Tolmentin
– Discussion: – along with Aspirin is the only NSAIA approved in children; – Adult: RA, OA: 400 mg PO tid; 1800 mg maximum dose; – 2 hr half life – Peds > 2 years: 20 mg/kg/day (max dose 30 mg/kg/day) – supplied: 200, 400, 600
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TOLECTIN, TOLECTIN DS
Adults: Anti-inflammatory: 400 mg PO tid w/ meals or milk; Max: 2 gm/24hr; Caps: 400 mg; Tabs: 200mg
TOLBUTAMIDE/ORINASE
See: Hypoglycemics – for DM II: – Adult Dose: – 1st 1-2gm PO in divided doses; then 250mg-2 gm PO; – lasts 6-12h
Toe Nail Fungus (Onychomycosis)
– Discussion: – most often caused by dermatophytes (Trichophyton rubrum and Trichophyton interdigitale); – affects 3-5% of younger patients, but effects up to half of the elderly population; – Treatment: – medicated nail polish: – indicated if there is only one … Read more
Toe Fractures:
Discussion: – Seymour’s frx: – open type of fracture in which germinal matrix of the nail bed is trapped in the fracture site; – needs to be treated with ORIF (K wires) as well as IV antibiotics The Stubbed Great Toe: Importance of Early Recognition and Treatment of Open Fractures of the Distal Phalanx
Tobramycin
– See: aminoglycosides and addition of aminoglyocides to cement – Discussion: – adult dose w/ normal renal F(x) & serious infection: 1mg/kg q8hr; – peds: 7.5 mb/kg/day q8hr (Levels: trough <2; peak: 4-8 hr) – for life threatening infection may use 1.66mg/kg q8hr (reduce dose as soon as possible); … Read more
TKR: Trial Components and Tracking
– Trial Components: – component fit: – evaluate femoral and tibial trial components and determine areas that will need additional cement; – flexion & extension gaps – range of motion: use the largest polyethylene spacer that allows full extension; … Read more
TKR: Tibial Component
– TKR Surgical Technique: – extramedullary guides – proximal tibial resection: – posterior slope of the tibial component: – depth of tibial cut: – Effect of the tibial cut on subsidence following total knee arthroplasty. – joint … Read more
TKR Technique: Tibial Component
– Tibial Component Preparation: – ACL is resected, w/ or w/o PCL preservation; – Extramedullary Guides – alignment is made w/ jig parallel to ant crest of tibia shaft. – referencing was taken off the lateral tibial plateau. – Proximal Tibial Resection – Determine appropriate Posterior Slope – Depth of Tibial … Read more
TKR: Surgical Approach
– Discussion: – anterior longitudinal incision allows full exposure of the proximal tibia; – this incision allows exposure of both medial & lateral aspects of joint w/o the necessity for large skin flaps; – this incsion has advantage that … Read more