tag:blogger.com,1999:blog-38117614.post7372200418477798852..comments2023-05-27T22:13:31.352+08:00Comments on Medical PBL: Case Files 4 - Emergency/ Int Med: Dying From WithinUnknownnoreply@blogger.comBlogger2125tag:blogger.com,1999:blog-38117614.post-60092440405853063802011-08-06T15:38:35.122+08:002011-08-06T15:38:35.122+08:00Very sorry for the long pause. The routine thing t...Very sorry for the long pause. The routine thing to do in paraquat poisoning will of course be the administration of Fuller's earth and Mist Alba to induce diarrhea, activated charcoal as well as hydration. Daily urine paraquat and Renal profile is indicated. CXR should be done at presentation as a baseline.<br />As for the immunosuppresion therapy, the patient should be started on IV Methylprednisolone 1g per day for the first 3 days.If you are in a district without methylpred, give a stat dose of hydrocortisone 200 mg and quickly refer. If renal impairment develop later, IV cyclophosphomide 15mg/kg/day for 2 days is given. However, if renal failure or respiratory complications(as indicated by PaO2<80mmHg) after methylprednisolone therapy, IV or oral dexamethasone 16 to 24mg per day can be given.<br /><br />Additional cyclophosphomide and pulse methylpred can be given if patient develop respiratory failure.<br /><br />Watch urine output. Start hemodialysis if reduced with positive urine paraquat.<br /><br />Please don't forget to watchout for concurrent opportunistic infections during immunosuppresive treatments.<br /><br />Hope this helps. Thanx :)Jeffreynoreply@blogger.comtag:blogger.com,1999:blog-38117614.post-3194207591754752562011-07-03T09:16:38.126+08:002011-07-03T09:16:38.126+08:00IV cyclophosphamide 1.7 mg/kg/8h for 14 days, IV d...IV cyclophosphamide 1.7 mg/kg/8h for 14 days, IV dexamethasone 10 mg /8h for 14 days.<br /><br />indicated in severe paraquat poisoning (after mild but before fulminant stage) when there is lung injury to slow down lung fibrosis. <br /><br />what was the dosage for dexa pulse therapy though?Xu Vinhttps://www.blogger.com/profile/17579156936856818885noreply@blogger.com