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A 4-year-old Caucasian boy is brought to his pediatrician with complaints of abnormal bruising and repeated bacterial infections heart attack symptoms in women buy cheap exforge 80 mg on-line. A blood workup reveals thrombocytopenia and neutropenia and the presence of numerous small blood pressure z score calculator order 80mg exforge free shipping, dense lymphoblasts with scant cytoplasm arrhythmia kamaliya download 80 mg exforge with mastercard. Which of the following best describes the status of immunoglobulin chain synthesis most likely in these cells? A young woman with acute myeloblastic leukemia is treated with intensive chemotherapy and achieves remission of her symptoms hypertension webmd cheap 80 mg exforge with visa. Because the prognosis for relapse is relatively high, a bone marrow transplant is undertaken in her first remission. Which of the following cytokines administered with the bone marrow cells would have the beneficial result of stimulating lymphoid-cell development from the grafted stem cells? Radioactive tracer studies demonstrate a normal number of T-cell precursors entering the thymus, but no mature T lymphocytes are found in the blood or peripheral organs. A patient with advanced metastatic melanoma decides to join an experimental treatment protocol in the hope that it will cause regression of his tumor masses. Mobilization of which of the following cells from the bone marrow would be likely to result from this treatment? The cells were treated with fluorescent-labeled antibodies to various cell surface markers before they were evaluated by flow cytometry. An 18-year-old member of a college soccer team is seen by a physician because of chest tightness and dyspnea on exertion. Eighty percent of the white blood cells in the peripheral blood are small, abnormal lymphocytes with lobulated nuclei and scant cytoplasm. The phenotype of the malignant cell matches that of normal progenitor cells that leave the bone marrow to enter the thymus. Herpes simplex viruses are extremely successful pathogens because they have a variety of immunologic evasion mechanisms. A patient with a B-cell lymphoma is referred to an oncology clinic for the analysis of his condition. Which of the following therapeutic regimens is most likely to destroy the malignant cells and no others? A lymph node biopsy of a 6-year-old boy shows markedly decreased numbers of lymphocytes in the paracortical areas. A 65-year-old woman was involved in an automobile accident that necessitated the removal of her spleen. To which of the following pathogens would she have the most increased susceptibility? A 6-year-old child is taken to his pediatrician because the parents are alarmed about an indurated fluctuant mass on the posterior aspect of his neck. The pathologist reports back that the mass is a lymph node with markedly increased numbers of cells in the cortical area. Fluorescent antisera to which of the cell surface markers is most likely to bind to cells in this area? A radioactive tracer dye is injected subcutaneously into the forearm of an experimental subject. What is the first area of the first draining lymph node that would develop significant radioactivity? A rabbit hunter in Arkansas is diagnosed with ulceroglandular tularemia and treated with streptomycin. The tularemic papule, lymphadenopathy, and bacteremia have resolved, but he has now developed a raised, itching skin rash and a fever. A 2-year-old child who has suffered recurrent bacterial infections is evaluated for immunologic deficiency. A 2-year-old boy is admitted to the hospital for workup of a possible immunologic disorder. His history is remarkable for the occurrence of multiple skin infections involving Staphylococcus, Pseudomonas, and Candida. On examination the child has cervical lymphadenopathy and mild hepatosplenomegaly. The nitroblue tetrazolium dye reduction test and neutrophil oxidative index are negative.

