Failure to thrive medical therapy: Difference between revisions

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Latest revision as of 14:17, 13 September 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S [2]

Overview

Appetite stimulants such as cryptoheptadine and progesterones may be employed in patients with failure to thrive. However, these are not recommended. Medical therapy employed also depends on the underlying organic cause.

Medical Therapy

Discussing the specific treatment for organic causes of failure to thrive is beyond the scope of this chapter.
However, regardless of the cause, treatment of failure to thrive is always based on three basic principles ; a multidisciplinary approach aimed at treating the underlying cause, facilitating catch up growth via a nutritional rehabilitation program and a period of follow up thereafter.
One really needs to look at the bigger picture as the real treatment begins when the child leaves the hospital. ^[1]
First, stabilize the patient from complications such as electrolyte derangements, hypothermia, shock, sepsis, renal failure, etc. Depending on the suspected organic cause, laboratory investigations are then sent. "Failure To Thrive - StatPearls - NCBI Bookshelf".
In chronic cases of failure to thrive, a nutritionist, psychologist and social worker should be added to the treatment team.
Following the period of hospitalization, the follow up visits are essential in monitoring any relapses and adjusting the plan according to status of the patient.
They should be arranged from weekly to every few months depending on the age of the child (infants require more regular visits as compared to older children).
Cryptoheptadine or mesogestrol have been used at times, but in general, appetite stimulants are not preferred n patients with failure to thrive.
Based on the organic cause or complication, medical therapy is given.
Iron deficiency anemia is the most common complication and iron supplements are given.

References

↑ Goldbloom RB (1982). "Failure to thrive". Pediatr Clin North Am. 29 (1): 151–66. doi:10.1016/s0031-3955(16)34114-1. PMID 6276853.

Template:WH Template:WS

[pmid6276853-1] Goldbloom RB (1982). "Failure to thrive". Pediatr Clin North Am. 29 (1): 151–66. doi:10.1016/s0031-3955(16)34114-1. PMID 6276853.

[1]

@@ Line 4: / Line 4: @@
 ==Overview==
-There is no treatment for [disease name]; the mainstay of therapy is supportive care.
+Appetite stimulants such as cryptoheptadine and progesterones may be employed in patients with failure to thrive. However, these are not recommended. Medical therapy employed also depends on the underlying organic cause.
-OR
-Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
-OR
-The majority of cases of [disease name] are self-limited and require only supportive care.
-OR
-[Disease name] is a medical emergency and requires prompt treatment.
-OR
-The mainstay of treatment for [disease name] is [therapy].
-OR
-The optimal therapy for [malignancy name] depends on the stage at diagnosis.
-OR
-[Therapy] is recommended among all patients who develop [disease name].
-OR
-Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
-OR
-Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
-OR
-Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
-OR
-Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
 ==Medical Therapy==
-*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
+*Discussing the specific treatment for organic causes of failure to thrive is beyond the scope of this chapter.
-*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
+*However, regardless of the cause, treatment of failure to thrive is always based on three basic principles ; a multidisciplinary approach aimed at treating the underlying cause, facilitating catch up growth via a nutritional rehabilitation program and a period of follow up thereafter.
-*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
+*One really needs to look at the bigger picture as the real treatment begins when the child leaves the hospital. <ref name="pmid6276853">{{cite journal| author=Goldbloom RB| title=Failure to thrive. | journal=Pediatr Clin North Am | year= 1982 | volume= 29 | issue= 1 | pages= 151-66 | pmid=6276853 | doi=10.1016/s0031-3955(16)34114-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6276853  }} </ref>
-*Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
+*First, stabilize the patient from complications such as electrolyte derangements, hypothermia, shock, sepsis, renal failure, etc. Depending on the suspected organic cause, laboratory investigations are then sent.  {{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK459287/ |title=Failure To Thrive - StatPearls - NCBI Bookshelf |format= |work= |accessdate=}}
-===Disease Name===
+*In chronic cases of failure to thrive, a nutritionist, psychologist and social worker should be added to the treatment team.
+*Following the period of hospitalization, the follow up visits are essential in monitoring any relapses and adjusting the plan according to status of the patient.
-* '''1 Stage 1 - Name of stage'''
+*They should be arranged from weekly to every few months depending on the age of the child (infants require more regular visits as compared to older children).
-** 1.1 '''Specific Organ system involved 1'''
+*Cryptoheptadine or mesogestrol have been used at times, but in general, appetite stimulants are not preferred n patients with failure to thrive.
-*** 1.1.1 '''Adult'''
+*Based on the organic cause or complication, medical therapy is given.
-**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)'''
+*Iron deficiency anemia is the most common complication and iron supplements are given.
-**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
-**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
-**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
-**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
-**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
-*** 1.1.2 '''Pediatric'''
-**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
-***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose)
-***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
-***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
-***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
-***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
-****1.1.2.2 (Specific population e.g. '<nowiki/>'''''children < 8 years of age'''''')
-***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
-***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
-***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
-***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
-** 1.2 '''Specific Organ system involved 2'''
-*** 1.2.1 '''Adult'''
-**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
-*** 1.2.2  '''Pediatric'''
-**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
-* 2 '''Stage 2 - Name of stage'''
-** 2.1 '''Specific Organ system involved 1 '''
-**: '''Note (1):'''
-**: '''Note (2)''':
-**: '''Note (3):'''
-*** 2.1.1 '''Adult'''
-**** Parenteral regimen
-***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
-***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
-***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
-**** Oral regimen
-***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
-***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
-***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
-***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
-***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
-***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
-*** 2.1.2 '''Pediatric'''
-**** Parenteral regimen
-***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
-***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
-***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '<nowiki/>'''''(Contraindications/specific instructions)''''''
-**** Oral regimen
-***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
-***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
-***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
-***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
-***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
-***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
-** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
-**: '''Note (1):'''
-**: '''Note (2)''':
-**: '''Note (3):'''
-*** 2.2.1 '''Adult'''
-**** Parenteral regimen
-***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
-***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
-***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
-**** Oral regimen
-***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
-***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
-***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
-***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days
-***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
-***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
-*** 2.2.2 '''Pediatric'''
-**** Parenteral regimen
-***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
-***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
-***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
-**** Oral regimen
-***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
-***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
-***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
-***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
-***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
-***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
 ==References==

Failure to thrive medical therapy: Difference between revisions

Latest revision as of 14:17, 13 September 2020

Overview

Medical Therapy

References

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