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February 26, 1973, Vol 223, No. 9 >
ARTICLE | February 26, 1973

Guide to Drug Usage in Adult Patients With Impaired Renal Function: Title and subTitle BreakA Supplement FREE

William M. Bennett, MD; Irwin Singer, MD; Cecil H. Coggins, MD
[+] Author Affiliations

Reprint requests to 3181 SW Sam Jackson Park Rd, Portland, Ore 97201 (Dr. Bennett).


JAMA. 1973;223(9):991-997. doi:10.1001/jama.1973.03220090015004
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Article
References

Four previously published tables describing maintenance dosage intervals for common drugs used in patients with renal disease are supplemented and updated. Emphasis is given to the use of biological half-life and creatinine clearance for modification of the usual dose schedules. Toxic effects and adjustments required by patients undergoing dialysis are also noted.

REFERENCES

1 +
Bennett WM, Singer I, Coggins CH:  A practical guide to drug usage in adult patients with impaired renal function . JAMA 214:1468-1475, 1970;.
2 +
Goodman LS, Gilman A: The Pharmacologic Basis of Therapeutics . New York, Macmillan Co, 1970;.
3 +
Reidenberg MM: Renal Function and Drug Action . Philadelphia, W B Saunders Co, 1971;.
4 +
Ritschel WA:  Biological half-lives of drugs . Drug Intelligence and Clin Pharmacol 4:332-347, 1970;.
5 +
Schreiner GE, Teehan BP:  Dialysis of poisons and drugs . Trans Am Soc Artif Intern Organs 17:513-544, 1971;.
6 +
Schreiner GE, et al:  Extracorporeal and peritoneal dialysis of drugs . Handbook of Experimental Pharmacology 28(pt (1) ):403-420, 1971;.
7 +
 Symposium, Drug metabolism in man . Ann NY Acad Sci 179:9-773, 1971;.
8 +
Altman G, et al:  Blood levels of ampicillin, Kanamycin and gentamicin in the uremic . Isr J Med Sci 6:683-690, 1970;.
9 +
Buck AC, Cohen SL:  Absorption of antibiotics during peritoneal dialysis in patients with renal failure . J Clin Pathol 21:88-92, 1968;.
10 +
Koch-Weser J:  Adverse reactions to Sulfasoxasole, Sulfamethoxazole, and Nitrofurantoin . Arch Intern Med 128:399-404, 1971;.
11 +
Kunin CM:  Antibiotic usage in patients with renal impairment . Hosp Practice 7:141-149, 1971;.
12 +
O'Grady F:  Antibiotics in renal failure . Br Med Bull 27:142-147, 1971;.
13 +
Precht K, Briedigkeit H:  Experimentelle Untersuchungen zur Dialysierbarkeit von Antibiotika . Acta Biol Med (German) 20:339-343, 1968;.
14 +
Bindschalder DD, Bennett JE:  A pharmacologic guide to the clinical use of amphotericin B . J Infect Dis 120:427-436, 1969;.
15 +
Douglas JB, Healy JK:  Nephrotoxic effects of amphotericin B including renal tubular acidosis . Am J Med 46:154-162, 1969;.
16 +
Patterson RM, Ackerman GL:  Renal tubular acidosis due to amphotericin B nephrotoxicity . Arch Intern Med 127:241-244, 1971;.
17 +
Bailey RR, Gower PE, Dash CH:  The effect of impairment of renal function and hemodialysis on serum and urine levels of cephalexin . Postgrad Med J 46( (suppl) ):60-64, 1970;.
18 +
Curtis JR, Marshall MJ:  Cephaloridine serum levels in patients on maintenance hemodialysis . Br Med J 2:149-151, 1970;.
19 +
Griffith RS, Black HR:  Blood, urine and tissue concentrations of the cephalosporin antibiotics in normal subjects . Postgrad Med J 47( (suppl) ):32-37, 1971;.
20 +
Johnson WD, Applestein JM, Kaye D:  Clinical and laboratory experience with an orally administered cephalosporin . JAMA 206:2698-2702, 1968;.
21 +
Kabins SA, et al:  Cephalexin therapy as related to renal function . Am J Med Sci 259:133-142, 1970;.
22 +
Kirby WM, deMaine J, Serrill WS:  Pharmacokinetics of the cephalosporins in healthy volunteers and uremic patients . Post-grad Med J 47( (suppl) ):47-51, 1971;.
