Acid_Base_Conference_9_2_08_Lactic_Acidosis

Acid_Base_Conference_9_2_08_Lactic_Acidosis - Acid Base...

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Unformatted text preview: Acid Base David Shure September 2008 Overview Mitochondria: Krebs Cycle/ ETC & energy production Linezolid induced lactic acidosis.- How does it happen? NRTI induced lactic acidosis? Mechanism Is it bad for you? Linezolids Mechanism of Action Inhibits bacterial protein synthesis Linezolid-Induced Lactic Acidosis - 1st report Apodaca and Rakita NEJM 2003 (Virginia Mason Medical Ctr, WA) 52 F f/c/ 2wk cough, CT chest RML infiltrate, mediastinal adenopathy BAL/mediastinal biopsy = Nocardia ottidis- caviarum CT = brain, kidney, adrenal, ie disseminated Had 11 weeks linezolid and 5 wks gatifloxacin Cont. Low bicarbonate levels Lactate level = 9.9 mmol/L, both abx stopped lactate 1.4 after 10 days Both abx restarted, lactate level measured 7 days later was 4.8, nausea returned, gatiflx DCd, lactate now 6.5, DC linezolid normalization lactate level after 2 weeks. Pt switched to avalox, lactate levels remained normal, disseminated nocardiosis resolved. Mitochondrial Toxicity Assoc w/Linezolid Soriano, et al; Spain 2005 NEJM 3 pts developed weakness and lactic acidosis during prolonged course oral linezolid 1. 25 M, E. faecium of knee prostehsis (LA 40,59,41 mg/d: NL<20) 2. 75 M, Waldenstroms macroglob and nocardia cerebral abscess (LA 28 after 2 mths rx) 3. 55 M, MRSA knee prosthesis (peak LA 44 after 1.5 mths)...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Acid_Base_Conference_9_2_08_Lactic_Acidosis - Acid Base...

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