contains anything from ACS, HTN, HF to surgery guideline
plus related news update quite often
http://www.theheart.org/
good for practical guidelines and cool Video CME lectures
Sunday, February 22, 2009
Wednesday, February 18, 2009
U of Penn - Department of Medicine - Educational Resources
http://www.uphs.upenn.edu/medicine/education/residents/educationalResources/index.html [not working]
http://pennfm.pbworks.com/Intern-Survival-Guide
Intern Survival Guide
Clinical Guidelines
Textbooks and Journals
Other Links
2006
http://pennfm.pbworks.com/Intern-Survival-Guide
Intern Survival Guide
Clinical Guidelines
Textbooks and Journals
Other Links
2006
L-Carnitine in VPA overdose
L-carnitine supplementation is recommended for patients with CNS depression, evidence of hepatic dysfunction, and hyperammonemia with dosing ranging from 50 to 100 mg/kg/day up to a maximum dose of 2 g/day.
L-carnitine's mechanism of action is thought to be related to its ability to decrease elevated ammonia levels, which may contribute to development of coma in VPA toxicity. Its use remains investigational but can be considered in patients (such as ours) with coma, elevated ammonia levels, and hepatic dysfunction.[1] In our patient, we elected to start her on L-carnitine at 100 mg/kg/day in an attempt to correct her hyperammonemia and encephalopathy. This therapy was continued until her serum ammonia and VPA levels had normalized.
Other Tx for VPA overdose;
Supportive, naloxone, hemodialysis, hemoperfusion
Ref: Medscape
http://www.medscape.com/viewarticle/445062_print
L-carnitine's mechanism of action is thought to be related to its ability to decrease elevated ammonia levels, which may contribute to development of coma in VPA toxicity. Its use remains investigational but can be considered in patients (such as ours) with coma, elevated ammonia levels, and hepatic dysfunction.[1] In our patient, we elected to start her on L-carnitine at 100 mg/kg/day in an attempt to correct her hyperammonemia and encephalopathy. This therapy was continued until her serum ammonia and VPA levels had normalized.
Other Tx for VPA overdose;
Supportive, naloxone, hemodialysis, hemoperfusion
Ref: Medscape
http://www.medscape.com/viewarticle/445062_print
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