23 +
Kunin CM, Finkelberg Z:  Oral cephalexin and ampicillin: Antimicrobial activity, recovery in the urine and persistence in the blood of uremic patients . Ann Intern Med 72:349-356, 1970;.
24 +
Linquist JA, Siddiqui JY, Smith IM:  Cephalexin in patients with renal disease . N Engl J Med 283:720-723, 1970;.
25 +
Perkins RL, Smith EJ, Saslaw S:  Cephalothin and cephaloridine comparative pharmacodynamics in chronic uremia . Am J Med Sci 257:116-124, 1969;.
26 +
Regamey C, Humair L:  Pharmacokinetics of cephalexin in renal insufficiency . Postgrad Med J 47( (suppl) ):69-78, 1971;.
27 +
Reisberg BE, Mandelbaum JM:  Cephalexin: Absorption and excretion as related to renal function and hemodialysis . Infection and Immunity 3:540-543, 1971;.
28 +
Venuto RC, Plaut M:  Cephalothin handling in patients undergoing hemodialysis . Antimicrob Agents Chemother 10:50-52, 1970;.
29 +
Cimino JE, Tierno PM:  Hemodialysis properties of clindamycin . Appl Microbiol 17:446-448, 1969;.
30 +
Linberg AA, et al:  Concentration of chloramphenicol in the urine and blood in relation to renal function . Br Med J 2:724-728, 1966;.
31 +
Froman J, Gross L, Curatola S:  Serum and urine levels following parenteral administration of sodium colistimethate to normal individuals . J Urol 103:210-214, 1970;.
32 +
Koch-Weser J, et al:  Adverse effects of sodium colistimethate . Ann Intern Med 72:857-868, 1970;.
33 +
Swick HM, et al:  Peritoneal dialysis in colistin intoxication . J Pediatr 74:976-980, 1969;.
34 +
Peets EA, et al:  The absorption, excretion and metabolic fate of ethambutol in man . Am Rev Resp Dis 91:51-58, 1965;.
35 +
Place VA, Thomas JP:  Clinical pharmacology of ethambutol . Am Rev Resp Dis 87:901-904, 1963;.
36 +
Bergen T, Brodwall EK, øyri A:  Renal excretion of gentamicin in chronic pyelonephritis . Acta Med Scand 189:1-6, 1971;.
37 +
Cox CE:  Gentamicin, a new antibiotic . J Infect Dis 119:486-491, 1969;.
38 +
Cutler RE, et al:  Correlation of serum creatinine and gentamicin half-life . JAMA 219:1037-1041, 1972;.
39 +
Gary NE:  Peritoneal clearance and removal of gentamicin . J Infect Dis 124( (suppl) ):96-97, 1971;.
40 +
Gyselynck AM, Forrey A, Cutler R:  Pharmacokinetics of gentamicin: Distribution and plasma and renal clearance . J Infect Dis 124( (suppl) ):70-76, 1971;.
41 +
McHenry MC, et al:  Gentamicin dosages for renal insufficiency: Adjustments based on endogenous creatinine clearance and serum creatinine concentration . Ann Intern Med 74:192-197, 1971;.
42 +
Riff LJ, Jackson GG:  Pharmacology of gentamicin in man . J Infect Dis 124( (suppl) ):98-105, 1971;.
43 +
Smithivas R, et al:  The use of gentamicin in peritoneal dialysis: I. Pharmacologic results . J Infect Dis 124( (suppl) ):77-83, 1971;.
44 +
Warner WA, Sanders E:  Neuromuscular blockade associated with gentamicin therapy . JAMA 215:1153-1154, 1971;.
45 +
Wilfort JN, et al:  Renal insufficiency associated with gentamicin therapy . J Infect Dis 124( (suppl) ):148-153, 1971;.
46 +
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Singer I, Rotenberg D, Puschett JB:  Lithium-induced nephrogenic diabetes insipidus: In vivo and in vitro studies . J Clin Invest , to be published.
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Berkowitz B:  Influence of plasma levels and metabolism on pharmacologic properties: Pentazocine . Ann NY Acad Sci 179:269-281, 1971;.
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Alano FA, Webster GD:  Acute renal failure and pigmentation due to phenazopyridine . Ann Intern Med 72:85-91, 1971;.
