Ma Needs Your Prayers Too!

[UPSyours2]

Ma has been in the hospital since the day after Christmas because she's got really bad back pain & couldn't walk @ all her feet are too weak to support her body.

So far they've done X-Rays, MRI, CAT Scans, Galium Scan, because she has an infection in her back.

She's taking Starlix for Diabetes which they found out she has also.

Yesterday she was going to get a biopsy CT Scan but putting a needle in her back having her lay down on her stomach for any lenght of time is too painful & uncomfortable for her so they cancelled it yesterday.

Today @ 8 AM they are going to have to monitor her heart, give oxygen, anesthesia so she doesn't feel the pain, etc.

They say it's a simple procedure & is used for colonoscopies.

The cardiologist Dr. said she's got a weak heart probably from old age since she's 83! She's on ace inhibitors, beta-blockers (he didn't tell me which ones..I can always ask the nurse)

They need to find out what kind of infection she has so it can be treated w/the proper antibiotics.

It's bad enough a few days ago they needed my consent to put in a catheter IV in the crook of her arm so they can administer the antibiotic for 6 weeks but they can't start her treatment until they get the biopsy.

Thanks everyone... I'll keep ya posted!

My days are soo crazy...I do alot of driving & am tired. I just can't get sick. My allergies are enough for now & I'm getting a slight migraine.

DH is cranky since he's gotta be 3 people @ work because his boss is out sick w/ back problems, etc. has to take over for another co-worker who's out on WC.

By the time we get back from visiting Ma 5 - 8 PM have dinner it's beddy bye time cause 4:45 AM gets here fast! I do all the driving, even before picking up DH @ work I stop to visit Ma between 11 AM - 2 PM!

[Darlene]

I so hope they figure out what's going on with your Ma so they can get her comfortable & feeling better. You take good care Andrea & I'll be thinking of you all.

[Hollyhandi]

Thinking of you all.
Prayers for your Ma that she gets relief soon and for you and your DH
(((((((((( To you all ))))))))))

[dolphin]

I'll be praying for her to receive the proper treatment and get over this quickly.

Also praying that you and your dh will be able to hold up to all of the recent changes and that you don't get sick.

[UPSyours2]

Ma has been in the hospital since the day after Christmas because she's got really bad back pain & couldn't walk @ all her feet are too weak to support her body.

So far they've done X-Rays, MRI, CAT Scans, Galium Scan, because she has an infection in her back.

She's taking Starlix for Diabetes which they found out she has also.

Yesterday she was going to get a biopsy CT Scan but putting a needle in her back having her lay down on her stomach for any lenght of time is too painful & uncomfortable for her so they cancelled it yesterday.

Today @ 8 AM they are going to have to monitor her heart, give oxygen, anesthesia so she doesn't feel the pain, etc.

They say it's a simple procedure & is used for colonoscopies.

The cardiologist Dr. said she's got a weak heart probably from old age since she's 83! She's on ace inhibitors, beta-blockers (he didn't tell me which ones..I can always ask the nurse)

They need to find out what kind of infection she has so it can be treated w/the proper antibiotics.

It's bad enough a few days ago they needed my consent to put in a catheter IV in the crook of her arm so they can administer the antibiotic for 6 weeks but they can't start her treatment until they get the biopsy.

Thanks everyone... I'll keep ya posted!

My days are soo crazy...I do alot of driving & am tired. I just can't get sick. My allergies are enough for now & I'm getting a slight migraine.

DH is cranky since he's gotta be 3 people @ work because his boss is out sick w/ back problems, etc. has to take over for another co-worker who's out on WC.

By the time we get back from visiting Ma 5 - 8 PM have dinner it's beddy bye time cause 4:45 AM gets here fast! I do all the driving, even before picking up DH @ work I stop to visit Ma between 11 AM - 2 PM!

[Michele Annette]

Andrea, I hope your Mom is feeling better soon. Take care of yourself as well!

[Kimberlina]

[SewCrafty]

and strength for all of you to get through this.

[forestdale]

Andrea, I hope your mum recovers soon. It's very worrying when your parents are ill. Look after yourself too and take care.

[Mom23boys]

and prayers.

[couponchic]

Hope your Mom gets better soon.

[UPSyours2]

Thanks everyone for your kind words & keeping Ma in your thoughts, prayers,

DH & I went to visit her last night her biopsy test went ok w/her no problems or pain. She was quite talkative & making sense...some of the other days she'd be talking up a storm & not being able to sleep @ night maybe it was from the percoset or other pain meds.

