Therapeutic Notes
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قناة تعليمية، سريرية، تهتم بنشر ملاحظات علاجية تحتوي على ما يفيدك كطالب أو دكتور..📋 للاستفسار عن معلومة أو مصدر 👇 @Twasl2_1bot قناتنا الثانية خاصة بالكتب والمراجع👇🏻👇🏻👇🏻👇 📋PharmD books📗 https://t.me/PharmDBKH
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Где отзываются чаще
доля реакций к просмотрам- 26 апр.PPI DRUG COMPARISON0,92%
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- 13 июн.American Thyroid Association 2026 Guidelines for Thyroid Disease in Preconception, Pregnancy, and Postpartum 📋PharmD books📗 قناة تهتم بنشر كل المراجع العلمية وال [Guidelines ]بأحدث النسخ.. 🔍تفيدك كصيدلاني سريري ممارس أو باحث في إعداد مشاريع التخرج بالنسبة للصيدلة السريرية.. 👇🏻👇🏻👇🏻👇🏻 📋PharmD books📗 ♻️𝑻𝒆𝒍𝒆𝒈𝒓𝒂𝒎: https://t.me/PharmDBKH ✅شير رابط 🔗 القناة لكي تعم الفائدة ❤️0,52%
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- 3 апр.KDIGO 2026 CLINICAL PRACTICE GUIDELINE FOR ACUTE KIDNEY INJURY (AKI)AND ACUTE KIDNEY DISEASE (AKD). PharmD books📗 قناة تهتم بنشر كل المراجع العلمية وال [Guidelines ]بأحدث النسخ.. 🔍تفيدك كصيدلاني سريري ممارس أو باحث في إعداد مشاريع التخرج بالنسبة للصيدلة السريرية.. 👇🏻👇🏻👇🏻👇🏻 📋PharmD books📗 ♻️𝑻𝒆𝒍𝒆𝒈𝒓𝒂𝒎: https://t.me/PharmDBKH ✅شير رابط 🔗 القناة لكي تعم الفائدة ❤️0,32%
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- 18 мар.2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia PharmD books📗 قناة تهتم بنشر كل المراجع العلمية وال [Guidelines ]بأحدث النسخ.. 🔍تفيدك كصيدلاني سريري ممارس أو باحث في إعداد مشاريع التخرج بالنسبة للصيدلة السريرية.. 👇🏻👇🏻👇🏻👇🏻 📋PharmD books📗 ♻️𝑻𝒆𝒍𝒆𝒈𝒓𝒂𝒎: https://t.me/PharmDBKH ✅شير رابط 🔗 القناة لكي تعم الفائدة ❤️0,28%
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- 7 апр.The newly released (March 2026) draft of the KDIGO Clinical Practice Guideline for Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD) marks the first major paradigm shift in global acute kidney care since 2012. Here are the high-yield clinical and pharmacotherapeutic pearls from the updated framework: 1. Integration of the AKI-AKD-CKD Continuum * Closing the Conceptual Gap: The 2026 framework formally defines Acute Kidney Disease (AKD) as the critical transitional phase between AKI and Chronic Kidney Disease (CKD). It captures patients whose functional impairment or structural damage persists beyond 7 days but resolves or progresses before the 90-day diagnostic threshold for CKD. * Follow-Up Paradigm: Resolution of serum creatinine at discharge is no longer the endpoint of an AKI episode. There are stringent new recommendations for systematic post-AKI follow-up care to monitor functional trajectory, manage emergent proteinuria, and implement renoprotective strategies to mitigate long-term progression. 2. Biomarker-Enabled Diagnostics * Structural vs. Functional: Traditional functional markers (serum creatinine and urine output) are delayed indicators that often lag behind actual tissue injury. The new guidelines formally incorporate structural biomarkers (such as NGAL) into the diagnostic workflow. * Clinical Implication: This enables the identification of subclinical AKI—where acute tubular damage exists without a concurrent, measurable rise in serum creatinine—allowing for rapid intervention and nephrotoxin avoidance before critical functional nephron loss occurs. 3. Nephrotoxin Stewardship & EHR Integration * Systematized Stewardship: There is a robust new focus on comprehensive drug and nephrotoxin stewardship, establishing proactive medication management as a core pillar of AKI prevention and treatment. * Clinical Decision Support: The guidelines strongly advocate for utilizing validated risk prediction models coupled with Electronic Health Record (EHR) alerts. These systems are designed to trigger real-time medication reconciliation, prompt dynamic dose adjustments, and halt non-essential nephrotoxic agents. * Contrast-Associated AKI (CA-AKI): The update provides refined, individualized risk stratification protocols for contrast media, shifting away from universal preventative interventions toward targeted hydration and stewardship specifically for high-risk profiles. 4. Precision Fluid and Hemodynamic Management * De-resuscitation and Venous Congestion: Aggressive fluid loading is actively discouraged. The updated guidelines highlight the risk of renal venous congestion as a primary driver of AKI. Assessing venous excess (e.g., utilizing the VExUS ultrasound score) is gaining traction to guide early diuretic therapy and prevent fluid overload from physically impeding renal perfusion. * Fluid Selection: Balanced crystalloids continue to be strongly favored over 0.9% sodium chloride to prevent hyperchloremic metabolic acidosis and subsequent afferent arteriolar vasoconstriction. 5. Kidney Replacement Therapy (KRT) Kinetics * Demand-Capacity Mismatch: The decision to initiate KRT has shifted away from rigid temporal definitions ("early" vs. "late"). Initiation is now based on evaluating the mismatch between the patient's acute metabolic and fluid demands against their residual renal excretory capacity. * Dosing and Transition: The guidelines offer updated, highly specific parameters for selecting the appropriate KRT modality based on systemic hemodynamics, quantifying delivered clearance, and establishing objective criteria for safely discontinuing extracorporeal therapy as intrinsic renal function recovers.0,12%
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