DDose5 must be ddjustecJ ibr the degree of renal Impairment

Ineffective Therapies

Several pharmacologic therapies have been proven to be ineffective in reducing morbidity or mortality from the disease. Ineffective therapies include: reducing pancreatic secretion by administering somatostatin or atropine, reducing gastric acidity and decreasing pancreatic secretion with histamine2 -receptor antagonists, inhibition ofpancreatic enzymes using protease inhibitors such as aprotinin, probiotics, and im-

munomodulation. ' Nasogastric suction has only been effective in patients with ileus or persistent vomiting.28

Patient Encounter, Part 3: Treatment and Monitoring

The patient acutely decompensates upon leaving the CT scanner and is therefore transferred to the surgical intensive care unit for mechanical ventilation, blood pressure support, and surgical evaluation. A diagnosis of acute pancreatitis with pancreatic necrosis is made.

Formulate a care plan for this patient.

What are some possible causes ofrespiratory failure and hypotension in this patient? Are these findings poor prognostic indicators?

What is the recommended treatment for pancreatic necrosis?

What empiric antibiotic regimen would be a reasonable choice in this patient? Provide a drug, dose, route, and frequency.

Suppose a surgeon requested clindamycin 600 mg IV every 8 hours for this patient. Would this be a reasonable choice? Why or why not?

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