The crazy things she'd say was we were @ a Christmas Wedding in the hospital & Santa Claus was @ her window!

Im not sure what kind of infection she has in her back since the test results are not ready yet but the started treating her w/ IV antibiotics one of them is vancomycin & the other is rocephin. I have never heard of them & not sure if I spelled them right or not

The nurse gave her a shot of insulin, lovenox, etc.

I don't remember everything right now & I've got a bit of a headache still...DH is yelling @ me for being on my PC when I should be cleaning but I told him I'm eating lunch right now!

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[Strawberry]

Thanks for the update and I'll continue to keep your family in my thoughts and prayers

[UPSyours2]

About some of the meds:

VANCOMYCIN

http://www.molbio.princeton.edu/cour...vancomycin.htm



Introduction to Vancomycin: why it’s important (history)
Throughout the last century, humanity fought hard against bacterial infections, and bacteria themselves retaliated by developing resistance to our antibiotics. Vancomycin has been a key player in this war against bacterial pathogens; it has been so important, in fact, that it is often known as the “antibiotic of last resort.� This 1.5 kD glycopeptide is used to kill bacteria when no other drug works; it is the antibiotic to which many physicians have turned when fighting Staphylococcus aureus and Clostridium difficile. But now, forty years after the drug was introduced into the clinic, the medical community is facing an incipient crisis in the use of vancomycin. More and more bacteria are gaining resistance to a drug that is often still seen as the last hope when trying to cure a bacterial disease.

Scientists introduced vancomycin (see Fig. A, below) into hospitals more than forty years ago in response to new strains of Staphylococci that were growing resistant to penicillin. As the former wonder drug penicillin became increasingly ineffective in hospitals around the world, physicians began to see vancomycin as the new antibiotic that would keep humans ahead of bacterial pathogens. The introduction of methicillin decreased the use and importance of vancomycin for a few years; however, when methicillin-resistant S. aureus strains appeared in the past two decades, the glycopeptide antibiotic was reinstated as a therapeutic agent.[1] Vancomycin is now seen as the last-resort drug because it is often the last opportunity that a physician may have to eliminate a bacterial infection, since bacteria have become resistant to so many other drugs.

Mechanism of Action
Like many antibiotics (including the penicillins), vancomycin acts by interfering with the construction of cell walls in bacteria. Cell wall biosynthesis is one of the major means of killing bacteria.

The Bacterial Cell Wall. Bacterial cells are surrounded by a cell wall that is composed of a mesh-like network called peptidoglycan. The cell wall is absolutely crucial to the survival of the bacterium, for it provides the entire cell with mechanical support. The cell faces a huge intracellular osmotic pressure, and the rigidity of the peptidoglycan helps to maintain the cell’s shape and prevent it from lysing (exploding).[2] Inhibition of the biosynthetic pathway of the peptidoglycan layer in bacteria will therefore cause the cell to lyse.

The peptidoglycan layer is composed of a linear polysaccharide chain composed of alternating residues of the carbohydrates N-acetyl glucosamine (GlcNAc) and N-acetyl muramic acid (MurNAc). Many of these chains run parallel to one another, and are connected with each other via a peptide moiety of the five amino acids L-Alanine-D-Glutamic acid-L-Lysine-D-Ala-D-Ala. The peptide cross-bridges connect the MurNAc residues on the glycan chains, resulting in a net-like structure. This meshwork that forms the bacterial cell wall imparts a great deal of structural support to the cell.[3]

The bacterial peptidoglycan is synthesized in a series of steps that take place both inside and outside of the cell membrane. Just outside the membrane lie the transglycosylases, enzymes that put together GlcNAc-MurNAc subunits to form the glycan chains, and the transpeptidases, which perform the peptide cross-linking between these chains. The vancomycin family of antibiotics inhibits this stage of cell wall synthesis.[1] While penicillin affects the active sites of the transpeptidase enzymes themselves, vancomycin binds to the peptide substrate and prevents it from binding to the enzyme’s active site.[4] The bottom surface of vancomycin makes five hydrogen bonds to the D-Ala-D-Ala amino acids at the end of the peptide cross-bridges. By binding to these residues with high affinity, the antibiotic prevents them from being accessible to the active site of the transpeptidases. Peptide cross-linking therefore cannot occur, and the structural integrity of the peptidoglycan is compromised, causing the cell to lyse.

