Random CCT questions

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Random CCT questions
2010-03-21 08:50:50

Random CCT cards
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  1. Factors Influencing Blood Pressure
    • BP=CO (HRxSV) x SVR
    • CO=Cardiac Output
    • HR-Brady/Tachy could ↓ BP SV
    • Hypovolemia ↓ Preload/↓BP SVR
    • Anaphylaxis
    • Sepsis
  2. Chronotropic/Dromotropic/Inotropic
    • Chronotropic:Heart Rate
    • Dromotropic: Conduction Velocity
    • Inotropic: Contractility
  3. On 12 Lead-Right Ventricular Strain/P.E. S1 Q3
    • T3S Wave in I
    • Q Wave in III
    • T Wave Inversion in III
  4. L.E.M.O.N Score Used to Evaluate ease of Intubation
    • Used to Evaluate ease of Intubation
    • Look-Beard, Trauma, Obese, Buck Teeth
    • Evaluate-3,3,2,(fingers) 3 mouth opening, 3 Hyoid to Mentum, 2 Hyoid to Thyroid
    • Mallampatti-Class I-IV
    • Obstruction-Blood, Teeth, Vomit, etc
    • Neck- Mobility≥2 = Difficult Intubation&nbsp
  5. Treatment for Hyperkalemia C BIG K DropS
    • "Calcium for Myocardial Contractility
    • Bicarb stimulates exchange cellular H+ ↔ Na+
    • Shoulder Dystocia
  6. H.E.L.P.E.R
    • Call For Help
    • Episiotomy
    • Empty Bladder
    • Legs Up (McRoberts)Supra-pubic Pressure
    • Enter Maneuvers (Wood's Screw)
    • Remove Posterior Arm
    • Class: AnticholinergicAction: Blocks Acetylcholine thus ↓Parasympathetic
  8. MANNITOL 20%
    • Class: Osmotic DiureticAction: Draws fluid into intravascular space and increases fluid excreted by Kidneys. Thus ↓Cerebral EdemaIndications: ↑ICP
    • Measure of GFR
  9. TNK Tenecteplase
    • Class: Fibrinolytic AgentAction: Tissue Plasminogen Activator (tPA) binds to fibrin and converts plasminogen to plasmin. This cleaves the fibrin thrombus.Indications: Occlusive Coronary Thrombi associated with M.I.Contraindications: Bleeding
    • Hx Hemorrhagic CVA
    • Class: Anesthetic (non-Barbiturate)Action: CNS↓ similar to Benzo's and Barbiturates.  Potentiates  GABA receptor causing Cl- to enter cell making it harder to depolarize.  Also acts as a Sodium Channel Blocker.Indications: Excellent choice for Induction also Maintenance in Ventilated Patients. Contraindications: <12yrs or <40kgReactions: ↓BP
    • Apnea
  11. GABA
    • The major inhibitory neurotransmitter in the CNS.  
    • Upon activation the GABA-A receptor selectively conducts Cl- through it's pore
    • Class: Sympathomimetic 
    • Action: Dopaminergic Effects 0.5-5mcg/kg/min (not proven)β1 Effects 5-10 mcg/kg/minα Effects 10-20 mcg/kg/min
    • Indications: Correct Hemodynamic Instability and Renal Blood FlowReactions: Ectopic beats tachycardia
    • Class: SympathomimeticAction: Norepi is an Alpha and Beta-1 Adrenergic AgonistPotent Vasoconstrictor ↑Contractility
    • Indications: Cariogenic Shock
    Class: BarbiturateAction: Acts on Na+ and K+ Channels of the Neuron.  Also has effect on GABA receptors on the neuron causing influx of Cl- into the cell.Indications: Prevention and Tx of Seizure Activity
    • Class: Anesthetic/Hypnotic 
    • Action: Produces hypnosis causing CNS depression and Anesthesia 
    • Indications: Induction of Anesthesia for RSI/Facilitated.Ideal for CHI as it has no Histamine Response therefore little effect on BP.
