Clinical pharmacy
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The pathogenesis, epidemiology, clinical features, sequelae, and treatment of bronchiolitis are reviewed. Acute bronchiolitis is the most common severe lower-respiratory-tract infection of infancy. During epidemics, more than 80% of cases may be caused by respiratory syncytial virus (RSV). ⋯ Intravenous immune globulin may have a role in the treatment of lower-respiratory-tract infections involving RSV; however, since few studies have been performed in humans, it is not possible to determine its place in the treatment of bronchiolitis. A trial of aerosolized beta 2 agonists is warranted in patients with bronchiolitis. Ribavirin may be considered in patients with severe disease or those at high risk for severe disease.
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The treatment of two common adverse effects of dapsone (methemoglobinemia and hemolytic anemia) is discussed, and a case of acute dapsone intoxication is described. A pregnant 29-year-old woman was admitted to an emergency room three hours after ingesting 50 tablets of dapsone (100 mg each) and six alcoholic drinks. One hour after admission 50 g of activated charcoal was given p.o., and 65 mg of methylene blue was given i.v. ⋯ Methemoglobin concentrations never rose above 20% after the sixth dose of methylene blue. On hospital days 2 and 3, laboratory values were consistent with a diagnosis of hemolytic anemia; the patient received two units of packed red blood cells. The hematocrit decreased over the next three days to 23.9%, and the patient received four units of packed red blood cells.(ABSTRACT TRUNCATED AT 250 WORDS)