Treatments for Reye's Syndrome
Treatments for Reye's Syndrome
The list of treatments mentioned in various sources
for Reye's Syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Reye's Syndrome: Is the Diagnosis Correct?
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to get a correct diagnosis.
Differential diagnosis list for Reye's Syndrome may include:
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Discussion of treatments for Reye's Syndrome:
There is no cure for RS. Successful management, which
depends on early diagnosis, is primarily aimed at protecting the brain
against irreversible damage by reducing brain swelling, reversing the
metabolic injury, preventing complications in the lungs, and anticipating
cardiac arrest.
It has been learned that several inborn errors of
metabolism mimic RS in that the first manifestation of these errors may be
an encephalopathy with liver dysfunction. These disorders must be
considered in all suspected cases of RS.
Some evidence suggests that
treatment in the end stages of RS with hypertonic IV glucose solutions may
prevent progression of the syndrome.
(Source: excerpt from
NINDS Reye's Syndrome Information Page: NINDS)
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Hepatomegaly:
Treatment
(In a Page: Signs and Symptoms)
-
Heart failure: Diuretics, inotropes, and afterload reduction
-
Viral hepatitis: Supportive care and antivirals in some chronic cases
-
Alcoholic liver disease: Abstinence from alcohol, steroids in severe cases, and possible transplant
-
Fatty liver: Treat underlying obesity, diabetes, hyperlipidemia
-
Sarcoidosis: Steroids
-
Hemochromatosis: Iron removal by weekly phlebotomy for 2–3 years and/or deferoxamine chelation
-
Wilson's disease: Copper chelation with D-penicillamine or trientine; may require liver transplantation
-
Neoplasms: Resection and chemotherapy
-
Abscess or cyst: Antimicrobials, percutaneous drainage, and/or surgical resection
-
Amyloidosis: Prednisone and alkylating agents
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hepatomegaly:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Geared towards specific disease
-
Cholestasis
–Ursodeoxycholic acid
–Supplemental fat soluble vitamins A, D, E, K
-
Infections
–Consider interferon for hepatitis B
–Consider interferon and ribaviron for hepatitis C
-
Toxins
–Use of NTBC for tyrosinemia
-
Metabolic disease
–Metabolism consultation
–Often requires specific restricted formulas
-
Surgical repair for biliary atresia
–Kasai portoenterostomy has better outcome if done before 60 days of age
-
Mucomyst for acute acetaminophen toxicity
-
Immune suppression for autoimmune hepatitis
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Reye's syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
For treatment guidelines, see Stages of treatment for Reye’s syndrome.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Viral hepatitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
No specific drug therapy has been developed for hepatitis, with the exception of hepatitis C, which has been treated somewhat successfully with interferon alpha. Instead, patients are advised to rest in the early stages of the illness and to combat anorexia by eating small, high-calorie, high-protein meals. (Protein intake should be reduced if signs or symptoms of pre-coma — lethargy, confusion, and mental changes — develop.) Large meals are usually better tolerated in the morning because many patients experience nausea late in the day.
In acute viral hepatitis, hospitalization usually is required only for the patient with severe symptoms or complications. Parenteral nutrition may be required if the patient experiences persistent vomiting and is unable to maintain oral intake.
Antiemetics may be given 30 minutes before meals to relieve nausea and prevent vomiting; phenothiazines have a cholestatic effect and should be avoided. For severe pruritus, the resin cholestyramine may be given.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Nonviral hepatitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective treatment must remove the causative agent by lavage, catharsis, or hyperventilation, depending on the route of exposure. Acetylcysteine may serve as an antidote for toxic hepatitis caused by acetaminophen poisoning but doesn’t prevent drug-induced hepatitis caused by other substances. Corticosteroids may be ordered for patients with the drug-induced type.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hepatic encephalopathy:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective treatment stops progression of encephalopathy by reducing blood ammonia levels. Treatment includes eliminating ammonia-producing substances from the GI tract by administering neomycin to suppress bacterial flora (preventing them from converting amino acids into ammonia), performing sorbitol-induced catharsis to produce osmotic diarrhea and continuous aspiration of blood from the stomach, and reducing dietary protein intake.
Lactulose, which traps ammonia in the bowel and promotes its excretion, is administered to reduce blood ammonia levels. Bacterial enzymes change lactulose to lactic acid, thereby rendering the colon too acidic for bacterial growth. At the same time, the resulting increase in free hydrogen ions prevents diffusion of ammonia through the mucosa; lactulose promotes conversion of systemically absorbable ammonia to ammonium, which is poorly absorbed and can be excreted. It’s usually given orally. However, if the patient is in a coma, it may be administered by retention enema.
Treatment may also include potassium supplements to correct alkalosis due to increased ammonia levels, especially if the patient is taking diuretics. Hemodialysis may sometimes be used to clear toxic blood temporarily. Salt-poor albumin may be used to maintain fluid and electrolyte balance, replace depleted albumin levels, and restore plasma. Sedatives, tranquilizers, and other medications metabolized or excreted by the liver should be avoided if possible. Medications containing ammonium (including certain antacids) should also be avoided.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Fatty liver:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of fatty liver is essentially supportive and consists of correcting the underlying condition or eliminating its cause. For instance, when fatty liver results from parenteral nutrition, decreasing the rate of carbohydrate infusion may correct the disease. In alcoholic fatty liver, abstinence from alcohol and a proper diet can begin to correct liver changes within 4 to 8 weeks. Such correction requires comprehensive patient teaching.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Reye's syndrome:
Treatment
(Handbook of Diseases)
The stage of the syndrome dictates the type of treatment necessary. (See Stages of treatment for Reye’s syndrome.)
