For Kawasaki how to adjust the drug and disease drug dosing

1 what are the preferred drugs for Kawasaki disease?Kawasaki disease is systemic vasculitis, the main treatment is to control vascular infla

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1 what are the preferred drugs for Kawasaki disease?

Kawasaki disease is systemic vasculitis, the main treatment is to control vascular inflammation and prevent platelet aggregation, prevention of coronary artery aneurysm formation and vascular embolization. The first choice of intravenous immunoglobulin (IVIG) intravenous infusion to control inflammation. And oral aspirin, anti-inflammatory and anticoagulant effect.

2 when gamma globulin infusion is best? How dose dose be calculated?

The best treatment period of intravenous immunoglobulin for the duration of 5~7 days, preferably not more than 10 days, < 5< span=" " > days of use, the effect is often not good, will increase the amount of immunoglobulin, > 10 days, more than the best time to prevent coronary artery dilatation, children prone to sequelae. Use a dose of 2g/kg, a day infusion, or 1g/kg for 2 consecutive days.

Some 3 children are not sensitive to gamma globulin, how to treat the next step? Does hormone promote the formation of coronary artery aneurysm?

Most of the children in the use of intravenous immunoglobulin after 48 hours of fever, decreased inflammatory index, the disease was controlled. But there are a few patients using 36~48 hours after intravenous immunoglobulin is still not fever, not sensitive to IVIg, the need to use once, if used again cannot control the disease can be treated with hormone, hormone therapy must pay attention to anticoagulation, especially for children with hormone medication, side effects of coagulant and if your child medication, must tell the doctor take other measures to avoid anticoagulation, thrombosis and other side effects.

4 what happens when you need to adjust the dosage or change of aspirin?

Aspirin dosage is usually in the acute phase of middle dosage, an anti-inflammatory and anticoagulant effect, daily 30~50mg/kg, 3~4 dose and time to disease control, normal inflammatory indexes changed after anticoagulation, namely small dose, 3~5mg/kg every day, taking 2~3 times. If the children have coronary artery giant tumor (> 8mm), and warfarin anticoagulation therapy, patients taking warfarin must be in the doctor's monitoring, according to coagulation function adjustment of dosage.

5 what time need plus dipyridamole? How dose calculated?

Pan Shengding also called dipyridamole, with anti platelet aggregation effect. Kawasaki in patients with subacute and part of the patient's recovery of platelet will be significantly increased, even 450~1500109, taking aspirin dipyridamole can assist joint anticoagulation, prevention of myocardial ischemia. The use of a dose of 3~5mg/kg per day, divided 2~3 times.

6 long term aspirin will have any side effects? How to monitor?

The main side effects of aspirin are gastrointestinal discomfort, rare gastrointestinal bleeding and perforation. Don't take medicine and observe the fasting, children defecate, such as black and bloody stool promptly to the hospital. Secondly, due to the inhibitory effect of aspirin on platelet and aspirin in children may increase the risk of bleeding, a few of the children can be observed in leg bruises like rash, parents should note while taking care of children, try to avoid collision or fall. Bleeding children in time to the hospital. In addition to a small number of children allergic reaction occurs, including skin rash, pruritus, urticaria, edema, asthma and other drugs to be used for. A rare case of transient liver injury accompanied by hepatic transaminase elevation, the need for regular monitoring of liver function.

7 when do you need to intervene and bypass surgery?

Kawasaki sick children regularly go to the hospital with the diagnosis of coronary artery aneurysm is greater than or equal to 6mm in addition to the aggregation and anticoagulation and antiplatelet therapy should be carried out in June, once echocardiography and ECG examination, an exercise test every year, monitoring factors causing atherosclerosis. When the diagnosis of myocardial ischemia, coronary angiography should be performed, if the results suggest that there is a significant stenosis of coronary artery stenosis, the need for intervention or bypass surgery intervention.

8 children need lifelong medication? What are the criteria for withdrawal?

Children with Kawasaki disease, such as coronary artery disease, need to take medicine for 6~8 weeks, patients with coronary artery disease who need medication to the lesion to normal, and no myocardial ischemia. Coronary artery aneurysm and other lesions are difficult to return to normal often need lifelong medication.

 

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