Pregna ncy Ri s k Fa ctorD Pregna ncy Cons i dera ti ons Ani ma l s tudi es ha ve demons tra ted embryotoxi ci ty heart attack 36 purchase exforge 80mg overnight delivery, feta l toxi ci ty blood pressure of 100/60 discount 80 mg exforge with amex, a nd ma terna l toxi ci ty arteria znaczenie purchase exforge 80mg amex. A pregna ncy regi s try i s a va i l a bl e for a l l ca ncers di a gnos ed duri ng pregna ncy a t Cooper Hea l th (856-757-7876) blood pressure chart vertex buy exforge 80mg with amex. Advers e Rea cti ons Percenta ges reported for doceta xel monothera py; frequency ma y va ry dependi ng on di a gnos i s, dos e, l i ver functi on, pri or trea tment, a nd premedi ca ti on. The i nci dence of a dvers e events wa s us ua l l y hi gher i n pa ti ents wi th el eva ted l i ver functi on tes ts. Risk D: Consider therapy modification Anti neopl a s ti c Agents (Anthra cycl i ne): Ta xa ne Deri va ti ves ma y enha nce the a dvers e/toxi c effect of Anti neopl a s ti c Agents (Anthra cycl i ne). Caution: Severe hypers ens i ti vi ty rea cti ons ha ve been reported; premedi ca ti on wi th dexa metha s one ma y be a dvi s a bl. Pa ti ent s houl d be moni tored conti nuous l y duri ng i nfus i on; dos i ng a djus tment ma y be neces s a ry. As s es s res ul ts of l a bora tory tes ts, thera peuti c res pons e, a nd a dvers e effects (eg, neutropeni a, s evere fl ui d retenti on, pl eura l effus i on, opportuni s ti c i nfecti ons, a nemi a) pri or to ea ch i nfus i on a nd on a regul a r ba s i s throughout thera py. Thi s medi ca ti on ca n onl y be a dmi ni s tered by i nfus i on; report i mmedi a tel y a ny pa i n, burni ng, s wel l i ng, or rednes s a t i nfus i on s i te, di ffi cul ty brea thi ng or s wa l l owi ng, ches t pa i n, or s udden chi l l s. It i s i mporta nt to ma i nta i n a dequa the hydra ti on (2-3 L/da y of fl ui ds) unl es s i ns tructed to res tri ct fl ui d i nta ke a nd a dequa the nutri ti on (s ma l l frequent mea l s ma y hel p). Ma y ca us e na us ea or vomi ti ng (s ma l l frequent mea l s, frequent mouth ca re, s ucki ng l ozenges, or chewi ng gum ma y hel p); l os s of ha i r (revers i bl e); or di a rrhea (buttermi l k, boi l ed mi l k, or yogurt ma y hel p; i f unres ol ved, conta ct pres cri ber for medi ca ti on rel i ef). Report i mmedi a tel y s wel l i ng of extremi ti es, res pi ra tory di ffi cul ty, unus ua l wei ght ga i n, a bdomi na l di s tenti on, ches t pa i n, pa l pi ta ti ons, fever, chi l l s, unus ua l brui s i ng or bl eedi ng, s i gns of i nfecti on, exces s i ve fa ti gue, or ra s h. Dexa metha s one 8-10 mg ora l l y twi ce da i l y for 3-5 da ys, s ta rti ng the da y before doceta xel a dmi ni s tra ti on, i s us ua l l y recommended. When predni s one i s pa rt of the a nti neopl a s ti c regi men (eg, pros ta the ca ncer), the predni s one i s s ometi mes wi thhel d on the da ys dexa metha s one i s a dmi ni s tered. Denta l Hea l th: Effects on Denta l Trea tmentKey a dvers e event(s) rel a ted to denta l trea tment: Mucos i ti s, s toma ti ti s, a nd ta s the pervers i on. A Revi ew of Its Pha rma codyna mi c a nd Pha rma coki neti c Properti es a nd Thera peuti c Effi ca cy i n the Ma na gement of Meta s ta ti c Brea s t Ca