Tham Acidosis

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Metformin, Diabetes Mellitus, Adverse effects of metformin, How does metformin work, Mechanism of action of metformin, Indications of metformin, Contraindications of metformin, Blood Glucose, Hypoglycemia, Side Effects of metformin Adverse effects of metformin, Oral hypoglycemic Drugs, Metformin and lactic Acidosis, Type II diabetes mellitus, NIDDM, Non insulin dependent diabetes mellitus, Uses of Metformin. About Me: Dr. Sumit Verma MD, DNB , with more than 15 years of experience in clinical medicine / clinical research / pharmacovigilance domain I have co-authored a book titled "Fundamentals of Pharmacovigilance" (http://www.amazon.in/Fundamentals-Pha...) https://www.linkedin.com/in/dr-sumit-... Disclaimer: Medicine is an ever-changing science. The information presented in the video or on this channel is of a general informational nature and should not be considered as specific to the needs of a particular individual or organisation or entity. Please consult your doctor, medical specialist or your health care professional for all matters related to health. The video does not contain all the information about any drug. Any information presented in the video or on this channel does not replace any advice given to you by your doctor, medical specialist or your health care professional. If you have any queries or concerns regarding the information presented in the video or on this channel, please consult your doctor, specialist, your health care professional or seek professional advise. Any use of information presented herein (including content of the videos or on this channel) is at the user's own risk. The author, presenter or any other parties associated with the content of the videos or on this channel do not assume and hereby disclaim any liability (including, without limitation, damages for loss of data or profit, or due to business interruption) to any party for any loss, damage, or disruption that may directly or indirectly result from use of any information or graphics in the videos or on this channel. The author, presenter or any other parties associated with the content (presented in the videos or on this channel) will not be held liable for any errors or omissions that may be found in the content of the videos or on this channel. Any information presented in the video or on this channel is provided 'as is'. The author, presenter or any other parties associated with the content of the videos or on this channel, make no warranties, expressed or implied, and hereby disclaim and negate all other warranties, including without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. Further, the author, presenter or any other parties associated with the content of the videos or on this channel do not warrant or make any representations concerning the accuracy, likely results, or reliability of the use of the materials on the video or on this channel. The materials appearing on the video or on this channel may include technical, typographical, or photographic errors. The author, presenter or any other parties associated with the content of the videos or on this channel do not warrant that any of the materials presented herein are accurate, complete, or current. No one should act on any information presented in the videos or on this channel without specific professional advise.

Tham-tromethamine: Mechanism, Indication, Contraindications, Dosing, Adverse Effect, Interaction | Pediatric Oncall

It is a sodium free organic buffer used to treat metabolic acidosis, primarily in patients who have received maximum sodium bicarbonate therapy or who have hypercarbia or hypernatremia. Tromethamine is used to treat metabolic acidosis (an electrolyte imbalance). Metabolic acidosis can have many causes. It often occurs after heart bypass surgery or cardiac arrest. allergic to any drugs, or if you have asthma, kidney disease, or congestive heart failure.uremia Wt (Kg) x 1.1 x base deficit (Meq/L) as loading dose. Continuous infusion=3ml/kg/hour. Do not give for more than 24 hours hyperosmolality, hepatotoxicity, hyperkalemia, hypoglycemia, hypocalcemia, respiratory depression, apnea, and tissue necrosis on extravasation. aspirin ? tromethamineApplies to:acetaminophen/aspirin and Tham (tromethamine)Using tromethamine together with aspirin may decrease the effects of aspirin. Contact your doctor if your condition changes.tromethamine ? pseudoephedrineApplies to:Tham (tromethamine) and Allermed (pseudoephedrine)Using pseudoephedrine together with tromethamine may increase the effects of pseudoephedrine. Contact your doctor if you experience tremor, anxiety, insomnia, irritability, or n Continue reading >>

