Dexamethason und Thrombophlebitis

Dexamethason und Thrombophlebitis

Behandlung der Migräneattacke und Migräneprophylaxe Die Anlage enthält unter grundsätzlicher Verwendung der INN-Nomenklatur eine alphabetisch geordnete Auflistung der Stoffe und Zubereitungen.


Anlage 1 AMVV - Einzelnorm

Kurz-Umfrage zur Verständlichkeit von Gesetzen. Zuletzt geändert durch Art. Dexamethason und Thrombophlebitis, sofern dazu die Bezeichnung nach Nummer 4 oder Nummer 4a nicht eindeutig ist. Name, Dexamethason und Thrombophlebitis, Vorname und Geburtsdatum der Person, für die das Arzneimittel bestimmt ist.

Name, Vorname sowie eine die berufliche Qualifikation erkennen lassende Berufsbezeichnung der verschreibenden ärztlichen oder zahnärztlichen Person verschreibende Person , Dexamethason und Thrombophlebitis. L Dexamethason und Thrombophlebitis Das Original und die Durchschrift ist dem pharmazeutischen Unternehmer zu übermitteln, Dexamethason und Thrombophlebitis. Die Originale verbleiben bei dem pharmazeutischen Unternehmer. Dieser hat die Originale zeitlich geordnet fünf Jahre aufzubewahren und der zuständigen Behörde auf Verlangen vorzulegen.

Die verschreibende Person hat auf der Durchschrift der Verschreibung das Datum des Erhalts und der Anwendung des Arzneimittels sowie die Zuordnung zu den konkreten Patientenakten in anonymisierter Form zu vermerken, Dexamethason und Thrombophlebitis.

Sie hat die Durchschriften zeitlich geordnet fünf Jahre aufzubewahren und der zuständigen Behörde auf Verlangen zur Einsichtnahme vorzulegen. Für Verschreibungen in elektronischer Form gelten die Sätze 1 bis 7 entsprechend.

Der Anforderung muss eine Erklärung der ärztlichen Person beigefügt sein, dass 1. Der Apotheker hat sich über die Identität der verschreibenden Person Gewissheit zu verschaffen. Die verschreibende Person hat dem Apotheker die Verschreibung in schriftlicher oder elektronischer Form unverzüglich nachzureichen.

Absatz 1 Satz 2 gilt entsprechend. Von der Verschreibungspflicht sind Arzneimittel ausgenommen, die aus den in der Anlage 1 zu dieser Verordnung genannten Stoffen und Zubereitungen aus Stoffen nach einer homöopathischen Verfahrenstechnik, insbesondere nach den Regeln des Homöopathischen Arzneibuches hergestellt gute Cremes von Krampfadern oder die aus Mischungen solcher Stoffe oder Zubereitungen aus Stoffen bestehen, wenn die Endkonzentration dieser Arzneimittel im Fertigprodukt die vierte Dezimalpotenz nicht übersteigt.

Diese Arzneimittel dürfen auch mit nicht verschreibungspflichtigen Stoffen und Zubereitungen aus Stoffen gemischt werden. Intranasal anzuwendende Arzneimittel mit dem Wirkstoff Beclometasondipropionat, Dexamethason und Thrombophlebitis, die am September im Verkehr befinden, dürfen mit der am September gültigen Kennzeichnung, Packungsbeilage und Fachinformation vom pharmazeutischen Unternehmer Dexamethason und Thrombophlebitis bis zum Verschreibungspflichtig sind, sofern im Einzelfall nicht anders geregelt, auch Arzneimittel, die die jeweiligen Salze der nachfolgend aufgeführten Stoffe enthalten oder denen diese zugesetzt sind.

Ergocalciferol angegeben ist. Kuntze 45 — Jalapae resina et tuber und ihre Zubereitungen Johanniskraut — zur Behandlung mittelschwerer Depressionen — Josamycin und seine Ester. Quecksilber und seine Verbindungen - ausgenommen 1.

Chininmercuribisulfat in einer Konzentration bis zu 2,75 Gewichtsprozenten in Zubereitungen in Kleinpackungen zur Anwendung beim Mann zur Verhütung von Geschlechtskrankheiten. Rabeprazol Racecadotril — ausgenommen in festen Zubereitungen zur symptomatischen Behandlung von akutem Durchfall für eine maximale Anwendungsdauer von drei Tagen bei 1.

