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Suggest Remedy For Abdominal Pain, Weakness And Loss Of Appetite
Question: This is 91 year old male member who presented with abdominal pain, weakness and loss of appetite.He is a known case of hypertension, diabetes mellitus, coronary artery disease, and kidney failure
CT scan report:
On the left side a 2.1 x 2.4 x 1.5 cm stone is noted in the renal pelvis compromising the urinary flow with marked dilation of the upper urinary tracts and swelling of the kidney. Inflammatory changes are also seen in the peri nephrotic fat tissue.
While the right adrenal gland is normal that is a solid mass lesion in the left adrenal region (4 x 3 x 2.5 cm in size), containing no rent fat tissue or calcification. It appears to be involved in the inflammatory process of the left kidney.
Enlarged prostate with central calcification.
he was treated in the hospital for the correction electrolytes and chronic anemia. cystoscopy and J stenting was also done during hospitalization.
Our concern in this case for the following medications.
1. Heparin injection: Initially this member was bed bound and was started with DVT prophylaxis and continue till the discharge of the patient. He stayed in the hospital for total of 9 days of admission. He was ambulatory for the last 2 days of admission. please confirm if Heparin injection will stop immediately once the member starting walking or it can be continued till the discharge of the patient.
2. Magestrol was given to the member as the appetite was not good. it was given to the member to improve his appetite. As per FDA, this can be given to the member who are diagnosed to have HIV and it can cause hypoadrenalism. this member have adrenal cancer, is it safe to give this medication in this patient.
3. 2 doses of Aranesp was also given to this patient with the gap of 1 week but not sure about the dosage given to this patient. please give us your expert opinion dosage and use of this medication in chronic renal failure patient with anemia. Please note that this is the first time he is receiving this medicine.
CT scan report:
On the left side a 2.1 x 2.4 x 1.5 cm stone is noted in the renal pelvis compromising the urinary flow with marked dilation of the upper urinary tracts and swelling of the kidney. Inflammatory changes are also seen in the peri nephrotic fat tissue.
While the right adrenal gland is normal that is a solid mass lesion in the left adrenal region (4 x 3 x 2.5 cm in size), containing no rent fat tissue or calcification. It appears to be involved in the inflammatory process of the left kidney.
Enlarged prostate with central calcification.
he was treated in the hospital for the correction electrolytes and chronic anemia. cystoscopy and J stenting was also done during hospitalization.
Our concern in this case for the following medications.
1. Heparin injection: Initially this member was bed bound and was started with DVT prophylaxis and continue till the discharge of the patient. He stayed in the hospital for total of 9 days of admission. He was ambulatory for the last 2 days of admission. please confirm if Heparin injection will stop immediately once the member starting walking or it can be continued till the discharge of the patient.
2. Magestrol was given to the member as the appetite was not good. it was given to the member to improve his appetite. As per FDA, this can be given to the member who are diagnosed to have HIV and it can cause hypoadrenalism. this member have adrenal cancer, is it safe to give this medication in this patient.
3. 2 doses of Aranesp was also given to this patient with the gap of 1 week but not sure about the dosage given to this patient. please give us your expert opinion dosage and use of this medication in chronic renal failure patient with anemia. Please note that this is the first time he is receiving this medicine.
Brief Answer:
can continue Heparin ,megestrol,and aranesp
Detailed Answer:
1. Heparin is routinely used for dvt prophylaxis. It can be given for few days to weeks. If patient needs long term prophylaxis oral anticoagulants are better. If the patient has reasonable ambulation and your doctor feels that there is no risk of dvt heparin can be stoped. Adrenal tumor can also contribute to dvt.
2 . Megestrol. Supresses pituitary adrenal axis and is generally used for palliative care on cancer patients. It can be given for long term under guidance of the treating doctor to monitor side effects.
3. Aranesp is darbapoitin. It is a erythrocyte stimulating agent . The injection dose is guided by body weight and patients hemoglobin level. The doctor should recheck hemoglobin every month and decrease the frequency of injection if there is adequate rise of hemoglobin level.
It may be continued for months as once in 2 weeks injection.
Best wishes. In case of furthur query please write in.
can continue Heparin ,megestrol,and aranesp
Detailed Answer:
1. Heparin is routinely used for dvt prophylaxis. It can be given for few days to weeks. If patient needs long term prophylaxis oral anticoagulants are better. If the patient has reasonable ambulation and your doctor feels that there is no risk of dvt heparin can be stoped. Adrenal tumor can also contribute to dvt.
2 . Megestrol. Supresses pituitary adrenal axis and is generally used for palliative care on cancer patients. It can be given for long term under guidance of the treating doctor to monitor side effects.
3. Aranesp is darbapoitin. It is a erythrocyte stimulating agent . The injection dose is guided by body weight and patients hemoglobin level. The doctor should recheck hemoglobin every month and decrease the frequency of injection if there is adequate rise of hemoglobin level.
It may be continued for months as once in 2 weeks injection.
Best wishes. In case of furthur query please write in.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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