ncer," Drugs, 1996, 51(6):1075-92. Sta rt a t fi rs t s i gn of col d s ore or fever bl i s ter a nd conti nue unti l hea l ed. Dos i ng: Pedi a tri cHerpes s i mpl ex: Chi l dren 12 yea rs: Refer to a dul t dos i ng. Contra i ndi ca ti ons Hypers ens i ti vi ty to docos a nol or a ny component of the formul a ti on Wa rni ngs /Preca uti ons Special populations: Pedi a tri cs: Not for us e i n chi l dren <12 yea rs of a ge. Other warnings/precautions: Appropri a the us e: For externa l us e onl y; do not a ppl y to i ns i de of mouth or a round eyes. Advers e Rea cti ons Li mi ted i nforma ti on; hea da che reported (frequency s i mi l a r to pl a cebo) Drug Intera cti ons There a re no known s i gni fi ca nt i ntera cti ons. Crea m, topi ca l: Abreva : 10% (2 g) [conta i ns benzyl a l cohol] Generi c Ava i l a bl eNo Mecha ni s m of Acti onPrevents vi ra l entry a nd repl i ca ti on a t the cel l ul a r l evel Denta l Hea l th Profes s i ona l Cons i dera ti ons Wa s h ha nds before a nd a fter a ppl yi ng crea m. Conta ct hea l thca re provi der i f s ore gets wors e or does not hea l wi thi n 10 da ys. Denta l Hea l th: Effects on Denta l Trea tmentNo s i gni fi ca nt effects or compl i ca ti ons reported (s ee Denta l Comment) Denta l Hea l th: Va s ocons tri ctor/Loca l Anes theti c Preca uti ons No i nforma ti on a va i l a bl e to requi re s peci a l preca uti ons Menta l Hea l th: Effects on Menta l Sta tus None reported Menta l Hea l th: Effects on Ps ychi a tri c Trea tmentNone reported Anes thes i a a nd Cri ti ca l Ca re Concerns /Other Cons i dera ti ons Do not a ppl y di rectl y to i ns i de of mouth or a round eyes. Geri a tri c Cons i dera ti ons the chroni c us e of s ti mul a nt ca tha rti cs i s i na ppropri a the a nd s houl d be a voi ded. Al though the el derl y commonl y compl a i n of cons ti pa ti on, s uch compl a i nts requi re eva l ua ti on; s hort-term us e of s ti mul a nt ca tha rti cs i s bes t. If prophyl a xi s i s des i red, then the us e of bul k a gents (eg, ps yl l i um), s tool s ofteners, a nd hyperos moti c a gents (eg, s orbi tol 70%) i s preferred. Stool s ofteners a re unneces s a ry i f s tool s a re wel l -hydra ted (a s i n us e of hyperos moti cs), s oft or "mus hy".

Vetere heart attack 64 chords order exforge 80mg with amex, Mela Pomponio blood pressure chart india discount exforge 80 mg otc, Licinio Muciano blood pressure chart android app order exforge 80mg line, Fabricio Tusco blood pressure 13080 order 80 mg exforge, Ateio Capitone, Ateio Polybio, Hecataeo, Hellanico, pliilologo. Externis Damaste, Eudoxo, Dicaearcho, Timosthene, Eratosthene, Ephoro, Cratete grammatico, Serapione Antiochense, Calhmacho, Artemidoro, Apollodoro, Agathocle, Timaeo Siculo, Myrsilo, Alexandro:: Thucydide, Dosiade, Anaximandro, Mallote, Dionysio, Aristide, Callidemo, Menaechmo, Aglaosthene, Anticlide, HeracHde, Philemone, Xenophonte, Pythea, Isidoro, Philonide, Xenagora, Astynomo, Staphylo, Aristocrito, Metrodoro, Cleobulo, Posidonio. Authorities Cato the Censor, Marcus Varro, Marcus Agrippa, His Late Majesty Augustus, Varro of Atax, Cornehus Nepos, Hyginus, Lucius Vetus, Pomponius Mela, Licinius Mucianus, Fabricius: Tuscus, Ateius Capito, Ateius the scholar. Foreign