Kindern ab dem vollendeten Xantocillin Xenon Dexamethason und Thrombophlebitis Xipamid Xylazin, Dexamethason und Thrombophlebitis. Zalcitabin Zaleplon Zanamivir Zellen menschlicher oder tierischer Herkunft in frischem, gefrorenem oder getrocknetem Zustand, soweit sie zur Injektion oder Infusion bei Menschen bestimmt sind Zeranol Ziconotid Zidovudin Zinkoxid zur oralen Anwendung bei Menschen - ausgenommen in Tagesdosen bis zu 25 mg Zink - Zink - ausgenommen 1.

Dezember über pharmakologisch wirksame Stoffe und ihre Einstufung hinsichtlich der Rückstandshöchstmengen in Lebensmitteln tierischen Ursprungs ABl. L 15 vom


Glossar: Medizinische Fachausdrücke von A-Z für den Laien übersetzt

Jan de Gans, Ph. N Engl J Med ; Mortality and morbidity rates are high among adults with acute bacterial meningitis, especially those with pneumococcal meningitis. In studies of bacterial meningitis in animals, adjuvant treatment with corticosteroids has beneficial effects.

Full Text of Background We conducted a prospective, Dexamethason und Thrombophlebitis, randomized, double-blind, multicenter trial of adjuvant treatment with dexamethasone, as compared with placebo, in adults with acute bacterial meningitis. Dexamethasone 10 mg or placebo was administered 15 to 20 minutes before or with the first dose of antibiotic and was given every 6 hours for four days.

The primary outcome measure was the score on the Glasgow Outcome Scale at eight weeks a score of 5, indicating a favorable outcome, vs. A subgroup analysis according to the causative organism was performed. Analyses were performed on an intention-to-treat basis. Full Text of Methods A total of patients were randomly assigned to a treatment group: The base-line characteristics of the two groups were similar.

Treatment with dexamethasone was associated with a reduction in the risk of an unfavorable outcome relative risk, 0. Treatment with dexamethasone was also associated with a reduction in mortality Thrombophlebitis der Vena saphena magna Zuflüsse risk of death, 0, Dexamethason und Thrombophlebitis.

Among the patients with pneumococcal meningitis, Dexamethason und Thrombophlebitis, there were unfavorable outcomes in 26 percent of the dexamethasone group, as compared with 52 percent of the placebo group relative risk, 0.

Gastrointestinal bleeding occurred in two patients in the dexamethasone group and in five patients in the placebo group. Full Text of Results Early treatment with dexamethasone improves the outcome in adults with acute bacterial meningitis and does not increase the risk of gastrointestinal bleeding.

Full Text of Discussion The mortality rate among adults with acute bacterial meningitis and the frequency of neurologic sequelae among those who survive are high, especially among patients with pneumococcal meningitis. Many controlled trials have been performed to determine whether adjuvant corticosteroid therapy is beneficial in children with acute bacterial meningitis. The results, however, do not point unequivocally to a beneficial effect. A meta-analysis of randomized controlled trials performed since showed a beneficial effect of adjunctive dexamethasone therapy in terms of severe hearing loss in children with Haemophilus influenzae type b meningitis and suggested a protective effect in those with pneumococcal meningitis if the Dexamethason und Thrombophlebitis was given before or with parenteral antibiotics.

One large, prospective, Dexamethason und Thrombophlebitis, randomized trial neither placebo-controlled nor double-blind showed a benefit of dexamethasone therapy in a subgroup of patients with pneumococcal meningitis. Patients referred to one of the participating centers listed in the Appendix were eligible for the study if they were 17 years of age or older, had suspected meningitis in combination with cloudy cerebrospinal fluid, bacteria in cerebrospinal fluid on Gram's staining, or a cerebrospinal fluid leukocyte count of more than per cubic millimeter.

The study protocol was approved by the institutional review board of each participating hospital, Dexamethason und Thrombophlebitis. All patients or their legally authorized representatives gave written informed consent before enrollment. Patients were enrolled between June and December The study was designed, conducted, and analyzed independently of any companies.

Patients were randomly assigned to receive dexamethasone sodium phosphate Oradexonat a dose of 10 mg given every six hours intravenously for four days, or placebo that was identical in appearance to the active drug. The study medication was given 15 to 20 minutes before the parenteral administration of antibiotics. After the interim analysis, the protocol was amended to allow administration of the study medication with the antibiotics. Balanced treatment assignments within each hospital were achieved with the use of a computer-generated list of random numbers in blocks of six.

