Special populations include pregnant women
Posted: Sun Feb 02, 2025 8:45 am
An electrocardiogram should be performed before taking the drug. This drug should be contraindicated in patients with arrhythmia (eg, conduction block), retinal disease, or hearing loss.
2 Therapeutic drug monitoring
Some antiviral and antibacterial drugs require therapeutic drug monitoring (TDM). Table 1 shows plasma concentrations of such drugs and their dosage adjustments. When deviations in plasma drug concentrations occur, treatment regimens should be adjusted based on clinical symptoms and concomitant medications.
Table 1. Concentration range and signal points of common TDM drugs for COVID19 patients
3 Attention to potential drug interactions
Antiviral drugs such as lopinavir/ritonavir are metabolized via the CYP3A enzyme in the liver. Potential drug interactions should be carefully monitored if patients are receiving concomitant medications. Table 2 shows interactions between antiviral drugs and common drugs used to treat underlying conditions.
Table 2. Interactions between antiviral drugs and commonly used drugs for the treatment of major diseases.
Note: “—”: no relevant data; TDM: therapeutic drug monitoring; AUC: area under the curve; UGT1A9: uridine diphosphate glucosidase 1A9.
4 Prevention of medical harm in special populations
patients with hepatic and renal insufficiency, patients on japan number data mechanical ventilation, patients undergoing continuous renal replacement therapy (CRRT) or extracorporeal membrane oxygenation (ECMO), etc. The following aspects should be noted during drug administration.
Pregnant women: Lopinavir/ritonavir tablets may be used. Favipiravir and chloroquine phosphate are prohibited.
Patients with liver failure: Drugs that are excreted unchanged through the kidneys, such as penicillin and cephalosporins, etc., are preferred.
Patients with renal failure (including those on hemodialysis). Drugs that are metabolized through the liver or excreted through the liver and kidneys, such as linezolid, moxifloxacin, ceftriaxone, etc., are preferred.
Patients on CRRT for 24 hours. For vancomycin, the following regimen is recommended: loading dose of 1 g and maintenance dose of 0.5 g, every 12 hours. For imipenem, the maximum daily dose should not exceed 2 g.
XIV. Psychological intervention in COVID-19 patients
1 Psychological stress and symptoms of patients with COVID-19
Patients with confirmed COVID-19 often have symptoms such as regret and resentment, loneliness and helplessness, depression, anxiety and phobia, irritability and sleep deprivation. Some patients may have panic attacks. Psychological studies in isolation wards have shown that about 48% of confirmed COVID-19 patients showed psychological stress upon early admission, in most cases in the form of an emotional reaction to stress. Delirium is high among critically ill patients. There is even a report of encephalitis caused by SARS CoV-2, which led to psychological symptoms such as loss of consciousness and irritability.
2 Therapeutic drug monitoring
Some antiviral and antibacterial drugs require therapeutic drug monitoring (TDM). Table 1 shows plasma concentrations of such drugs and their dosage adjustments. When deviations in plasma drug concentrations occur, treatment regimens should be adjusted based on clinical symptoms and concomitant medications.
Table 1. Concentration range and signal points of common TDM drugs for COVID19 patients
3 Attention to potential drug interactions
Antiviral drugs such as lopinavir/ritonavir are metabolized via the CYP3A enzyme in the liver. Potential drug interactions should be carefully monitored if patients are receiving concomitant medications. Table 2 shows interactions between antiviral drugs and common drugs used to treat underlying conditions.
Table 2. Interactions between antiviral drugs and commonly used drugs for the treatment of major diseases.
Note: “—”: no relevant data; TDM: therapeutic drug monitoring; AUC: area under the curve; UGT1A9: uridine diphosphate glucosidase 1A9.
4 Prevention of medical harm in special populations
patients with hepatic and renal insufficiency, patients on japan number data mechanical ventilation, patients undergoing continuous renal replacement therapy (CRRT) or extracorporeal membrane oxygenation (ECMO), etc. The following aspects should be noted during drug administration.
Pregnant women: Lopinavir/ritonavir tablets may be used. Favipiravir and chloroquine phosphate are prohibited.
Patients with liver failure: Drugs that are excreted unchanged through the kidneys, such as penicillin and cephalosporins, etc., are preferred.
Patients with renal failure (including those on hemodialysis). Drugs that are metabolized through the liver or excreted through the liver and kidneys, such as linezolid, moxifloxacin, ceftriaxone, etc., are preferred.
Patients on CRRT for 24 hours. For vancomycin, the following regimen is recommended: loading dose of 1 g and maintenance dose of 0.5 g, every 12 hours. For imipenem, the maximum daily dose should not exceed 2 g.
XIV. Psychological intervention in COVID-19 patients
1 Psychological stress and symptoms of patients with COVID-19
Patients with confirmed COVID-19 often have symptoms such as regret and resentment, loneliness and helplessness, depression, anxiety and phobia, irritability and sleep deprivation. Some patients may have panic attacks. Psychological studies in isolation wards have shown that about 48% of confirmed COVID-19 patients showed psychological stress upon early admission, in most cases in the form of an emotional reaction to stress. Delirium is high among critically ill patients. There is even a report of encephalitis caused by SARS CoV-2, which led to psychological symptoms such as loss of consciousness and irritability.