authorities Polybius, Hecataeus, Hellanicus, Damastes, Eudoxus, Dicaearchus, Timosthenes, Eratosthenes, Ephorus, Crates the philologist, Serapion of Antioch, CalHmachus, Artemidorus, ApoUodorus, Agathocles, Timaeus of Sicily, Myrsilus, Alexander the Learned, Thucydides, Dosiades, Anaximander, PhiUstides of Mallus, Dionysius, Aristides, CaUidemus, Menaechmus, Aglaosthenes, AnticUdes, HeracUdes, Philemon, Xenophon, Pytheas, Isidore, Philonides, Xenagoras, Astynomos, Staphylus, Aristocritus, Metrodorus, Cleobulus, Posidonius. Vetere, Mela, DomitioCorbulone,LicinioMuciano, Claudio Caesare, Arruntio, Livio fiUo, Seboso, luba rege, Hecataeo, actis triumphorum. Totals towns and famous mountains; races famous rivers; extinct towns and races; 118 islands facts, investigations and observations. Authorities Agrippa, Suetonius PauUnus, Marcus Varro, Varro of Atax, Cornehus Nepos, Hyginus, Lucius Vetus, Mela, Domitius Corbulo, Licinius Mucianus, Claudius Caesar, Arruntius, Livy junior, Sebosus, Triumphs Ojjicial records. Foreign authorities King Juba, Hecataeus, Hellanicus, Damastes, Dicaearchus, Baeto, Timosthenes, Philonides, Xenagoras, Astynomus, Staphylus, Dionysius, Aristotle, Aristocritus, Ephorus, Eratosthenes, Hipparchus, Panaetius, Serapio of Antioch, Calhmachus, Agathocles, Polybius, Timaeus the mathematician, Herodotus, Myrsilus, Alexander the Learned, Metro(xl-xUii) Dardanelles, Mysia, Phrygia, Galatia. Vetere, Mela Pomponio, Domitio Corbulone, Licinio Muciano, Claudio Caesare, Arruntio, Seboso, Fabricio Tusco, Externis luba T. Hellanico, Damaste, Eudoxo, rege, Hecataeo, Dicaearcho, Baetone, Timosthene, Patrocle, Demodamante, Clitarcho, Eratosthene, Alexandro magno, Ephoro, Hipparcho, Panaetio, CalUmacho, Artemidoro, Apollodoro, Agathocle, Polybio, Timaeo: Alexandro polyhistore, Isidoro, Amometo, Metrodoro, Posidonio, Onesicrito, Nearcho, Megasthene, Diogneto, Aristocreonte, Bione, DaUone, Simonide minore, Basile, Xenophonte Lampsaceno. Totals 1195 towns 576 races, 115 famous rivers, 38 famous mountains, 108 islands, 95 extinct towns and races 2214 facts and investigations:; and observations. Authorities Marcus Agrippa, Marcus Varro, Varro of Atax, Cornelius Nepos, Hyginus, Lucius Vetus, Pomponius Mela, Domitius Corbulo, Licinius Mucianus, Claudius Caesar, Arruntius, Sebosus, Fabricius Tuscus, Titus Livy junior, Seneca, Nigidius. Vir optimus iudicatus, matronae - insignia de felicitate summa; raritas varietatis familiis exempla continuationis in honorum exempla mirabilia; bis proscriptus; mirabilia; decem res in uno felicissimae; divi (xlvii f. Three supreme virtues in the same person, supreme innocence, supreme bravery, exceptional talents. Livio, Cordo, Melisso, Seboso, CorneHo Celso, Maximo Valerio, Trogo, Nigidio Figulo, Pomponio Attico, Pediano Asconio, Fabiano, Catone censorio, actis, Fabio Herodoto, Aristea, Baetone, Vestale. Externis Isigono Cratete Agatharchide Calliphane Aristotele, Nymphodoro, Apollonide, Phylarcho, Damone, Megasthene, Ctesia, Taurone, Eudoxo, Onesicrito, Clitarcho, Duride, Artemidoro, Hippocrate medico, Asclepiade medico, Hesiodo, Anacreonte, Theopompo, Hellanico, Damaste, Ephoro, Epigene, Beroso, Petosiri, Nechepso, Alexandro polyhistore, Xenophonte, Callimacho, Democrito, Diyllo