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118 +
Reidenberg MM, et al:  Protein binding of diphenylhydantoin and desmethylimipramine in plasma from patients with poor renal function . N Engl J Med 285:264-267, 1971;.
119 +
Fairley KF, Barrie JU, Johnson E:  Sterility and testicular atrophy related to cyclophosphamide therapy . Lancet 1:568-569, 1972;.
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Johnson WW, Meadows DC:  Urinary bladder changes and cyclophosphamide . N Engl J Med 284:290-294, 1971;.
122 +
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123 +
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124 +
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125 +
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127 +
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128 +
Jarzobski J, et al:  Vasculitis with allopurinol therapy . Am Heart J 79:116-121, 1970;.
129 +
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Figures

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Bennett WM, Singer I, Coggins CH:  A practical guide to drug usage in adult patients with impaired renal function . JAMA 214:1468-1475, 1970;.
2 +
Goodman LS, Gilman A: The Pharmacologic Basis of Therapeutics . New York, Macmillan Co, 1970;.
3 +
Reidenberg MM: Renal Function and Drug Action . Philadelphia, W B Saunders Co, 1971;.
4 +
Ritschel WA:  Biological half-lives of drugs . Drug Intelligence and Clin Pharmacol 4:332-347, 1970;.
5 +
Schreiner GE, Teehan BP:  Dialysis of poisons and drugs . Trans Am Soc Artif Intern Organs 17:513-544, 1971;.
6 +
Schreiner GE, et al:  Extracorporeal and peritoneal dialysis of drugs . Handbook of Experimental Pharmacology 28(pt (1) ):403-420, 1971;.
7 +
 Symposium, Drug metabolism in man . Ann NY Acad Sci 179:9-773, 1971;.
8 +
Altman G, et al:  Blood levels of ampicillin, Kanamycin and gentamicin in the uremic . Isr J Med Sci 6:683-690, 1970;.
9 +
Buck AC, Cohen SL:  Absorption of antibiotics during peritoneal dialysis in patients with renal failure . J Clin Pathol 21:88-92, 1968;.
10 +
Koch-Weser J:  Adverse reactions to Sulfasoxasole, Sulfamethoxazole, and Nitrofurantoin . Arch Intern Med 128:399-404, 1971;.
11 +
Kunin CM:  Antibiotic usage in patients with renal impairment . Hosp Practice 7:141-149, 1971;.
12 +
O'Grady F:  Antibiotics in renal failure . Br Med Bull 27:142-147, 1971;.
13 +
Precht K, Briedigkeit H:  Experimentelle Untersuchungen zur Dialysierbarkeit von Antibiotika . Acta Biol Med (German) 20:339-343, 1968;.
14 +
Bindschalder DD, Bennett JE:  A pharmacologic guide to the clinical use of amphotericin B . J Infect Dis 120:427-436, 1969;.
15 +
Douglas JB, Healy JK:  Nephrotoxic effects of amphotericin B including renal tubular acidosis . Am J Med 46:154-162, 1969;.
16 +
Patterson RM, Ackerman GL:  Renal tubular acidosis due to amphotericin B nephrotoxicity . Arch Intern Med 127:241-244, 1971;.
17 +
Bailey RR, Gower PE, Dash CH:  The effect of impairment of renal function and hemodialysis on serum and urine levels of cephalexin . Postgrad Med J 46( (suppl) ):60-64, 1970;.
18 +
Curtis JR, Marshall MJ:  Cephaloridine serum levels in patients on maintenance hemodialysis . Br Med J 2:149-151, 1970;.
19 +
Griffith RS, Black HR:  Blood, urine and tissue concentrations of the cephalosporin antibiotics in normal subjects . Postgrad Med J 47( (suppl) ):32-37, 1971;.
20 +
Johnson WD, Applestein JM, Kaye D:  Clinical and laboratory experience with an orally administered cephalosporin . JAMA 206:2698-2702, 1968;.
21 +
Kabins SA, et al:  Cephalexin therapy as related to renal function . Am J Med Sci 259:133-142, 1970;.
22 +
Kirby WM, deMaine J, Serrill WS:  Pharmacokinetics of the cephalosporins in healthy volunteers and uremic patients . Post-grad Med J 47( (suppl) ):47-51, 1971;.
