Imaging modalities frequently utilize iodinated-based contrast agents (IBCAs) to assist professionals in deficit identification and improve clinical outcomes for patients. However, they are not without risk. In patients with post-radiological neurological deficits, contrast-induced neurotoxicity (CIN) should be among the top differentials. In this case report, we present the case of a 61-year-old female who experienced classical signs and symptoms of neurotoxicity after a cerebral angiogram. The patient's clinical detriments stemming from iodinated contrast resolved after a multi-day treatment of high-dose steroid use.

Remdesivir is an antiviral, nucleoside analog used extensively during the coronavirus-disease 2019 (COVID-19) pandemic with proven efficacy against COVID-19-induced acute respiratory distress syndrome (ARDS). Our case report details the clinical course of a 50-year-old, COVID-19-positive patient who developed sinus arrest after being treated with remdesivir. Within 24 hours of discontinuing remdesivir therapy, the patient's sinus arrest resolved to a normal sinus rhythm. The findings from our case report add to a growing body of evidence on the cardiotoxic profile of remdesivir. Remdesivir's ability to cause bradyarrhythmias, and specifically sinus arrest, should be acknowledged when considering the use of this drug in at-risk patients.

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San Francisco Endogenous o p i a t e s a r e involved i n a d u l t c i r c u l a t o r y responses t o s t r e s s and may function by decreasing s e n s i t i v i t y of n i c o t i n i c receptors (Nature 283:489, 1980). To examine t h e i r r o l e i n the f e t u s , we studied the h e a r t r a t e (HR) and mean a o r t i c pressure (MAP) responses t o maternal hypoxemia i n 5 nonnoxic (N:pO2>2OmmHg, pH27.38) and 5 chronically s t r e s s e d f e t u s e s (S:pOe2OmmHg spantaneously f o r > 24 hours) a t 120-130 days g e s t a t i o n . and were s i m i l a r during c o n t r o l recordings i n both groups. H R decreased (p<0.001, ANOV) and MAP increased (p<0.001, ANOV) i n response t o hypoxia i n a l l animals. I n N f e t u s e s during hypoxia, naloxone (Nx: 1 mgfkg) increased MAP from 55f4 t o 61f4 (~~s E M , p<0.001, ANOV) i n the 5 minutes following i t ; but H R did not c h a n g e . I n t h e s t r e s s e d f e t u s e s during hypoxia, Nx did not change MAP but decreased from 161f12 t o 140213 (p<0.001, ANOV). . Blood pH f e l l 0.09f0.03 and 0.1f0.02 u n i t s following Nx i n t h e N and S f e t u s e s respectively (p<0.005, paired t -t e s t ) .The Nxinduced r i s e i n i n t h e N f e t u s e s i s consistent with increased vasoconstriction due t o p o t e n t i a t i o n of sympathetico-adrenala c t i v i t y and a balanced parasympathetic-sympathetic e f f e c t on HR. The lack of a response t o Nx i n the S f e t u s e s suggests exhaustion of s y m p a t h e t i c~~a d r e n a l output which unmasks the parasympathetic e f f e c t on HR. These data i n d i c a t e t h a t endogenous o p i a t e s a r e involved i n HR and MAP c o n t r o l i n utero, and a r e c o n s i s t e n t with a Nx f a c i l i t a t e d increase i n ganglionic transmission. (Supported i n p a r t by NIH grant HL00756-01.) IS THERE REALLY A GENTAMICIN DOSE SCHEDULE FOR 344 NEONATES? M. Leitner, L. Steddum, A. Sola, C. Kapadia, J. Gershanik, (Spon. by G. Gregory), Southern B a p t i s t Hospital, Department of Neonatology, New Orleans Recent evidence suggests t h e need t o modify t h e gentamicin (G) dose regimen f o r neonates. To determine t h e appropriate drug schedule we measured 587 gentamicin serum l e v e l s (G.S.L.) on 150 neonates, (G.A. 25-43 wks. and B. W. 680-4820 qms.) admitted t o our NICU. When we used t h e standard dose of 2.5 mg/kg q 12 H our r e s u l t s during t h e f i r s t 2 days of l i f e revealed trough l e v e l s 7 2 ug/ml i n 53.6% (42/78), suggesting possible G accumul a t i o n , and peak 1evels)E ug/ml i n 18% (14/78) a n d L 4 ug/ml i n 10% (8/78). W e then modified t h e i n i t i a l dose regimen according t o g e s t a t i o n a l age:(30 wks., 1.5-2.0 mg/kg q 24 H; 30-37 wks., 2.0-2.5 mg/kg q 18 H; a n d 2 3 7 wks., 2.0-2.5 mg/kg q 12 H. Subsequent r e s u l t s showed a marked decrease i n babies withe e l evated trough l e v e l s (~2 ug/ml) t o 16.6% (12/72). Peak l e v e l s 7 8 ug/ml decreased t o 6.8% (5/72). However, peak l e v e l s 4 4 ug/ m l increased t o 27% (20...

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