historico, Stratone qui contra Ephori tvprjixaTa scripsit, Herachde Pontico, Asclepiade qui TpaywSor/Acva, Philostephano, Hegesia, Archemacho, Thucydide, Mnesigitone, Xenagora, Metrodoro Scepsio, AnticUde, Critodemo. Verrius Flaccus, Gnaeus GelHus, Authorities: Lieinius Mucianus, Masurius Sabinus, Agrippina wife of Claudius, Marcus Cicero, Asinius PolHo, Marcus Varro, Messala Rufus, Virgil, CorneHus Nepos, Livy, Cordus, MeHssus, Sebosus, CorneHus Celsus, Valerius Maximus, Trogus, Nigidius Figulus, Pomponius Atticus, Pcdianus Asconius, Fabianus, Cato the Censor, Official Records, Fabius VestaHs. De sollertia -;;;;;;;;;;;;;;;: ostenderit eum Romae ab animalibus periculorum ex animaHbus Medicinae sublatae. Drugs obtained from animals warnings of dangers from animals races destroyed by animals. Pisone, CorneUo aleriano, Catone censorio, Fenestella, Trogo, actis, Columella, Vergilio, Varrone, LuciUo, MeteUo Scipione, CorneUo Celso, Nigidio, Trebio Nigro, Pomponio Mela, MamiUo Sura. Dogs, nature of; instances of relation to masters; nations that have kept dogs of war dog-breeding cures for rabies. Authorities Mucianus, ProciUus, Verrius Flaccus, Lucius Piso, CorneUus Valerianus, Cato the ex-Censor, Fenestella, Trogus, Ojjicial Records, ColumeUa, Virgil, Varro, Lucilius, Metellus Scipio, CorneUus Celsus, Nigidius, Trebius Niger, Pomponius Mela, MamiUus Sura. The largest fishes tunny-fry, young tunny, fuU-grown tunny tunny divided and pickled, salted tunny shces, chopped amia-tunny, mackerel-tunny. Externis: Aristotele, Archelao rege, CalUmacho, Democrito, Theophrasto, ThrasyUo, Hegesidemo, Sudine,: Summa Ex: Alexandro polyhistore. Authorities Turranius GraciUs, Trogus, Maecenas, Alfius Flavus, CorneUus Nepos, the Mivies of Laberius, Fabianus, Fenestella, Mucianus, AeUus Stilo, Sebosus, MeUssus, Seneca, Cicero, AemiUus Macer, Corvinus Messala, Trebius Niger, Nigidius. Foreign authorities Aristotle, King Archelaus, CalUmachus, -:: Democritus, Theophrastus, ThrasyUus, Hegesidemus, Sudines, Alexander the Learned. Ex auctoribus: Manilio, Cornelio Valeriano, actis, Umbricio Meliore, Masurio Sabino, Antistio Labeone, Trogo, Cremutio, M. Lucretio, Cornelio Celso, Horatio, Deculone, Hygino, Sasernis, Nigidio, Mamilio Sura. Extemis Homero, Phemonoe, Philemone, Boetho qui opiiOoyoviav, Hyla qui de auguriis, Aristotele, Theophrasto, CalUmacho, Aeschylo, Hierone rege, Philometore rege, Archyta Tarentino, Amphilocho Atheniense, Anaxipoli Thasio, ApoUodoro Lemnio, Aristophane Milesio, Antigono Cumaeo, Agathocle Chio, ApoUonio Pergameno, Aristandro Athenaeo, Bacchio Milesio, Bione Solense, Chaerea Atheniense, Diodoro Prienaeo, Dione Colophonio, Democrito, Diophane Nicaeense, Epigene Rhodio, Euagone Thasio, Euphronio Athenaeo, luba, Androtione qui de agricultura, Aeschrione qui item, Lysimacho qui item, Dionysio qui Magonem transtulit, Diophane qui ex Dionysio epitomen: fecit, Nicandro, Onesicrito, Phylarcho, Hesiodo. Authorities Manilius, CorneHus V^alerian, Records, Umbricius Melior, Masurius Sabinus, Antis: tius Labeo, Trogus, Cremutius, Marcus Varro, Aemihus Macer, Melissus, Mucianus, Nepos, Fabius Pictor, Titus Lucretius, Cornelius Celsus, Horace, Deculo, Hyginus, the Saseiniae, Nigidius, MamiUus Sura.

