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Peritoneal Dialysis

aminoglycosides

To my knowledge, there haven't been any updated peritonitis references since 2005. Can anyone clarify when tobra is preferred over gent or vice versa? I had this particular question from a nephrologist and couldn't come up with an answer off the top of my head. Thanks in advance.

magnesium in dialysis solutions

Does anyone have experience with adding magnesium sulphate to dialysis solutions(eg. Dianeal)?
Suzanne

Statistics on Pharmacists in Home Dialysis

At our hospital we are expecting a major increase of outpatients at the Home Dialysis Unit. Therefore we will need to increase the Nursing,Dietician, Social Worker and Clinical Pharmacist staffing accordingly. To do so we would need to get some information about: how many pharmacists work in renal centers with home dialysis (hemo and peritoneal) in Ontario and what is the ratio to patient. Can anyone help with that type of information or where can I get more useful data. Thank you so much!

insulin adjustment in peritoneal dialysis

Hello,

I am a pharmacist and a CDE. In our diabetes education centre we are seeing an increasing number of patients that are on insulin and receiving peritoneal dialysis. At the diabetes centre we have a medical directive to adjust insulin doses for patients of our endocrinologists. I was wondering if anyone had any tips/guidelines/protocols that you could be willing to share with us.

Thanks!

David Leeson, B.Sc., B.Sc.Pharm., CDE
Lawson Diabetes Centre
St. Joseph's Health Care London
London, ON

insulin adjustment in peritoneal dialysis

Hello,

I am a pharmacist and a CDE. In our diabetes education centre we are seeing an increasing number of patients that are on insulin and receiving peritoneal dialysis. At the diabetes centre we have a medical directive to adjust insulin doses for patients of our endocrinologists. I was wondering if anyone had any tips/guidelines/protocols that you could be willing to share with us.

Thanks!

David Leeson, B.Sc., B.Sc.Pharm., CDE
Lawson Diabetes Centre
St. Joseph's Health Care London
London, ON

Ampicillin IP

Does anyone have any experience with IP ampicillin? We are treating a patient with an enterococcus peritonitis sensitive to ampicillin and gentamicin. According to the ISPD guidelines, the ampicillin dose is 125 mg/L. However, I can only find stability data for 50 mg/L in Dianeal - 2 days (NPA Peritoneal Dialysis handbook). What do other centres do? My patient will be adding the antibiotics to their Dianeal at home for overnight dialysis.

Thanks!
Maryanne McDonald
Nephrology Clinic Pharmacist
Alberta Children's Hospital

polyethylene glycol in PD patients

Any experience using this product for bowel maintenance in our PD population? I vaguely remember going to a talk that promoted using small volumes (ie 100-250mL daily) instead of the regular stool softener/stimulant/osmotic laxative combinations. Thanks in advance.

calcium liquid

Funny that this hasn't come up since I have started in renal. I have a PD patient who wants to use calcium liquid instead of the regular tablet formulations. It is a lactate/gluconate mix yielding 100mg elemental calcium/5mL. I couldn't find any information on binding capacity in the KDOQI guidelines or through a MedLine search. Any experiences?

Dispensing Antibiotics for Peritonitis

Hello RPN members,

We currently draw up and refrigerate/freeze individual doses of PD
antibiotics for peritonitis. However, our outpatient pharmacy is closing in
the Fall and would like to look at having retail pharmacies provide these
antibiotics. I would like to do a survey (the results will be sent to the
RPN newsletter) on how other centres handle their peritonitis antibiotics.

Please send a quick response with your centre's name and how these antibiotics
are provided to your patients.

Thank you,
Lori Wazny

PD catheter clearance

Just wondering what the different sites do in terms of PD catheter clearance. Here we try flushing 1st with the hep-lock solution and then either replace the line or revise it. We are looking at whether we should add an alteplase protocol for adults since we are trying to add one for pediatric patients who have less options due to limited abdo wall. Thanks!
Alice Chan
U of A

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