Kidney stone medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].

OR

The majority of cases of [disease name] are self-limited and require only supportive care.

OR

[Disease name] is a medical emergency and requires prompt treatment.

OR

The mainstay of treatment for [disease name] is [therapy].

OR   The optimal therapy for [malignancy name] depends on the stage at diagnosis.

OR

[Therapy] is recommended among all patients who develop [disease name].

OR

Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].

OR

Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].

Medical Therapy

Nephroliithiasis

Non pharmacological measures

Straining

• Stone ≤5 mm can pass spontaneously.
• Passage of stone also depends on the site of stone.

Pharmacological measures

• Both NSAIDS and opiods are seen efficacious for the pain relief related to nephrolithiasis.

Non steroidal anti inflammatory drugs (NSAIDS)

 * Parenteral regimen

• • Preferred regimen (1)2 g IV q24h for 14 (14–21) days
    • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
    • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
  • Oral regimen
    • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
    • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
    • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
    • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
• 2.1.2 Pediatric
  • Parenteral regimen
    • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
    • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
    • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '(Contraindications/specific instructions)'
  • Oral regimen
    • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
    • Preferred regimen (2): drug name (for children aged ≥ 8 years) 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
    • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
    • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
    • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
    • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)

• 2.2 'Other Organ system involved 2'

  Note (1):

  Note (2):

  Note (3):

  • 2.2.1 Adult
    • Parenteral regimen
      • Preferred regimen (1): drug name 2 g IV q24h for 14 (14–21) days
      • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
      • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
    • Oral regimen
      • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
      • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
      • Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
      • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
      • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
      • Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
  • 2.2.2 Pediatric
    • Parenteral regimen
      • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
      • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
      • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
    • Oral regimen
      • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
      • Preferred regimen (2): drug name 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
      • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
      • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
      • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
      • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)