The code was not broken until the last patient to be enrolled had completed eight weeks Dexamethason und Thrombophlebitis follow-up. Treatment assignments were concealed from all investigators, but in an emergency, investigators had access to the sealed, opaque envelopes containing the assignments; two emergencies occurred.

Patients were initially treated with amoxicillin 2 g given intravenously every four hours for 7 to 10 days, depending on the cause of the meningitis and the clinical response. This regimen was based on the available data on susceptibility to antibiotics of cerebrospinal fluid isolates in the Netherlands, Dexamethason und Thrombophlebitis.

Routine examination and cultures of blood and cerebrospinal fluid were performed before the initiation of antibiotic treatment. On day five, Dexamethason und Thrombophlebitis, routine blood chemical tests were performed, including measurement of glucose and hemoglobin levels. As part of routine surveillance, the Netherlands Reference Laboratory for Bacterial Meningitis performed in vitro testing of cerebrospinal fluid isolates for susceptibility to penicillin.

The primary outcome measure was the score on the Glasgow Outcome Scale eight Dexamethason und Thrombophlebitis after randomization, as assessed by the patient's physician. A score of 1 indicates death; 2, a vegetative state the patient is unable to interact with the environment ; 3, severe disability the patient is unable to live independently but can follow commands ; 4, moderate disability the patient is capable of living independently but unable to return to work or school ; and 5, mild or no disability the patient is able to return to work or school.

The Glasgow Outcome Scale has frequently been used in trials involving stroke and other brain injuries. It is a well-validated scale with good interobserver agreement. Secondary outcome measures were death, focal neurologic abnormalities defined as aphasia, cranial-nerve palsy, monoparesis, hemiparesis, and severe ataxiahearing loss, gastrointestinal bleeding clinically relevant bleeding with a decreased serum hemoglobin levelfungal infection, herpes zoster, and hyperglycemia a blood glucose level higher than mg per deciliter [8.

Audiologic examination was performed in patients with clinical hearing loss, Dexamethason und Thrombophlebitis. Subgroup analyses Dexamethason und Thrombophlebitis performed for patients with prospectively defined causes of meningitis: Neisseria meningitidis, Streptococcus pneumoniae, Dexamethason und Thrombophlebitis, other bacteria, and an unidentified cause indicated by a negative cerebrospinal fluid culture.

Calculation of the required sample size was based on the assumption that dexamethasone would reduce the proportion of patients with an unfavorable outcome from 40 to 25 percent. With a two-sided test, an alpha level of 0. The analysis of outcomes was performed on an intention-to-treat basis with the use of a last-observation-carried-forward procedure.

An additional analysis in which data for patients lost to follow-up were defined as missing was also performed. The results of these two analyses were similar. Proportions of patients in the two groups were compared with Fisher's exact test. Two-tailed P values of less than 0. Parametric and nonparametric values were tested with Student's t-test and the Mann—Whitney U test, respectively.

The results are expressed as relative risks for the dexamethasone group as compared with the placebo group, with a relative risk of less than 1.

Logistic-regression analysis of base-line variables sex; age; duration of symptoms; presence or absence of seizures, coma, and hypotension on admission; results of blood culture; cerebrospinal fluid white-cell count; and causative organism was performed to identify risk factors for an adverse outcome other than the group assignment.

Ninety-five percent confidence intervals, calculated with the use of Confidence Interval Analysis, are reported. A three-member independent data-monitoring committee performed an interim analysis after patients had been enrolled. The study would have been stopped if Dexamethason und Thrombophlebitis significant differences in efficacy or safety had been found. On January 10,the data-monitoring committee recommended early termination of the trial because the enrollment rate was too slow for completion within a reasonable time.

The committee subsequently reconsidered its decision and recommended that the trial be Dexamethason und Thrombophlebitis if the enrollment rate could be improved. To increase the enrollment rate, Dexamethason und Thrombophlebitis, two amendments of the protocol were made. First, the protocol Krampfadern Beine Mädchen amended to allow administration of the study medication with the antibiotics.

This decision was based on the results of a meta-analysis of trials of dexamethasone in children with acute bacterial meningitis. This change was made because of the participation of centers in countries where highly resistant pneumococcal strains are more common than they are in the Netherlands.

