tailieunhanh - obstetrics_part4

ký sinh trùng nhiễm trùng Bệnh sốt rét falciparum phức tạp trong quý 1 quinine IV truyền (liều lượng được thể hiện trong dihydrochloride quinine): Liều 20 mg / kg pha loãng trong dung dịch glucose, quản lý hơn 4 giờ. Sau đó, glucose 5% để giữ tĩnh mạch mở trong vòng 4 giờ tiếp theo. | Parasitic infections Complicated falciparum malaria during the 1st trimester quinine IV infusion dosage is expressed in quinine dihydrochloride Loading dose 20 mg kg diluted in glucose solution administered over 4 hours. Then 5 glucose to keep the vein open over the next 4 hours. Then maintenance dose 10 mg kg every 8 hours by infusion over 8 hours or better alternate 4 hours of quinine diluted in 5 glucose and 4 hours of 5 glucose . Do not administer loading dose to patients who have received oral quinine within the previous 24 hours. Start with maintenance dose. Monitor the patient closely risk of pulmonary oedema and hypoglycaemia . As soon as the patient has received at least 3 doses of parenteral quinine and can swallow change to the oral route with quinine PO to complete 7 days of treatment or with a complete curative treatment of 3 days with one of the following ACT AS SP or AS AQ. Complicated falciparum malaria during the 2nd and 3rd trimesters artemether IM anterolateral aspect of the thigh mg kg on the first day followed by mg kg once daily until the patient can swallow. Then change to oral route with a complete curative treatment of 3 days with one of the following ACT AS SP or AS AQ or AS MQ or co-artemether. Do not use the combination AS MQ if the patient developed neurological signs during the acute phase. or artesunate IV or IM if IV is no feasible mg kg on admission then at 12 hours and 24 hours then once daily. As soon as the patient can swallow change to oral route with an ACT as for artemether. or if no artemisinin derivative is available quinine IV as above. Malaria due to P. vivax P. malariae P. ovale irrespective of the age of the pregnancy chloroquine PO D1 D2 10 mg base kg D3 5 mg base kg Amoebiasis The disease is worsened by pregnancy. There is a risk of postnatal transmission to the newborn. The diagnosis should be established by microscopic examination of fresh stools. If the result of the examination is positive secnidazole .