almost the same time.dabigatran etexilate: a review of its use as a direct oral anticoagulant in the prevention and treatment of venous thromboembolism. dabigatran etexilate is a reversible direct thrombin inhibitor that has been approved in a wide range of doses for the prevention and treatment of venous thromboembolism (vte). pharmacokinetic/pharmacodynamic studies indicate that it is rapidly absorbed after administration of either oral or intravenous (i.v.) doses, and that it exhibits linear pharmacokinetics. in pharmacokinetic studies, plasma elimination half-life ranged from 24.4 to 38.5 h after the oral administration of doses ranging from 110 to 220 mg bid and from 26.5 to 44.3 h after i. administration of doses ranging from 20 to 220 mg bid. dabigatran etexilate is metabolized by the liver and appears to be mainly eliminated by renal excretion. the anticoagulant effects of dabigatran etexilate are dose-proportional. the effects of coadministered food do not appear to affect the pharmacokinetic properties of dabigatran etexilate, and food administration is therefore not required when the drug is administered at a fixed dose. in a dose-finding study, the incidence of bleeding was very low with the doses of dabigatran etexilate used in the prevention and treatment of vte. in phase 3 studies in vte patients, dabigatran etexilate at doses of 150, 220 and 150 mg bid, administered in the prevention of vte, was noninferior to the standard dose of enoxaparin administered subcutaneously once daily for 35 days (n = 2038), and, in the treatment of vte, superior to the standard dose of warfarin administered in a dose-adjusted manner with the prothrombin time (inr) maintained in the therapeutic range (n = 1466). dabigatran etexilate is well tolerated in patients with hepatic impairment, but in clinical studies no dose adjustment is required in such patients. in a trial in patients with cirrhosis, the incidence of serious bleeding in patients treated with dabigatran etexilate 150 mg bid (n = 360) was similar to that in those treated with standard warfarin (n = 357; 6.7 vs 6.3%; p = 0.81). the incidence of other adverse events was also similar in the two groups. dabigatran etexilate administered at doses of 150 or 220 mg bid in the treatment of vte was associated with a significantly lower incidence of recurrent vte or death within 3 months than the standard dose of warfarin (n = 1224).