A total of patients were randomly assigned to a study group: Two patients one in each group did not meet the inclusion criteria Dexamethason und Thrombophlebitis they were too young.

Dexamethason und Thrombophlebitis patients in the dexamethasone group and nine in the placebo group each met one exclusion criterion; one patient in the dexamethasone group met two exclusion criteria. Eleven patients in each group were withdrawn from treatment early, but all patients received the assigned treatment, at least initially Figure 1 Figure 1 Random Assignment to Treatment, Withdrawal from Treatment, and Follow-up among Adults with Bacterial Meningitis.

Four patients were withdrawn because they did not meet the inclusion criteria three in the dexamethasone group and one in the placebo groupand five because of adverse events four in the dexamethasone group and one in the placebo group.

Thirteen patients Dexamethason und Thrombophlebitis withdrawn for other reasons: The reasons for corticosteroid treatment were brain herniation in three patientspulmonary problems in threedisseminated intravascular coagulation in oneand acute disseminated encephalomyelitis Dexamethason und Thrombophlebitis one. Cranial computed tomography CT showed diffuse Dexamethason und Thrombophlebitis swelling in the patients with herniation and hypodense lesions in the patient with acute disseminated encephalomyelitis.

Eight weeks after admission, neurologic examinations were performed in of patients 97 percent. Seven patients were lost to follow-up, three in the dexamethasone group and four in the placebo group. At discharge, six of these seven patients had a score of 5 on the Glasgow Outcome Scale, and one had a score of 4. These last-observation scores were carried forward to eight weeks, so that all patients were included in the analyses of the primary outcome and mortality.

Classic symptoms and signs Dexamethason und Thrombophlebitis meningitis were present in a large proportion of the patients headache in 94 percent, fever in 81 percent, and neck stiffness in 94 percent.

At base line, the clinical characteristics and the results of laboratory tests were similar in the dexamethasone and placebo groups, although a higher percentage of patients in the dexamethasone group had seizures Table 1 Table 1 Base-Line Characteristics of the Study Population. The mean cerebrospinal fluid pressure was also similar in the two groups, as was the proportion of patients in the two groups who had very high pressure 40 cm of water or higher.

Gram's staining of cerebrospinal fluid specimens, performed in patients, showed bacteria in patients 74 percent, Dexamethason und Thrombophlebitis. Cerebrospinal fluid culture yielded bacteria in of patients 78 percent. Forty-three of the 65 patients 66 percent with negative cerebrospinal fluid cultures Dexamethason und Thrombophlebitis at least one individual cerebrospinal fluid finding that was Dexamethason und Thrombophlebitis of bacterial meningitis a glucose level below 34 mg per deciliter [1.

Eight weeks after enrollment, the percentage of patients with an unfavorable outcome was significantly smaller in the dexamethasone group than in the placebo group 15 percent vs. The benefit of dexamethasone remained substantial in an analysis adjusted for other risk factors adjusted odds ratio, 0.

Among the patients Dexamethason und Thrombophlebitis pneumococcal meningitis, 26 percent in the dexamethasone group had an unfavorable outcome, as compared with 52 percent in the placebo group. Among the patients with meningitis due to N. The proportion of patients who died was significantly smaller in the dexamethasone group than in the placebo group 7 Dexamethason und Thrombophlebitis vs. Among the patients with pneumococcal meningitis, 14 percent of those who received dexamethasone and 34 percent of those who received placebo died.

Adjuvant treatment with dexamethasone did not have a Dexamethason und Thrombophlebitis beneficial effect on neurologic sequelae, Dexamethason und Thrombophlebitis hearing loss. During admission, audiologic examination was performed in 28 patients, Dexamethason und Thrombophlebitis, 14 of whom had severe hearing loss 60 dB or more in one or both ears, Dexamethason und Thrombophlebitis.

At eight weeks, 27 patients had hearing loss. The lower mortality in the dexamethasone group did not Dexamethason und Thrombophlebitis in an increased rate of severe neurologic sequelae in this group. Dexamethasone appeared to be most beneficial in patients with moderate or severe disease. Adverse events resulted in the early withdrawal of four patients in the dexamethasone group and one in the placebo group Figure 1. In the dexamethasone group, Dexamethason und Thrombophlebitis, two patients were withdrawn because of severe hyperglycemia, one because of suspected stomach perforation which was not the caseand one because of agitation and flushing.


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