Treatments for DiGeorge syndrome
Treatments for DiGeorge syndrome
The list of treatments mentioned in various sources
for DiGeorge syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Hypocalcemia:
Treatment
(In a Page: Signs and Symptoms)
-
Asymptomatic patients can be treated with oral calcium supplements plus vitamin D
-
If severe symptoms are present, administer 10% IV calcium gluconate and recheck calcium levels frequently
-
Change causative medications if possible
-
Treat underlying diseases as necessary (e.g., sepsis, pancreatitis, renal failure)
-
Correct other electrolyte abnormalities (e.g., hypomagnesemia)
-
Hypoalbuminemia may improve with adequate nutrition; however, there is no need to correct serum Ca2+, because the ionized calcium is normal
-
Hypoparathyroidism: Calcium carbonate supplementation of 1–2 g per day plus vitamin D supplementation
-
Vitamin D deficiency: Oral vitamin D or calcitriol (1,25-hydroxyvitamin D)
>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hypocalcemia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Acute correction of hypocalcemia: IV calcium gluconate (bolus or infusion) until Ca >7 mg/dL
-
Hypoparathyroidism
–Oral calcium supplement (dose as elemental calcium)
–1,25-(OH)2-vitamin D analog (calcitriol)
-
Vitamin D deficiency (nutritional rickets)
–25-OH-vitamin D analog (ergocalciferol) 2,000–4,000 IU/day
–Oral calcium supplement (dose as elemental calcium) to prevent “hungry bone syndrome”
-
Hypomagnesemia
–Treat with magnesium supplementation
-
Drugs
–Discontinue offending agents if possible
-
Goals of management
–Hypoparathyroidism: Maintain calcium at 8–9 mg/dL
to avoid nephrocalcinosis
–Vitamin D deficiency: Maintain normal calcium range
>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Chvostek's sign:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Test for Trousseau's sign, a reliable indicator of hypocalcemia. Closely monitor the patient for signs of tetany, such as carpopedal spasms or circumoral and extremity paresthesia.
Be prepared to act rapidly if a seizure occurs. Perform an electrocardiogram to check for changes associated with hypocalcemia that can predispose the patient to arrhythmias. Place the patient on a cardiac monitor.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Calcium imbalance:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment varies and requires correction of the acute imbalance, followed by maintenance therapy and correction of the underlying cause. Mild hypocalcemia may require nothing more than an adjustment in diet to allow adequate intake of calcium, vitamin D, and protein, possibly with oral calcium supplements. Acute hypocalcemia is an emergency that needs immediate correction by I.V. administration of calcium gluconate or calcium chloride. Chronic hypocalcemia also requires vitamin D supplements to facilitate GI absorption of calcium. To correct mild deficiency states, the amounts of vitamin D in most multivitamin preparations are adequate. For severe deficiency, vitamin D is used in four forms: ergocalciferol (vitamin D 2), cholecalciferol (vitamin D3), calcitriol, and dihydrotachysterol, a synthetic form of vitamin D2.
Treatment of hypercalcemia primarily eliminates excess serum calcium through hydration with normal saline solution, which promotes calcium excretion in the urine. Loop diuretics, such as ethacrynic acid and furosemide, also promote calcium excretion. (Thiazide diuretics are contraindicated in hypercalcemia because they inhibit calcium excretion.) Corticosteroids, such as prednisone and hydrocortisone, are helpful in treating sarcoidosis, hypervitaminosis D, and certain tumors. Plicamycin can also lower serum calcium levels and is especially effective against hypercalcemia secondary to certain tumors. Calcitonin may also be helpful in certain instances. Sodium phosphate solution administered orally or by retention enema promotes calcium deposition in bone and inhibits its absorption from the GI tract.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
DiGeorge syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Life-threatening hypocalcemia must be treated immediately, but it’s unusually resistant and requires aggressive treatment, for example, with a rapid I.V. infusion of 10% solution of calcium gluconate. During such an infusion, monitor heart rate and watch carefully to avoid infiltration. Remember that calcium supplements must be given with vitamin D, or sometimes also with parathyroid hormone, to ensure effective calcium utilization. After hypocalcemia is under control, a fetal thymus transplant may restore normal cell-mediated immunity. Cardiac anomalies require surgical repair when possible.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Chvostek's sign:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Test for Trousseau’s sign, a reliable indicator of hypocalcemia. Closely monitor the patient for signs of tetany, such as carpopedal spasms or circumoral and extremity paresthesia.
Be prepared to act rapidly if a seizure occurs. Perform an electrocardiogram to check for changes associated with hypocalcemia that can predispose the patient to arrhythmias. Place the patient on a cardiac monitor.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Calcium imbalance:
Treatment
(Handbook of Diseases)
An acute imbalance requires immediate correction, followed by maintenance therapy and correction of the underlying cause.
Hypocalcemia
A mild calcium deficit may require nothing more than an adjustment in diet to allow adequate intake of calcium, vitamin D, and protein, possibly with oral calcium supplements. Acute hypocalcemia is an emergency that needs immediate correction by I.V. administration of calcium gluconate or calcium chloride.
Chronic hypocalcemia also requires vitamin D supplements to facilitate GI absorption of calcium. Although the amount of vitamin D in most multivitamin preparations is adequate to correct a mild deficiency, different forms of vitamin D are used for severe deficiency, including ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), calcitriol, and dihydrotachysterol, a synthetic form of vitamin D2.
Hypercalcemia
Treatment of hypercalcemia primarily eliminates excess serum calcium through hydration with normal saline solution, which promotes calcium excretion in urine. Loop diuretics, such as ethacrynic acid and furosemide, also promote calcium excretion. (Because thiazide diuretics inhibit calcium excretion, they’re contraindicated in hypercalcemic patients.)
Corticosteroids, such as prednisone and hydrocortisone, are helpful in treating sarcoidosis, hypervitaminosis D, and certain tumors. Plicamycin can lower the serum calcium level and is especially effective against hypercalcemia secondary to certain tumors. Calcitonin may also be helpful in certain instances.
Sodium phosphate solution administered by mouth or by retention enema promotes calcium deposits in bone and inhibits its absorption from the GI tract.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Chvostek's sign:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Test for Trousseau’s sign, a reliable indicator of hypocalcemia. Closely monitor the patient for signs of tetany, such as carpopedal spasms or circumoral and extremity paresthesia.
Be prepared to act rapidly if a seizure occurs. Perform an electrocardiogram to check for changes associated with hypocalcemia, which can predispose the patient to arrhythmias. Place the patient on a cardiac monitor.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Chvostek's sign:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Collect blood samples for serial calcium studies to evaluate the severity of hypocalcemia and the effectiveness of therapy.
▪ Administer oral or I.V. calcium supplements.
▪ Assess for Chvostek's sign when evaluating a patient postoperatively.
Patient teaching
▪ Explain to the patient the early signs and symptoms of hypocalcemia that require immediate medical attention.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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