16 Drug therapy and poisoning
Questions
How should the body surface area be calculated when giving drugs for which doses are given per square metre of body surface area?
Where can I find a reference table that shows drugs that can safely be prescribed and avoided during pregnancy and during lactation? Might this be included in the next edition of Kumar and Clark’s Clinical Medicine?
My question is concerned with the practical use of steroids. In inflammatory bowel disease, what doses are used and when is the dose reduced?
What is the safe dosage/length of treatment for the drug dexmethasone so that its destructive effects are avoided?
I’m a medical student from the Faculty of Medicine, Peradeniya, Sri Lanka. I have a question about the management of aspirin poisoning. Is it reasonable to carry out a postalkaline diuresis in these patients?
What are the pulmonary manifestations of Pink’s disease and how common are they relative to the usual cerebral, skin and renal effects?
Is it necessary to administer antivenom to a person bitten by a snake 6 hours previously, presenting only with local leg swelling over the bitten site and so far no other systemic feature of poisoning?
In acute anaphylaxis, you recommend IM adrenaline (epinephrine). Surely in such an acute situation intravenous adrenaline would be better?
Many older drug therapies, e.g. penicillin in streptococcal sore throat, have never been submitted to rigorous trials such as a randomized controlled trial (RCT). Do you think they should be?
Can chronic exposure to organophosphorus compounds (in farmers) cause axonal radiculoneuropathy persisting for years? Is this disease reversible?
Body surface area is mainly used in children. The body surface area of a 70-kg man is 1.8m2. To calculate the dose in a child use the following formula:
However, the best way to ensure the correct dose in children is to use reference tables or the manufacturer’s guidelines.
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