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  1. honeynut

    hey all - new to bb.com but not new to the game... hopefully I'll be posting more on here when my thesis is written. I took a few months off training and ate like crap after I had surgery in the fall, so I have some fat to lose. I am currently in ketosis, day 10... using those lovely test strips to monitor my progress. I can't wait to pee and check my ketone levels like 4 times a day!
    My question is this: I am averaging a "moderate" level, pink, dead-center of the spectrum. Is this good and sustainable, or should I be aiming higher? Can ones ketone levels go too high?
    Background/deets if you need em,
    Diet consists of:
    PROTEIN (150 g/day)- Optimum Nutrition low carb chocolate shakes, ground turkey, egg whites, hardboiled whole eggs, canned tuna, roast beef, scallops, salmon, tilapia, sea bass when I can get it, and one recent, decadent feast of all-you-can-eat-snow crab.
    CARBS - are coming from fibrous greens such as rapini (ie. broc**** rabe), asparagus, green onions... a very small amount of cheese and here and there a small amount of nuts such as natty pb or a dozen or so shelled, unsalted pistachios.
    FATS - are coming from mayo, grapeseed oil, renee's caesar dressing 'cause it has no sugars, and whatever fat is in the nuts.
    Water is at 3 litres give or take, I also drink coffee and tea, limit my salt, and obsess about the ingredients of anything. I should cut out coffee but if I did I would go on a rampage.
    Supplements include creatine, l-glutamine, l-lysine, multi, vit. e, vit. c, cal/mag, vit b, folic acid, glucosamine, lipo-6. Edit: oh yeah, and R-ALA too
    I am taking in between 1100 and 1300 cals/day, including about 150 grams of protein, 30-40 g of unhydrogenated non-trans fats, and as little carbs as possible - not exactly sure, but under 20g for sure.
    weights 4x per week, 45 min sessions, heavy, supersetting, 6-8 reps.
    cardio 4x per week, 30 mins to 1 hr (no HIIT yet... chicken) of moderate to intense cycling and elliptical. I am not yet doing my cardio at the crack of dawn and hitting the weights in the afternoon - that is the plan, I am just on a messed up sleep schedule right now and getting up and staying up way later than I would ideally like. Hubby is in a different time zone and although I tried to stick to my own schedule, I can't help but want to maximize my time online with him (he is PST, I am EST...)
    Thanks in advance for your input to my question and/or to my regimen and diet.

  2. Eileen

    I'm relieved to see you are female with those cals, but your protein is too high, and your fats are too low. Aim of 1g of protein per pound of lean mass, and assume that is 30% of your calories.
    Really, this is a high fat diet. You can eat whole eggs, cheese, butter, nuts, chicken drumsticks. You don't need whey except just after a weights workout. Eating it at other times knocks your ratios out of whack. Same with egg whites etc. I like all the fish you eat.
    Green veg is excellent, don't be afraid to eat lots. Better nut choices are almonds, walnuts, brazil nuts, hazelnuts.
    Don't worry about the whole saturated/unsaturated fat thing. As long as you are eating clean unprocessed fat, they are all good. You actually need a certain amount of saturates for good health.
    You only need between "trace" and "small" on the ketosticks. Any higher and you are probably not drinking enough. There is no advantage to purple readings. Light pink is fine.
    You can keep drinking coffee. It won't affect the diet.

  3. jaym

    It's fine. As long as you are registering even trace amounts of ketones, you are in ketosis. It may go up and down depending on hydration levels or if you are expending all available ketones for energy. Learn to recognize you are in by other signs and not just what the strips say.

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THAM and Acidosis

Management Of Acidosis: The Role Of Buffer Agents

Management of acidosis: the role of buffer agents Sodium BicarbonateLactic AcidosisDiabetic KetoacidosisTHAMBicarbonate Buffer For more than 50 years, continuing up to about 1980, sodium bicarbonate was used for the treatment of metabolic acidosis. The rationale was that administration of an alkaline fluid would correct an acidotic state. However, the potential value of sodium bicarbonate was called into question when more recent studies demonstrated that it induced venous hypercarbia, and decreases in tissue and cerebrospinal fluid pH, as well as provoking tissue hypoxia, circulatory congestion, hypernatremia, and hyperosmolality, with consequent brain damage [ 1 , 2 , 3 , 4 , 5 , 6 ]. Bicarbonate buffers may intensify rather than ameliorate cellular acidosis because sodium bicarbonate generates CO2 and thereby increases intracellular (hypercarbic) acidosis [ 7 ]. Sodium bicarbonate administered to patients with diabetic ketoacidosis failed to favorably alter the clinical course or outcome. More specifically, the survival rate was similar in patients who did not receive bicarbonate [ 8 ]. During hypoxic lactic acidosis, sodium bicarbonate produced a decline in both systemic arter Continue reading >>

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  1. PickleMobster

    Utilization of ketone bodies by the brain (TBR Section 8 question)

    During prolonged starvation, the brain metabolized all of the following molecules as a primary fuel source EXCEPT:
    A. acetyl-CoA
    B. acetone
    C. acetoacetate
    D. B-hydroxybutyrate
    The answer is A. But I thought B is the answer because humans can't use acetone (breathed out). Acetyl-CoA doesn't make sense because the ketone bodies from liver are converted to Acetyl-CoA for energy by the brain via TCA
    Am I missing something here?
    Edit: A figure in the Kaplan book shows ketone bodies (except acetone) entering muscle, renal, and brain cells ---> converted into Acetyl CoA ---> enter Krebs

  2. Rowley_Jr

    You have it reversed, Acetyl-CoA is converted to ketone bodies for the brain, and acetone is one of those along with C) and D).