Since only prokaryotic cells have cell walls, antibiotics that inhibit peptidoglycan biosynthesis cannot harm the eukaryotic host cells. This target is therefore a very useful one to consider when developing new antibiotics in the future. [4]

Resistance to Vancomycin
Once an antibiotic has been introduced into hospitals, it can be as little as a few months before resistant strains of bacteria appear. The hope that vancomycin would be a cure-all antibiotic came to an end in 1987 when vancomycin-resistant enterococci (VRE) appeared in hospitals. Since then, VRE strains have spread extremely rapidly and have raised serious concerns within the scientific and health care communities.

Some facts about VRE:[5]
Between 1989 and 1993, the strains of VRE jumped from 0.3% to 7.9%.

Enterococci now cause 10% of all hospital-acquired infections

Cases of infection with VRE have resulted in mortality rates as high as 73%.

VRE has been found to be transmitted via the hands; the need to wash hands regularly with soap, particularly in the hospital setting, is therefore extremely critical to prevent the spread of resistant bacteria. Unfortunately, no therapy has yet been developed to combat systemic VRE infection.

Enterococci gain resistance to vancomycin by the accumulation of the vanHAX genes. The vanH enzyme, encoded by the gene of the same name, is involved in the creation of a new pathway of enzymes that produce D-lactate from pyruvate. The enzyme vanA adds a D-lactate moiety to the end of the peptide cross-bridge, rather than another D-alanine. The peptide strand therefore ends with a D-Ala-D-Lac, rather than the usual D-Ala-D-Ala. Finally, vanX hydrolyzes the D-Ala-D-Ala moiety so that the new peptide moiety is more common. Although the change in the last peptide from Ala to Lac does not have any effect upon the quality of the peptidoglycan layer or its ability to cross-link the glycan strands, it does lower the binding affinity of the vancomycin to its target by 1000-fold. Vancomycin therefore has much more of a difficulty in binding to its substrate and is rendered ineffective.[4]

The vanHAX genes are all located on a plasmid within the cell. The advantage of accumulating genes on plasmids is that these regions of DNA can replicate independently of the bacterial genome, and can also be readily transferred from one cell to another. Resistance can therefore easily spread not only between cells, but between species as well. In addition, these vancomycin-resistance genes are located on transposon elements, which can cut themselves out of one segment of DNA and move to another segment. These characteristics make it very easy for bacteria to transfer antibiotic resistance to other cells of the same (or different) species.

How to curb the misuse of vancomycin. The misuse of antibiotics in clinical settings is greatly exacerbating an already dire situation. A 1996 survey by Hospital Infection Control Practices Advisory Committee found that about two-thirds of the vancomycin that is prescribed is not used appropriately. It is such misuse of the antibiotic that perpetuates the emergence of new strains of VRE. Misuse also occurs outside of clinical settings. For example, some European nations give the antibiotic avoparcin to farm animals in order to improve meat yields. Avoparcin, however, is so closely related to vancomycin that bacteria which gain resistance to one antibiotic will also be resistant to the other. This practice is therefore extremely dangerous not only to the meat industry, but to health care in general.

In order to combat the emerging strains of VRE, scientists and policy-makers propose a number of different actions to take. First, the use of antibiotics such as vancomycin should be restricted in medical care of humans and of animals. Second, careful and frequent handwashing by nurses, physicians, and all other hospital staff will help prevent spread of VRE between patients. Proper hygiene is crucial.

Key Terms
Enterococci are spherical bacteria found in the feces of most humans and animals. They are usually a normal part of the human gastrointestinal and genital tracts; however, infections caused by these bacteria can include urinary tract infections, wound infections, and meningitis, all of which can be very serious if left untreated.[4] Enterococci are dangerous both because their infection can have serious consequences, and because they are some of the most antibiotic-resistant strains ever found.[4]

Transposons are DNA segments in bacteria that can move from one place on the DNA to another. Such movement of genes allows bacterial resistance to spread between cells and between species.

Footnotes
[1] Mayhall, C. Glen. “Prevention and Control of Vancomycin Resistance in Gram-Positive Coccal Microorganisms: Fire Prevention and Fire Fighting.� http://www.slackinc.com/general/iche...96/mayhall.htm

[2] Gale, E.F. et al. The Molecular Basis of Antibiotic Action. London: Wiley, 1972.

[3] Holtje, Joachim-Volker. “Growth of Stress-Bearing and Shape-Maintaining Sacculus of E. coli.� Microbiology and Molecular Biology Reviews 62:1 (1998) 181-203.

[4] Walsh, Christopher. “Molecular Mechanisms that confer antibacterial drug resistance.� Nature (406): 17 Aug 2001, 775-781.