23 +
Kunin CM, Finkelberg Z:  Oral cephalexin and ampicillin: Antimicrobial activity, recovery in the urine and persistence in the blood of uremic patients . Ann Intern Med 72:349-356, 1970;.
24 +
Linquist JA, Siddiqui JY, Smith IM:  Cephalexin in patients with renal disease . N Engl J Med 283:720-723, 1970;.
25 +
Perkins RL, Smith EJ, Saslaw S:  Cephalothin and cephaloridine comparative pharmacodynamics in chronic uremia . Am J Med Sci 257:116-124, 1969;.
26 +
Regamey C, Humair L:  Pharmacokinetics of cephalexin in renal insufficiency . Postgrad Med J 47( (suppl) ):69-78, 1971;.
27 +
Reisberg BE, Mandelbaum JM:  Cephalexin: Absorption and excretion as related to renal function and hemodialysis . Infection and Immunity 3:540-543, 1971;.
28 +
Venuto RC, Plaut M:  Cephalothin handling in patients undergoing hemodialysis . Antimicrob Agents Chemother 10:50-52, 1970;.
29 +
Cimino JE, Tierno PM:  Hemodialysis properties of clindamycin . Appl Microbiol 17:446-448, 1969;.
30 +
Linberg AA, et al:  Concentration of chloramphenicol in the urine and blood in relation to renal function . Br Med J 2:724-728, 1966;.
31 +
Froman J, Gross L, Curatola S:  Serum and urine levels following parenteral administration of sodium colistimethate to normal individuals . J Urol 103:210-214, 1970;.
32 +
Koch-Weser J, et al:  Adverse effects of sodium colistimethate . Ann Intern Med 72:857-868, 1970;.
33 +
Swick HM, et al:  Peritoneal dialysis in colistin intoxication . J Pediatr 74:976-980, 1969;.
34 +
Peets EA, et al:  The absorption, excretion and metabolic fate of ethambutol in man . Am Rev Resp Dis 91:51-58, 1965;.
35 +
Place VA, Thomas JP:  Clinical pharmacology of ethambutol . Am Rev Resp Dis 87:901-904, 1963;.
36 +
Bergen T, Brodwall EK, øyri A:  Renal excretion of gentamicin in chronic pyelonephritis . Acta Med Scand 189:1-6, 1971;.
37 +
Cox CE:  Gentamicin, a new antibiotic . J Infect Dis 119:486-491, 1969;.
38 +
Cutler RE, et al:  Correlation of serum creatinine and gentamicin half-life . JAMA 219:1037-1041, 1972;.
39 +
Gary NE:  Peritoneal clearance and removal of gentamicin . J Infect Dis 124( (suppl) ):96-97, 1971;.
40 +
Gyselynck AM, Forrey A, Cutler R:  Pharmacokinetics of gentamicin: Distribution and plasma and renal clearance . J Infect Dis 124( (suppl) ):70-76, 1971;.
41 +
McHenry MC, et al:  Gentamicin dosages for renal insufficiency: Adjustments based on endogenous creatinine clearance and serum creatinine concentration . Ann Intern Med 74:192-197, 1971;.
42 +
Riff LJ, Jackson GG:  Pharmacology of gentamicin in man . J Infect Dis 124( (suppl) ):98-105, 1971;.
43 +
Smithivas R, et al:  The use of gentamicin in peritoneal dialysis: I. Pharmacologic results . J Infect Dis 124( (suppl) ):77-83, 1971;.
44 +
Warner WA, Sanders E:  Neuromuscular blockade associated with gentamicin therapy . JAMA 215:1153-1154, 1971;.
45 +
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46 +
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47 +
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48 +
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49 +
McCloskey RV, Becker GG:  Evaluation of the Cutler-Orme method for administration of Kanamycin during renal failure . Antimicrob Agents Chemother 10:161-164, 1970;.
50 +
Bellamy HM, Bates BB, Reinarz JA:  Lincomycin metabolism in patients with hepatic insufficiency . Antimicrob Agents Chemother 7:36-41, 1967;.
51 +
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52 +
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53 +
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54 +
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55 +
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56 +
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57 +
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58 +
Felts JH, et al:  Neural, hematologic and bacteriologic effects of nitrofurantoin in renal insufficiency . Am J Med 51:331-339, 1971;.