  3. SeltzerMFwater

    Ya, the key word is brain here. The brain cannot use acetyl CoA from fatty acids during starvation like the majority of other cells, thus ketone bodies are used.

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Part of our series on hyponatraemia - where we tackle the causes of low sodium using a systematic approach. This video series is best watched from the start. Hyponatramia EXPLAINED: https://youtu.be/3QunAw5l0w8 Pseudohyponatraemia: https://www.youtube.com/watch?v=laQRt... True Hyponatraemia: https://www.youtube.com/watch?v=1krkd... Primary Polydipsia: https://www.youtube.com/watch?v=p05lj... Urine Osmolality vs Serum Osmolality: https://www.youtube.com/watch?v=0KUCw... Adrenal Insufficiency: https://www.youtube.com/watch?v=YZBpg... Fluid Assessment: https://www.youtube.com/watch?v=QOjzN... Hypovolaemia: https://www.youtube.com/watch?v=hq8u_... Oedematous Conditions: https://www.youtube.com/watch?v=9Rb3T... SIADH: https://www.youtube.com/watch?v=xS7m1... You only need five pieces of information to make a diagnosis! They are: 1. Serum sodium 2. Serum osmolality 3. Urine osmolality 4. Urine sodium 5. An assessment of the patient's fluid balance Causes include: Pseudohyponatraemia Primary polydipsia Adrenal insufficiency Hypovolaemia Oedematous States SIADH And take it from there! Hope you enjoy these videos - leave us some feedback and tell us what you'd like to see us cover next! REFERENCES: 1. Kearney T, Giritharan S, Kumar M. 2014. Endocrinology. In: Kalra, PA. Essential Revision Notes for MRCP (Fourth Edition). PasTest. pp 121 - 123 2. Longmore M, Wilkinson IB, Davidson EH Foulkes A, Mafi AR. 2010. Clinical chemistry. In: Oxford Handbook of Clinical Medicine (Eight Edition). Oxford Press. pp 676 - 708 3. Ballinger A. 2012. Endocrine disease. In: Essentials of Kumar & Clark's Clinical Medicine (Fifth Edition). Saunders Elsevier. pp 607-667 MUSIC: George Street Shuffle Hep Cats Pamgaea All courtesy of Kevin Mcleod at Incompetech.com

Payperview: Effects Of A Continuous Infusion Of Tris(hydroxymethyl)aminomethane On Acidosis, Oxygen Affinity, And Serum Osmolality - Karger Publishers

I have read the Karger Terms and Conditions and agree. The effects of a continuous infusion of tris(hydroxymethyl)-aminomethane (THAM) on pH, base excess, p50, serum osmolality, and plasma drug concentration during respiratory acidosis were studied in newborn piglets. Measurements were made during three experimental periods: (1) control period with normal blood gases; (2) hypercapnia period, and (3) hypercapnia plus THAM period (THAM infusion: 1.65 mmol/kg/h). pH decreased and paCO2 increased between control period (7.40 0.05 and 45 3 mm Hg) and hypercapnia period (7.24 0.06 and 59 2 mm Hg; p < 0.001; mean SD). pH returned to baseline (7.37 0.04) during the hypercapnia plus THAM period, while paCO2remained elevated (63 4 mm Hg). p50 increased from 30.7 5.9 to 38.3 4.7 (p < 0.05) during hypercapnia and decreased with hypercapnia plus THAM. THAM concentration and base excess increased with time and were linearly related. Serum osmolality was unchanged during the THAM infusion. We conclude that continuous infusion of THAM is effective in normalizing pH during respiratory acidosis in the piglet. Continue reading >>

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  1. MariaMia816

    Can anyone tell me what an average weight loss per week or month is for 20 carbs a day? Im loosing soooooo slow.

  2. GSD_Mama

    I guess it will be different for everyone. My first two weeks I've lost about 10, of which water was probably 5-7lb. I'm going on my third month now and losing slow, sometimes I gain sometimes I lose, no rhyme or reason.

  3. stevieedge2015

    10lbs in a month. I'm trying to keep my calories to under 1500. I smoke like a chimney though so...aiming to get to 130 so I can quit and not worry about gaining 10lbs

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