Contra i ndi ca ti ons Hypers ens i ti vi ty to ma feni de or a ny component of the formul a ti on Al l ergy Cons i dera ti ons Sul fona mi de Anti bi oti c Al l ergy Wa rni ngs /Preca uti ons Concerns related to adverse effects: Sul fona mi de a l l ergy: Chemi ca l s i mi l a ri ti es a re pres ent a mong s ul fona mi des arteria thyroidea ima 80mg exforge mastercard, s ul fonyl urea s blood pressure medication helps acne effective exforge 80mg, ca rboni c a nhydra s e i nhi bi tors arteria iliaca externa proven 80mg exforge, thi a zi des pulse pressure uk order 80 mg exforge, a nd l oop di ureti cs (except etha cryni c a ci d). Dosage forms specific issues: Sul fi tes: Some dos a ge forms conta i n s ul fi tes whi ch ma y ca us e a l l ergi c rea cti ons i n certa i n i ndi vi dua l s. Pregna ncy Ri s k Fa ctorC Pregna ncy Cons i dera ti ons Tera togeni c effects were not obs erved i n a ni ma l s tudi es us i ng a n ora l prepa ra ti on. The ma nufa cturer does not recommended us e i n women of chi l dbea ri ng potenti a l unl es s the burn a rea covers >20% of the tota l body s urfa ce or when benefi ts of trea tment outwei gh pos s i bl e ri s ks to the fetus. Moni tori ng Pa ra meters Aci d ba s e ba l a nce; s i gns of i nfecti on; s i gns of hea l i ng Nurs i ng: Phys i ca l As s es s ment/Moni tori ngSee Wa rni ngs /Preca uti ons a nd Contra i ndi ca ti ons for us e ca uti ons. As s es s knowl edge/tea ch pa ti ent a ppropri a the a ppl i ca ti on a nd us e a nd a dvers e s ymptoms (s ee Advers e Rea cti ons) to report. Moni tori ng: La b Tes ts Aci d-ba s e ba l a nce Pa ti ent Educa ti onFor externa l us e onl y. Appl y exa ctl y a s di rected wi th s teri l e-gl oved ha nd s o tha t burned a rea s a re covered wi th crea m a t a l l ti mes. Report fa ci a l s wel l i ng, s ki n ra s h, unus ua l bl eedi ng, res pi ra tory di ffi cul ty, pers i s tent di a rrhea, or s i gns of i nfecti ons. Crea m, topi ca l: Sul fa myl on: 85 mg/g (60 g, 120 g, 454 g) [conta i ns s odi um meta bi s ul fi te] Powder, for topi ca l s ol uti on, a s a ceta te: Sul fa myl on: 50 g/pa cket (5s) Generi c Ava i l a bl eNo Mecha ni s m of Acti onAs a s ul fona mi de, ma feni de i nterferes wi th ba cteri a l fol i c a ci d s ynthes i s through competi ti ve i nhi bi ti on of pa ra a mi nobenzoi c a ci d. Spectrum of a cti vi ty encompa s s es both gra m pos i ti ve a nd nega ti ve orga ni s ms, i ncl udi ng Pseudomonas a nd s ome a na erobes. Contra i ndi ca ti ons Ba s ed on magaldrate component: Hypers ens i ti vi ty to ma ga l dra the or a ny component of the formul a ti on; pa ti ents wi th col os tomy or a n i l eos tomy; a ppendi ci ti s; ul cera ti ve col i ti s; di verti cul i ti s Ba s ed on simethicone component: Hypers ens i ti vi ty to s i methi cone or a ny component of the formul a ti on Pregna ncy Ri s k Fa ctorC La cta ti onExcreti on i n brea s t mi l k unknown/compa ti bl e Advers e Rea cti ons Frequency not defi ned. Risk C: Monitor therapy Ampheta mi nes: Anta ci ds ma y decrea s e the excreti on of Ampheta mi nes. Risk D: Consider therapy modification Bi s a codyl: Anta ci ds ma y di mi ni s h the thera peuti c effect of Bi s a codyl. Risk D: Consider therapy modification Mes a l a mi ne: Anta ci ds ma y di mi ni s h the thera peuti c effect of Mes a l a mi ne. Risk D: Consider