Treatment
In critically ill patients admitted to an intensive care unit, if phosphate drops to below 0.65 mmol/L (2.0 mg/dL) from a previously normal level within three days of starting enteral or parenteral nutrition, caloric intake should be reduced to 480 kcals per day for at least two days while electrolytes are replaced. Daily doses of thiamine, vitamin B complex (strong) and a multivitamin and mineral preparation are strongly recommended. Blood biochemistry should be monitored regularly until it is stable. Although clinical trials are lacking in patients other than those admitted to intensive care, it is commonly recommended that energy intake should remain lower than that normally required for the first 3–5 days of treatment of refeeding syndrome for all patients. History
In his 5th century BC work On Fleshes (De Carnibus), Hippocrates writes, "if a person goes
seven days without eating or drinking anything, in this period most die; but there are some who survive that time but still die, and others are persuaded not to starve themselves to death but to eat and drink: however, the cavity no longer admits anything because the jejunum (nêstis) has grown together in that many days, and these people too die." Though Hippocrates misidentifies the cause of death, this passage likely represents an early description of refeeding syndrome. The Roman Historian Flavius Josephus writing in the first century described classic symptoms of the syndrome among survivors of the siege of Jerusalem.
Mirabegron, sold under the brand name Myrbetriq among others, is a medication used to treat overactive bladder. Its benefits are similar to antimuscarinic medication such as solifenacin or tolterodine. It is taken by mouth.Common side effects include high blood pressure, headaches, and urinary tract infections. Other significant side effects include urinary retention, irregular heart rate, and angioedema. It works by activating the β3 adrenergic receptor in the bladder, resulting in its relaxation.Mirabegron is the first clinically available beta-3 agonist with approval for use in adults with overactive bladder. Mirabegron was approved for medical use in the United States and in the European Union in 2012. In 2019, it was the 189th most commonly prescribed medication in the United States, with more than 3 million prescriptions. In the United Kingdom it is less preferred to antimuscarinic medication such as oxybutynin. Medical uses
Mirabegron is used is in the treatment of overactive bladder. It works equally well to antimuscarinic medication such as solifenacin or tolterodine. In the United Kingdom it is less preferred to these agents.Mirabegron is also indicated to treat neurogenic detrusor overactivity (NDO), a bladder dysfunction related to neurological impairment, in children ages three years and older.