Friday, July 10, 2009
EMERGENCY AND CONCERVATIVE TREATMENT OF KIDNEY STONES
EMERGENCY TREATMENT OF KIDNEY COLIC PAIN ATTACK
The renal colic pain attack is a rare event.
But if a patient get a colic pain attack, administer antispasmodic drug such as atropine 0.5 mg/ml SC injection or Scopolamine one mg /ml SC injection, combine with Diazepam 5 mg IM injection. If the pain had been relieved, administer Diazepam 2 mg/tablet per oral twice daily, combine with Buscopan 10 mg/tablet per oral twice daily.
For preventive of colic pain attack, Diazepam 2 mg/tablet once daily at bed time or phenobarbital 30 mg per oral daily.
If there is infections , administer Impresial [pipemidate acid] 400 mg/capsule per oral twice daily for 7 days, or ofloxacin 200 mg/capsule twice daily per oral for 7-10 days.
This treatment should be done or conducted by physician.
THE CONSERVATIVE TREATMENT OF KIDNEY STONE
General measures: Small stones may be passed. They do no harm if infection is not present. Fluids, if patient does not develop anuria [stop urine flow]or oliguria [less urine volume], fluids or water is best should be forced intake 2,5-3 liter per day in order to maintain a high urine flow and dilute the urine and the substances potentially form the stones. Calcium intake should be limited. Check carefully for passage of stone. If does not occur, examine by x-ray for position of stones. Attempt to recover stone by having patient void through a funnel layered with several thickness of gauze, and analyze chemically to determine type of stone.
Special measures: Treatment of calcium oxalate with potassium citrate or sodium citrate with moderate oxalate, fat and protein intake. Certain diuretics such as hydrochlorothiazide can treat the calcium phosphate stone, the effect decrease the amount of calcium released by the kidneys into the urine by favoring calcium retention in bone. The medicine allopurinol [drug for gout] may also be useful in some case of increases uric acid secretion. Struvite stone treatment with mandelamine and vitamin C. Sodium cellulose phosphate can administer to hypercalciuria [increased calcium in the urine] , which binds calcium in the intestines and prevents it from leaking in to the urine. Cystine stone treatment with alkali therapy penicillamine. Coexisting infection should be treated with suitable antibacterial drugs.
Treat predisposing disease such as surgical removal of parathyroid tumor or hyperplastic glands.
Additional vitamin A 20 000 IU/tablet PO once daily for prevention of vitamin A deficiency and regenerate the epithelia of the tubular of kidney for urine filtration.
Neurobion consists of vitamin B1 100 mg, B6 [pyridoxine] 100 mg] and vitamin B12 200 micro-grams /tablet once PO daily. Vitamin B1 for prevent of edema; vitamin B6 for decreasing production of oxalic acids in the liver and vitamin B12 for treatment or prevention of anemia due to hematuria [ red blood cells and white blood cells in urine]
The next subtopic is: SURGERY TREATMENT OF KIDNEY STONES