Abbreviations: (CPOE)

No abstract

Summary Twelve geldings were used to evaluate serum levels of penicillin following the intravenous (iv) and intramuscular (im) injection of benzylpenicillin, im procaine penicillin and im fortified benzathine penicillin, at a variety of dose rates. Blood samples were collected up to 7 h after iv and im benzylpenicillin, up to benzathine penicillin. Results were analysed using an analysis of variance and regression analyses were used to calculate the time taken for the serum penicillin concentration to decline to 0.5 μg/ml. As a result of the experiments the following dosage regimes could be recommended for each drug. Benzylpenicillin should be administered im at a dose rate of 10,000 iu/kg at the commencement of treatment. Procaine penicillin should be injected at a dose rate of 15,000 lu/kg every 12 h or 30,000 iu/kg every 24 h. In serious infections 10,000 iu/kg of benzylpenicillin im should be used concomitantly to begin therapy. Fortified benzathine penicillin appears to have little value for antimicrobial therapy in the horse. Résumé On utilisa 12 chevaux hongres pour évaluer le taux sériques de pénicilline faisant suite à l'injection intraveneuse (iv) ou intramusculaire (im) de benzylpénicilline, im de pénicilline procaïne et im de benzathine pénicilline renforcée suivant des dosages variés. Les échantillons de sang furent prélevés jusqu'à sept heures après l'injection iv ou im de benzylpénicilline; jusqu'à 24 h après injection pour la pénicilline procaine et jusqu'à 96 h après administration de benzathine pénicilline renforcée. Les résultats furent analysés (variance et régression) et l'on calcula le temps nécessaire pour que la concentration se que de pénicilline diminue jusqu'à environ 0.5 μg/ml. A la suite de cette expérimentation, les protocols de dosage suivants peuvent être conseillés pour chaque substance: La benzylpénicilline devraite être administrée im à raison de 10,000 ui/kg en début de traitement. La pénicilline procaîne devrait étre injectée à raison de 15,000 ui/kg toutes les 12 h ou à raison de 30,000 ui/kg toutes les 24 h. Dans les infections sérieux on devrait utiliser la benzylpénicilline im de manière concomitante en début de traitement. La benzathine pénicilline renforcée s'est révéle de peu d'intérêt dans la thérapeutique antibactérienne chez le cheval. Zusammenfassung Zwölf Wallache wurden verwendet zur Bestimmung von Penicillinspiegeln nach intravenöser und intramuskulärer Injektion von Benzylpenicillin, im. Procainpenicillin und im verstärktem Benzathinpenicillin in variierender Dosierung. Die Blutentnahmen erfolgten bis zu 7 h Stunden nach iv und im. Benzylpenicillin, bis zu 24 h nach Procainpenicillin und bis zu 96 h nach Benzathinpenicillin. Die Resultate wurden der Varianzanalyse unterworfen und die Regressionsanalyse wurde zur Berechnung derjenigen Zeit angewendet, in der die Serum‐Penicillinkonzentration um 0.5 μg/ml abnimmt. Als Ergebnis der Versuche wurden die folgenden Dosierungsempfehlungen aufgestellt: Benzylpenicillin sollte intramuskulär in einer Dosis von 10,000 iu/kg...

Diabetes mellitus is a complex, chronic disease affecting 29.1 million (9.3%) US residents. 1 Chronic hyperglycemia can result in potentially devastating microvascular and macrovascular complications, leading to major morbidity, mortality, and economic consequences in this patient population. Evidence demonstrates that these complications can be prevented by maintaining glycemic control to near normal levels. Achieving and maintaining adequate glycemic control requires consistent medical care, and most importantly, ongoing patient self-management. 2 While evidence shows that alcohol and exercise affect the absorption of insulin and increase the risk of hypoglycemia, there is a lack of evidence-based decision tools to allow for translation of this information into practice. 3-6 Patients with type 1 diabetes (T1D) must manage their disease by injecting insulin deliverable through syringes, insulin pens, or insulin pumps. Premeal insulin dosage compliance and accuracy is a key factor in achieving target postprandial glucose levels. In 2013 insulin pumps were being used by over 350 000 people in the United States, 7 incorporate proprietary mathematical algorithms called bolus calculators or bolus wizards to determine individualized premeal dosing. 8-10 The benefits achieved through the use of insulin pumps and continuous 663746D STXXX10.

Optimizing glucose control in patients with type 1 diabetes mellitus (T1D) is known to reduce microvascular and macrovascular complications. 1 The intensive insulin therapy needed to accomplish glycemic goals can be delivered either via multiple daily injections or continuous subcutaneous insulin infusion devices, also referred to as insulin pump (IP) therapy. However, intensive insulin therapy alone is not sufficient to achieve desired glycemic goals. Successful diabetes self-management requires behavioral changes to achieve glucose targets. The 2016 American Diabetes Association (ADA) Standards of Care Guidelines outline the behaviors required for daily self-management, including recommendations to monitor blood glucose (BG) 6-10 times per day, and dose prandial insulin 3-4 times per day as it relates to carbohydrate intake. 2 As technology for diabetes has advanced, so have the informatics capabilities of IPs and BG monitors. Devices store objectively measured data that can be downloaded and used to quantify behaviors and outcomes. IPs store data such as the bolus amount suggested by the insulin pump bolus calculator (IPBC), the bolus amount selected by the patient, carbohydrates entered into the IP by the patient, and BG levels from a connected BG monitor and/or a continuous glucose monitoring system (CGMS). Adherence to self-management behaviors (SMB) such as carbohydrate intake, administering insulin boluses to cover 666538D STXXX10.