Kidney stone medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Line 42: Line 42:
==Medical Therapy==
==Medical Therapy==
===Nephroliithiasis===
===Nephroliithiasis===
'''Non pharmacological measures'''
 
====== Straining ======
==== '''Non pharmacological measures''' ====
 
===== Straining =====
** Stone ≤5 mm can pass spontaneously.
** Stone ≤5 mm can pass spontaneously.
** Passage of stone also depends on the site of stone.<ref name="pmid10458343">{{cite journal |vauthors=Miller OF, Kane CJ |title=Time to stone passage for observed ureteral calculi: a guide for patient education |journal=J. Urol. |volume=162 |issue=3 Pt 1 |pages=688–90; discussion 690–1 |date=September 1999 |pmid=10458343 |doi= |url=}}</ref>
** Passage of stone also depends on the site of stone.<ref name="pmid10458343">{{cite journal |vauthors=Miller OF, Kane CJ |title=Time to stone passage for observed ureteral calculi: a guide for patient education |journal=J. Urol. |volume=162 |issue=3 Pt 1 |pages=688–90; discussion 690–1 |date=September 1999 |pmid=10458343 |doi= |url=}}</ref>
'''Pharmacological measures'''
 
* 2.1 '''Specific Organ system involv'''
==== '''Pharmacological measures''' ====
*** Parenteral regimen
* Both NSAIDS and opiods are seen efficacious for the pain relief related to nephrolithiasis.<ref name="pmid15178585">{{cite journal |vauthors=Holdgate A, Pollock T |title=Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic |journal=BMJ |volume=328 |issue=7453 |pages=1401 |date=June 2004 |pmid=15178585 |pmc=421776 |doi=10.1136/bmj.38119.581991.55 |url=}}</ref>
**** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
 
**** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
====== Non steroidal anti inflammatory drugs (NSAIDS) ======
**** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
** Parenteral regimen
*** Oral regimen
*** Preferred regimen (1)2 g IV q24h for 14 (14–21) days
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days  
*** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
**** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days  
*** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
** Oral regimen
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days   
*** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days  
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days  
*** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days  
**** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days   
** 2.1.2 '''Pediatric'''
*** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days  
*** Parenteral regimen
* 2.1.2 '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
** Parenteral regimen
**** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
*** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
**** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
*** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
*** Oral regimen
*** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
**** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
** Oral regimen
**** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
*** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
**** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
*** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
**** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
*** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
**** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
*** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
**** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
*** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
*** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
 
* 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
* 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
*: '''Note (1):'''  
*: '''Note (1):'''  

Revision as of 19:41, 15 June 2018

Kidney stone Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Kidney stone from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Ultrasonography

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Kidney stone medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Kidney stone medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Kidney stone medical therapy

CDC on Kidney stone medical therapy

Kidney stone medical therapy in the news

Blogs onKidney stone medical therapy

Directions to Hospitals Treating Kidney stone

Risk calculators and risk factors for Kidney stone medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

OR

Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].

OR

Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].

Medical Therapy

Nephroliithiasis

Non pharmacological measures

Straining
    • Stone ≤5 mm can pass spontaneously.
    • Passage of stone also depends on the site of stone.[1]

Pharmacological measures

  • Both NSAIDS and opiods are seen efficacious for the pain relief related to nephrolithiasis.[2]
Non steroidal anti inflammatory drugs (NSAIDS)
    • Parenteral regimen
      • Preferred regimen (1)2 g IV q24h for 14 (14–21) days
      • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
      • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
    • Oral regimen
      • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
      • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
      • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
  • 2.1.2 Pediatric
    • Parenteral regimen
      • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
      • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
      • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '(Contraindications/specific instructions)'
    • Oral regimen
      • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
      • Preferred regimen (2): drug name (for children aged ≥ 8 years) 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
      • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
      • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
      • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
      • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
  • 2.2 'Other Organ system involved 2'
    Note (1):
    Note (2):
    Note (3):
    • 2.2.1 Adult
      • Parenteral regimen
        • Preferred regimen (1): drug name 2 g IV q24h for 14 (14–21) days
        • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
        • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
      • Oral regimen
        • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
        • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
        • Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
        • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
        • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
        • Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
    • 2.2.2 Pediatric
      • Parenteral regimen
        • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
        • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
        • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
      • Oral regimen
        • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
        • Preferred regimen (2): drug name 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
        • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
        • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
        • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
        • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)

References

  1. ↑ Miller OF, Kane CJ (September 1999). "Time to stone passage for observed ureteral calculi: a guide for patient education". J. Urol. 162 (3 Pt 1): 688–90, discussion 690–1. PMID 10458343.
  2. ↑ Holdgate A, Pollock T (June 2004). "Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic". BMJ. 328 (7453): 1401. doi:10.1136/bmj.38119.581991.55. PMC 421776. PMID 15178585.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Kidney_stone_medical_therapy&oldid=1477345"