[5] “Vancomycin Resistant Enterococci.� http://www.nicl.com/clinicaltopics/vre.html

[6] “The Facts about Vancomycin-resistant enterococci.� http://www.amm.co.uk/pubs/fa_vre.htm




ROCEPHIN

http://www.medbroadcast.com/drug_inf...ept_disclaimer

Brand Name
Rocephin

Common Name
ceftriaxone


How does this medication work? What will it do for me?

Ceftriaxone is an antibiotic - it fights infections caused by bacteria. It belongs to the family of antibiotics known as cephalosporins. It is given by injection only and is used to treat susceptible bacterial infections and, in some cases, to prevent infections before, during, and after operations in the hospital.

Ceftriaxone is often used to treat infections of the lung, urinary tract, skin, abdomen, bone, and lining of the brain (meningitis), depending on the bacteria causing them.

Your doctor may choose to use this medication for other conditions not listed here. If you're unsure why you are taking this medication, please ask your doctor.

How should I use this medication?

The recommended dose and dosing schedule of ceftriaxone varies according to the specific infection being treated, the response to therapy, and other drugs or treatments being used. The dose administered is also based on age, body size, and kidney and liver function. Adult doses range from 1 g to 2 g daily given once every 24 hours or divided into two equal doses and given every 12 hours.

Ceftriaxone is injected into a vein or into a muscle by a health professional under the supervision of your doctor. Treatment may be necessary for a matter of days to weeks, depending on the infection being treated. Since many things can affect the dose and schedule of medication that a person needs, such as body weight, other medical conditions, and other medications, your dose or schedule may differ from the ones cited here.

Keep this and other medications out of reach of children.

What form(s) does this medication come in?

Rocephin® is available in sterile vials in powder form containing ceftriaxone 250 mg, 1 g, or 2 g. There are no nonmedicinal ingredients.

Who should NOT take this medication?

Ceftriaxone should not be used by anyone allergic to ceftriaxone or any of the other cephalosporin or penicillin antibiotics.

It is important to note that up to 10% of people with an allergy to penicillin are also allergic to cephalosporins such as ceftriaxone. If ceftriaxone is to be given despite this risk, extreme caution should be taken, and the drug discontinued at once if an allergic reaction continues. Discuss emergency procedure plans with your doctor, in case a serious allergic reaction does occur.

LOVENOX

http://www.lovenox.com/consumer/homeAction.do

LOVENOX facts
LOVENOX® (enoxaparin sodium injection) may be helpful in protecting you from DVT, or Deep Vein Thrombosis, a blood clot that can form in your legs which may move to your lungs, where it could be fatal.

In clinical trials, Lovenox® has been shown to be 99% effective in protecting hospitalized patients from DVT blood clots.
LOVENOX® is an anticoagulant — it thins the blood and alters the body’s normal blood-clotting process.
Over 100 million people worldwide have been treated with Lovenox®.
LOVENOX® can be taken safely with most other medications, has few side effects, and only needs to be administered once a day


Important Safety Information

LOVENOX® (enoxaparin sodium injection) is not the same as "unfractionated heparin" or other drugs called "low-molecular-weight heparins." Therefore, these drugs cannot be used interchangeably with LOVENOX®.

Certain procedures, called "epidural/spinal anesthesia" and "spinal puncture," may be used as a normal part of hospitalization. Patients requiring these procedures while being treated with LOVENOX® or other low-molecular-weight heparins are at risk of developing a blood clot in or around the spine. This condition may result in long-term or permanent paralysis.

LOVENOX® can alter the blood's ability to clot. Patients treated with LOVENOX®, who also have conditions affecting the clotting system, must be carefully monitored by their healthcare professional. Adjusting the dose of LOVENOX® may be necessary for patients who have certain forms of kidney disease. All patients receiving LOVENOX®, as well as other anticoagulants, should be carefully monitored for bleeding by their healthcare professional. Bleeding can occur at any site with LOVENOX® use.

Platelet drops, known as "thrombocytopenia," can occur with LOVENOX® use. Cases of a related condition called "heparin-induced thrombocytopenia" have been observed in clinical practice. If you have had this condition, you must notify your healthcare professional. Your physician may perform blood tests to monitor for the occurrence of any drop in platelet count.

The use of LOVENOX® has not been adequately studied in pregnant women with artificial (mechanical) heart valves.

LOVENOX® should not be used in patients with an allergy or sensitivity reaction to the active ingredient called enoxaparin sodium, heparin, or pork products, and in patients with active major bleeding.healthcare professional

Common side effects include mild local reactions or irritation at the site of injection, pain, bruising, and redness of skin.

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[Katybird]

Andrea, I hope your mother is feeling better soon. I will say a prayer for her.