Medical Malpractice Insurance for orthopaedic surgeons

Methotrexate

– Dosing:       – leukemia:              – 2.5 to 5 mg for children & 2.5 mg to 10 mg for adults;       – continuous infusion of large amounts of methotrexate may be employed (from 250 mg to 1 g/sq m., q week), when leucovorin rescue is … Read more

Methotrexate: Drug Interactions and Toxicity

– Contraindications:      – Septra (Bone marrow toxicity)      – Probenecid (blocks tubular secretion of methotrexate) – GI Toxicity:      – GI intolerance is the most common adverse reaction;      – anorexia, nausea, vomiting, diarrhea, and even unexplained wt loss – Bone Marrow Toxicity:      – may occur and is … Read more

METHOXAMINE HYDROCHLORIDE

– for hypotension:  – initial dose: 3-5 mg IV push;  – titrate BP: given as continuous infusion;  – begin at 5 ug/min;  – dilute 40mg/250ml D5W;  – may cause Bradycardia

METHYLDOPA/ALDOMET

– for essential hypertension;  – Adult Dosing:  – 250-500mg PO bid/tid (max: 2-3gm/day) or 250mg-1gm IV q4-8hr; – Precautions:  – sudden withdrawl may result in significant rebound HTN; – do not use in presence of liver disease;  – use smaller doses in renal failure

Metatarsus Adductus

– Discussion:     – a condition in which the there is medial displacement of the metatarsals on the cuneiform;     – forefoot is adducted at the tarsal metarsal joint;     – usually seen in the first year;     – is bilateral in 50% of patients may be associated with hip displasia … Read more

Metatrophic Dysplasia

– See: Kniest Dysplasia: – Discussion:  – rare skeletal dysplasia characterized by change in body proportions w/growth;  – because of the short limbs and relatively long trunk during infancy, this condition often has been confused with achrondroplasia;  – unlike pts with achrondroplasia, the head and face appear normal;  – severe kyphoscoliosis may develop, w/ a … Read more

Metformin / Glucophage

– Discussion:     – oral hypoglycemic agent;     – note: some anesthesiologists will prefer to hold this agent on the day of surgery due to reports of uncontroled hypoglycemia during surgery;              – if this medication is given the morning of surgery, then serial blood sugars need to … Read more

Methenamine Hippurate/Hiprex

– similar to Methenamine Mandelate) – these are oral agents used only for suppression or prophylaxis of chronic UTI; – they are absorbed well and are excreted into the urine in high conc. – these agents have no intrinsic antibacterial activity, but at a pH of 5.5 or less, mandelic and hippuric acids are antibacterial and … Read more