Treatment of severe alcoholic hepatitis with corticosteroids and pentoxifylline

American Academy of Dermatology and AAD Association, “Position Statement on Isotretinoin, (last update November 13, 2010).
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Chiu V, Cheng A, Oliver D, “Isotretinoin and association with depression.” Presented as a poster (P704) at the 68th Annual Meeting of the American Academy of Dermatology, March 2010; Miami.(Commercial support: None identified).
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Crockett SD, Gulati A, Sandler RS et al. “A causal association between isotretinoin and inflammatory bowel disease has yet to be established.” Am J Gastroenterol 2009; 104: 2387-93.
Goldsmith LA, Bolognia JL, Callen JP et al. “American Academy of Dermatology Consensus Conference on the safe and optimal use of isotretinoin: summary and recommendations.” J Am Acad Dermatol 2004; 50: 900-6.
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The use of hemodialysis for patients with hypercalcemia but without renal failure may require alterations in the composition of conventional dialysis solutions in order to avoid an exacerbation or induction of other metabolic abnormalities, particularly hypophosphatemia. As an example, hemodialysis with a dialysis solution enriched with phosphorus (final phosphorous concentration of 4 mg/dL) resulted in rapid correction of all abnormalities in one patient in whom medical therapy had failed to reverse hypercalcemia, mental status changes, and hypophosphatemia due to primary hyperparathyroidism [ 58 ].

But should this difficult circumstance develop, it is probably best to err on the side of going down quickly on the T3 therapy, perhaps even faster than one decrement per day, or perhaps even faster than one decrement per dose. The plummeting T3 levels would at least reduce what is likely to be a major factor in the side effects: T3 unsteadiness. If the T3 therapy is decreased very quickly, a commensurately supportive dose of T4 therapy should be considered. For example, if the T3 was being decreased from 75 mcg/dose down to mcg/dose in one day, a supportive dose of .025mg – .05mg of T4 should be considered. And if that mcg/dose was reduced to zero the next day, the T4 dosage could be continued or perhaps increased slightly. Remember, T4 is 4 times less potent than T3, less than half of the T4 prescribed will be converted to T3, and it will take a week for 1/2 of what will be converted to T3, to be converted. But, it will be a steady source, and it will help to give the patient’s own thyroid function time to come up.

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  • Citation tools Download this article to citation manager Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial BMJ 2004; 328 :791
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    Treatment of severe alcoholic hepatitis with corticosteroids and pentoxifylline

    treatment of severe alcoholic hepatitis with corticosteroids and pentoxifylline

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  • Citation tools Download this article to citation manager Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: a multicentre randomised controlled trial BMJ 2004; 328 :791
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