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Ringer's lactate solution has a lower rate of acidosis as compared with normal saline. [1] [4] Use is generally safe in pregnancy and breastfeeding. [2] Ringer's lactate solution is in the crystalloid family of medications. [5] It is isotonic, i.e. it has the same tonicity as blood. [2]
Ringer's solution is a solution of several salts dissolved in water for the purpose of creating an isotonic solution relative to the body fluids of an animal. Ringer's solution typically contains sodium chloride , potassium chloride , calcium chloride and sodium bicarbonate , with the last used to buffer the pH .
Kidney function gradually decreases as someone ages. The elderly are also likely to be underweight. In addition, these older people tend to be dehydrated and be taking other medications. These factors increase the likelihood of developing side effects of digoxin and digoxin toxicity. Often lowering the dose is considered by the prescriber. [6]
Digoxin is taken by mouth or by injection into a vein. [4] Digoxin has a half life of approximately 36 hours given at average doses in patients with normal renal function. It is excreted mostly unchanged in the urine. Common side effects include breast enlargement with other side effects generally due to an excessive dose.
A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [9] It is therefore recommended that digoxin concentration be maintained in approximately this range if it is used in heart failure patients.
Some animals will be asymptomatic or just have mild anorexia whilst others will have serious symptoms such as cardiac problems. Most symptoms are not directly caused by pancreatitis itself. [4] One study found the most common symptoms of pancreatitis in dogs to be: lethargy (88%), anorexia (86%), emesis (83%), and abdominal pain (59%). [16] [4]
Even less safe are drugs such as digoxin, a cardiac glycoside; its therapeutic index is approximately 2:1. [12] Other examples of drugs with a narrow therapeutic range, which may require drug monitoring both to achieve therapeutic levels and to minimize toxicity, include dimercaprol, theophylline, warfarin and lithium carbonate.
In pharmacokinetics, a loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose. [ 1 ] A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life .