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hepatitis, viral:
Treatment
(Handbook of Diseases)
No specific drug therapy has been developed for hepatitis, with the exception of hepatitis C, which has been treated somewhat successfully with interferon alfa-2b and the more recently FDA-approved peginterferon alfa-2a. Instead, the patient is advised to rest in the early stages of the illness and to combat anorexia by eating small, high-protein meals.
Clinical tip The largest meal should be eaten in the morning because nausea tends to intensify as the day progresses.
Protein intake should be reduced if signs of precoma — lethargy, confusion, and mental changes — develop.
In acute viral hepatitis, hospitalization is usually required only for patients with severe symptoms (severe nausea, vomiting, change in mental status, and PT greater than 3 seconds above normal) or complications. Parenteral nutrition may be required if the patient experiences persistent vomiting and can’t maintain oral intake.
Antiemetics (diphenhydramine or prochlorperazine) may be given 30 minutes before meals to relieve nausea and prevent vomiting; phenothiazines have a cholestatic effect and should be avoided. For severe pruritus, the resin cholestyramine may be given.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hepatitis, nonviral:
Treatment
(Handbook of Diseases)
Effective treatment must remove the causative agent by lavage, catharsis, or hyperventilation, depending on the route of exposure. Acetylcysteine may serve as an antidote for toxic hepatitis caused by acetaminophen poisoning but doesn’t prevent drug-induced hep-atitis caused by other substances.
Corticosteroids may be prescribed for patients with drug-induced hepatitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hepatic encephalopathy:
Treatment
(Handbook of Diseases)
Effective treatment stops the progression of encephalopathy by reducing blood ammonia levels. Such treatment eliminates ammonia-producing substances from the GI tract by:
❑ administration of lactulose to reduce the blood ammonia levels and use of sorbitol-induced catharsis to produce osmotic diarrhea; neomycin therapy may be added if lactulose alone doesn’t reduce ammonia levels
❑ reduction of dietary protein intake
❑ continuous aspiration of blood from the stomach.
Lactulose
Lactulose traps ammonia in the bowel and promotes its excretion. It’s effective because bacterial enzymes change lactulose to lactic acid, thereby rendering the colon too acidic for bacterial growth. At the same time, the resulting increase in free hydrogen ions prevents diffusion of ammonia through the mucosa; lactulose promotes conversion of systemically absorbable ammonia to ammonium, which is poorly absorbed and can be excreted.
The usual dosage of lactulose syrup is 30 to 45 ml by mouth (P.O.) three or four times daily. For acute hepatic coma, 300 ml of lactulose syrup diluted with 700 ml of water may be administered by retention enema. Lactulose therapy requires careful monitoring of fluid and electrolyte balance.
Neomycin
Neomycin is usually given in a dose of 3 to 4 g daily P.O. or by retention enema. Although neomycin is nonabsorbable at the recommended dosage, an amount that exceeds 4 g daily may produce irreversible hearing loss and nephrotoxicity after prolonged use.
Other treatments
Treatment may also include potassium supplements to correct alkalosis (from increased ammonia levels), especially if the patient is taking diuretics.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Fatty liver:
Treatment
(Handbook of Diseases)
The treatment for fatty liver is essentially supportive and consists of correcting the underlying condition or eliminating its cause. Fatty liver that results from TPN may be ameliorated or prevented by giving choline.
In alcoholic fatty liver, abstinence from alcohol and a proper diet can begin to correct liver changes within 4 to 8 weeks. This requires comprehensive patient teaching.
Depending on the degree of severity, the patient may need to undergo liver transplantation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hepatomegaly:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to avoid alcohol. Explain the importance of following the treatment plan to correct or control the underlying disorder as needed. Tell the patient to avoid exposure to people with infections and to maintain good personal hygiene. Explain the importance of pacing activities and having frequent rest periods.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hepatomegaly:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for liver enzyme, alkaline phosphatase, bilirubin, albumin, and globulin studies to evaluate liver function and for X-rays, a liver scan, celiac arteriography, a computed tomography scan, and ultrasonography to confirm hepatomegaly.
▪ Provide bed rest, relief from stress, and adequate nutrition to help protect liver cells from further damage and to allow the liver to regenerate functioning cells.
▪ Monitor and restrict dietary protein as needed.
▪ Give hepatotoxic drugs or drugs metabolized by the liver in very small doses, if at all.
Patient teaching
▪ Explain the underlying disorder and its treatments.
▪ Stress the importance of avoiding alcohol and people with infections.
▪ Discuss the importance of pacing activities and rest periods.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Hepatitis:
Management
(Pediatric Infectious Disease)
Currently, there is no specific therapy for hepatitis infection. Treatment is
supportive.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
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