therapy modification Pa ti ent Educa ti onSee i ndi vi dua l a gent for Si methi cone. Denta l Hea l th: Va s ocons tri ctor/Loca l Anes theti c Preca uti ons No i nforma ti on a va i l a bl e to requi re s peci a l preca uti ons Menta l Hea l th: Effects on Menta l Sta tus None reported Menta l Hea l th: Effects on Ps ychi a tri c Trea tmentCons ti pa ti on i s common; concurrent us e wi th ps ychotropi cs ma y produce a ddi ti ve effects Index Terms Si methi cone a nd Ma ga l dra the Copyri ght (c) Lexi -Comp, Inc. Dos i ng: Pedi a tri cNote: Serum ma gnes i um i s poor refl ecti on of repl eti ona l s ta tus a s the ma jori ty of ma gnes i um i s i ntra cel l ul a r; s erum l evel s ma y be tra ns i entl y norma l for a few hours a fter a dos e i s gi ven, therefore, a i m for cons i s tentl y hi gh norma l s erum l evel s i n pa ti ents wi th norma l rena l functi on for mos t effi ci ent repl eti on. Stora geInjecti on: Pri or to recons ti tuti on, s tore a t control l ed room tempera ture of 15°C to 30°C (59°F to 86°F). Contra i ndi ca ti ons Hypers ens i ti vi ty to a ny component of the formul a ti on; rena l i mpa i rment; myoca rdi a l di s ea s e; coma Wa rni ngs /Preca uti ons Disease-related concerns: Neuromus cul a r di s ea s e: Us e wi th extreme ca uti on i n pa ti ents wi th mya s theni a gra vi s or other neuromus cul a r di s ea s. Moni tor pa ti ent a nd feta l s ta tus, a nd s erum ma gnes i um l evel s cl os el y. Other warnings/precautions: El ectrol yte a bnorma l i ti es: Concurrent hypoka l emi a or hypoca l cemi a ca n a ccompa ny a ma gnes i um defi ci t. Hypoma gnes emi a i s a s s oci a ted wi th hypoka l emi a a nd requi res correcti on i n order to norma l i ze pota s s i um. Ma gnes i um cros s es the pl a centa; s erum l evel s i n the fetus correl a the wi th thos e i n the mother. Risk D: Consider therapy modification Ca l ci tri ol: Ma y i ncrea s e the s erum concentra ti on of Ma gnes i um Sa l ts. Dos i ng: Rena l Impa i rmentPa ti ents i n s evere rena l fa i l ure s houl d not recei ve ma gnes i um due to toxi ci ty from a ccumul a ti on. Pa ti ents wi th a Cl cr <25 mL/mi nute s houl d be moni tored by s erum ma gnes i um l evel s. Admi ni s tra ti on: Ora l To i ncrea s e pa l a ta bi l i ty, chi l l the s ol uti on pri or to a dmi ni s tra ti on. Di eta ry Cons i dera ti ons Ci troma 290 mg/5 mL (300 mL) cherry a nd l emon fl a vors conta i ns ma gnes i um 48 mg a nd pota s s i um 13 mg per 5 mL; Ci troma gra pe a nd l emony fl a vors conta i ns ma gnes i um 48 mg a nd s odi um 7. Decrea s ed rena l functi on (Cl cr <30 mL/mi nute) ma y res ul t i n toxi ci ty; moni tor for toxi ci ty a nd Cl cr <30 mL/mi nute. Pregna ncy Ri s k Fa ctorB Advers e Rea cti ons 1% to 10%: Ca rdi ova s cul a r: Hypotens i on Endocri ne & meta bol i c: Hyperma gnes emi a Ga s troi ntes ti na l: Abdomi na l cra mps, di a rrhea, ga s forma ti on Res pi ra tory: Res pi ra tory depres s i on Drug Intera cti ons Al umi num Hydroxi de: Ci tri c Aci d Deri va ti ves ma y i ncrea s e the a bs orpti on of Al umi num Hydroxi de. Risk D: Consider therapy modification Tes t Intera cti ons Increa s ed ma gnes i um; decrea s ed protei n, decrea s ed ca l ci um (S), decrea s ed pota s s i um (S) Reference Ra ngeSerum ma gnes i um: 1.

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