    • Reactions: Myoclonus *Give Fentanyl prior to administration of Etomidate*
    • muscle tremors
    • Class: Antihypertensive
    • Action: Lowers BP by altering cellular Ca+ metabolism causing peripheral vasodilation *Arteriolar Dilator*.
    • Indications: Severe HTN Eclamptic HTN. 
    • Contraindications: Idiopathic Lupus
    • Whole Blood (LRF): Contains EBC's and Plasma
    • Red Blood Cells (LRF): Only EBC's
    • Platelets (LRF): *Suspended in Plasma*
    • Plasma/FFP (LRF): Plasma Proteins
    • Clotting Factors as Fibrinogen and FactorIX. ↑Pressure
  18. Pleural Effusion
    Pus serum
  19. KETAFOL Propofol-ketamine technique
    • is a non-BVM spontaneous ventilation intravenous dissociative anesthetic. 
    • *Monitor For Apnea*
    • Dose: 0.5mg/kg and 0.5 mg/kg each
    • Class: Antiarrhythmic /Local Anesthetic  
    • Action: Sodium Channel Blocker that alters depolarization in neurons.
    • Indications: PVC's Ventricular Tachydysrhythmias
    Class: Sympathomimetic Action: β1 β2
    • Class: β2 Bronchodilator 
    • Action: Stimulation of β2 adrenergic receptors in Bronchial smooth muscle
    • Indications: Asthma COPD
    • Class: Anesthetic
    • Action: Dissociative Anesthesia Anelgesia
    • Indications: Anesthetic for Procedures
  24. Adult vs Pediatric Airway
  25. NARCAN  Class:  Narcotic AntagonistAction: Blocks Opiate ReceptorsIndications: Respiratory Depression due to narcotic overdose
    “Coma Cocktail”Reactions: Withdrawal
  26. BETA BLOCKER O.D.  PacingAtropineGlucagon ++Insulin 100u then 10u/hr(with D50)Intralipid  (TPN IV) Soaks up β Blocker with fats 
  27. MIDAZOLAM/VERSED Class: BenzodiazepineAction: Benzo’s cause major inhibitory transmissions in CNSIndications: Anxiolytic
  28. CVP Normal: 2-8mm/hgCVP is a numerical value that represents the right atrial pressure or right ventricle filling pressure.Simply: CVP is an indication of fluid status and right cardiac function. 
  29. FORMULA TO CORRECT ETCO2 Take ETCO2 you HAVE÷WANTThen multiply by current:Respiratory Rate
  30. AMIODARONE Class: AntiarrhythmicAction: Repolarization inhibition
    increases refractory period of Atria
  31. PARTIAL THROMBOPLASTIN TIME Activated PTT 30-40 secondsCritical Value: >70 SecondsIndications: PTT test is used to assess the Intrinsic system and the common pathway of clot formation.Also used to monitor heparin therapy.
