Kidney stone medical therapy

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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].

Medical Therapy

Nephroliithiasis

Non pharmacological measures

Straining

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

Pharmacological measures

• Both NSAIDS and opiods are seen efficacious for the pain relief related to nephrolithiasis.
• The combination works in effective pain relief.
• NSAIDS should be stopped before undergoing Extracorporeal shockwave lithotripsy to reduce the risk of bleeding.

Non steroidal anti inflammatory drugs (NSAIDS)

• Parenteral regimen
  • Preferred regimen (1): Ketorolac 60 mg as a single dose or 30 mg IM q6h
  • Alternative regimen (1): Ketorolac 10 to 30 mg (as single dose) IM and then q4-6 h as needed (maximum: 120 mg/day)
  • Alternative regimen (2): Ketorolac 30 mg as a single dose or 30 mg IV q6h (maximum: 120 mg/day)
• Oral regimen
  • Preferred regimen (1): Ketorolac 20 mg, followed by 10 mg q4-6 h as needed; maximum: 40 mg/day; follows the parenteral dose (contraindicated in patients with renal failure)
  • Alternative regimen (1):Indomethacin 20 mg PO q8h
  • Alternative regimen (2):Indomethacin 40 mg PO q8-12h

Opioids

• Parenteral regimen
  • Preferred regimen (1): Morphine 5 mg IV q4h as needed.