59 +
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60 +
Hoffman TA, Bullock WE:  Carbenicillin therapy of Pseudomonas and other gram-negative bacillary infections . Ann Intern Med 73:165-172, 1970;.
61 +
Hoffman TA, Castero R, Bullock WE:  Pharmacokinetics of carbenicillin in hepatic and renal failure . J Infect Dis 122:75-78, 1970;.
62 +
Kind AC, et al:  Mechanisms responsible for plasma levels of nafcillin lower than those of oxacillin . Arch Intern Med 125:685-690, 1970;.
63 +
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64 +
McCloskey RV, Hayes CP:  Plasma levels of dicloxacillin in oliguric patients and the effects of hemodialysis . Antimicrob Agents Chemother 7:770-772, 1967;.
65 +
McClure PD, et al:  Carbenicillin-induced bleeding disorder . Lancet 2:1307-1308, 1970;.
66 +
Whelton A, Carter GG, Garth MA:  Carbenicillin-induced acidosis and seizures . JAMA 218:1942-1943, 1971;.
67 +
Williams TW, et al:  Effect of hemodialysis on dicloxacillin concentration in plasma . Antimicrob Agents Chemother 7:767-769, 1967;.
68 +
DeVita VT, et al:  Pneumocystis carinii pneumonia . N Engl J Med 280:287-291, 1969;.
69 +
Cohn HD:  Clinical studies with a new rifamycin derivative . J Clin Pharm 9:118-125, 1969;.
70 +
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71 +
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72 +
Little PJ, Bailey RR:  Tetracyclines and renal failure . NZ Med J 72:183-184, 1970;.
73 +
Mahon WA, Wittenberg JV, Tuffnel PG:  Studies on the absorption and distribution of doxycycline in normal patients and patients with severely impaired renal function . Can Med Assoc J 103:1031-1033, 1970;.
74 +
Maclean D:  Treatment of paracetamol poisoning . Lancet 2:849-852, 1968;.
75 +
Prescott LF:  The metabolism of phenacetin in patients with renal disease . Clin Pharmacol Ther 10:383-394, 1969;.
76 +
Proudfoot AT, Wright N:  Acute paracetamol poisoning . Br Med J 3:557-558, 1970;.
77 +
Davison C:  Salicylate metabolism in man . Ann NY Acad Sci 179:249-268, 1971;.
78 +
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79 +
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80 +
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81 +
Koechlin BA, et al:  The metabolic fate of 14C-labelled chlordiazepoxide in man, in the dog, and in the rat . J Pharmacol Exp Ther 148:399-411, 1965;.
82 +
DeSilva JA, Koechlin BA, Bader G:  Blood level distribution patterns of diazepam and its major metabolites in man . J Pharm Sci 55:692-702, 1966;.
83 +
Drach JC, et al:  Species differences in metabolism of diphenhydramine (Benadryl) . Proc Soc Exp Biol Med 135:849-853, 1964;.
84 +
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85 +
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86 +
Berkowitz B:  Influence of plasma levels and metabolism on pharmacologic properties: Pentazocine . Ann NY Acad Sci 179:269-281, 1971;.
87 +
Berkowitz B, Way EL:  Metabolism and excretion of pentazocine in man . Clin Pharmacol Ther 10:681-689, 1969;.
88 +
Spector S, Vessel ES:  Disposition of morphine in man . Science 174:421-422, 1971;.
89 +
Way EL:  Distribution and metabolism of morphine and its surrogates . Proc Assoc Res Nerv Ment Dis 46:13-31, 1968;.
90 +
Alano FA, Webster GD:  Acute renal failure and pigmentation due to phenazopyridine . Ann Intern Med 72:85-91, 1971;.
91 +
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92 +
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93 +
Reidenberg MM:  Protein binding of diphenylhydantoin and desmethylimipramine in plasma from patients with poor renal function . N Engl J Med 285:264-267, 1971;.
94 +
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95 +
Koch-Weser J:  Pharmacokinetics of procainamide in man . Ann NY Acad Sci 179:370-382, 1971;.
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Koch-Weser J, Klein SW:  Procainamide dosage schedules, plasma concentrations, and clinical effects . JAMA 215:1454-1460, 1971;.
97 +
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98 +
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99 +
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100 +
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102 +
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105 +
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106 +
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To understand the clinical management of acute heart failure syndromes.
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Compression-Only CPR: Pushing the Science Forward
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