  32. LORAZEPAM/ATIVAN Action: bind to Benzo receptor next to GABA receptor  which causes an influx of Cl- into the cell thus making it harder to depoloraize.Anxiolyic then
    anticonvulsant decreasing muscle tonus.Indication: Sedation
  33. ANTIDOTES AcetaminophenAnticholinergicsBenzo'sβ BlockersCa++ BlockersDigoxinMethanol/Ethylene GlycolOpiodsOrganophosphatesTCACyanideCoumadin   Acetaminophen-Mucomyst Anticholinergics-PhysostygmineBenzo's-Flumazenilβ Blockers-GlucagonCa Blockers-Ca ChlorideDigoxin-DigibindMethanol/Ethylene Glycol-AntizolOpiods-NarcanOrganophosphates-AtropineTCA-NaHCO3Cyanide-B12Coumadin-Vitamin K
  34. Ca++ Normal 8-10Serum calcium test is used to evaluate Parathyroid function (controls Ca++)Muscle contractility
    Blood Clotting
  35. ARDSDx and TX Dx: PaO2 <200mmHg on an FiO2 1.0Bilateral Infiltrates on CXRNon-Cardiogenic Pulmonary EdemaPCWP <18mmHgTx: Vt 5-6cc/kg
    f>25BPM to prevent over distention.High PEEP (Splint Alveoli)FiO2 of 1.0↑Rise TimeHigh Frequency Oscillator (HFO)   
  36. HALDOL Class: AntipsychoticAction: Unknown
    Antidopinergic that may block post synaptic dopamine.Indications: Psychotic Disorders
  37. STEMITIL Class: Tranquilizer
    AntiemeticAction: Acts on chemoreceptor trigger zone to inhibit N+V Reactions: Hypotension
  38. CREATININE Normal 50-100umoL/l Creatinine is a catabolic product of Creatinine Phosphate
    which is used in skeletal muscle contraction.  Creatinine is excreted by kidneys.A doubling of Creatinine suggests a 50% reduction in GFR.Unlike B.U.N. creatinine is minimally affected by hepatic function. 
  39. HEMOGLOBIN Normal 130-180 g/l Vehicle for O2 and carbon dioxide transportAlso acid base buffer systemIndicated: Hgb tests are repeated serially in pt’s with ongoing bleeding or evaluating anemia.Elevated: Intravascular sludging
  40. PLATELETS  Normal 150-400 Number of THROMBOCYTES (platelets) per cubic mm of blood.  It is preformed on all patients who develop petechiae
    spontaneous bleeding
  41. GLASGOW COMA SCALE  EYE OPENING            4 Spontaneous3 To Voice2 To Pain1 None VERBAL RESPONSE            5 Oriented4 Confused3 Inappropriate Words2 Incomprehensible Words1 None MOTOR RESPONSE             6 Obeys Command5 Localizes4 Withdraw3 Flexion2 Extension1 None 
  42. LASIX/FUROSEMIDE Class: Loop DiureticAction: Loop diuretic that inhibits Na+ and Cl- re-absorption at the proximal and distal tubules in ascending Loop of Henle.Indications: Acute Pulmonary Edema
  43. DIAZEPAM/VALIUM Class: BenzodiazepineAction: Benzo’s bind to Benzo receptor next to GABA receptor causing an influx of Cl- into the cell thus making it harder to depolarize.Indications: Anxiolytic
  44. INSULIN Class: Hypoglycemic Agent
    produced in the Islets of Langerhans in the pancreas.Action: Insulin causes cells in the liver
  45. Dextrose in Water 50%(D50) Class: Caloric AgentAction: Increases blood glucose
    Transient osmotic diureticIndications: < 4mmol BGT
  46. ROCURONIUM Class: Non-depolarizing neuromuscular BlockerAction: Binds competitively to cholinergic receptors at motor-end plate to antagonize action of Acetylcholine.  Reversible in the presence of Acetylcholinerase inhibitors such as Neostigmine and Edrophonium.Reactions: Arrhythmia
  47. NEUROTRANSMITTERS FOR A.N.S  ACEYTLCHOLINE: Released at the synapses of the Parasympathetic nerves and at neuromuscular junctions (cholinergic).Bind to nicotinic and muscarinic receptors. EPINEPHERINE and NOREPINEPHERINE: Postgangliotic sympathetic neurons. AKA Catecholamines.Bind to Alpha and Beta receptors
  48. HEPARIN Action: Blood clot prevention
    does not dissolve preexisting clots.Indications: Prevent extension/prophylaxis/treatment of thromboembolic
  49. P.E.A. CAUSES H’s and T’sH+ (acidosis)HypoxiaHypovolemiaHypothermiaHyper/Hypo K+T's Thrombosis P.E.Thrombosis M.I.Tension PneumothoraxTamponadeToxins
  50. DEXAMETHASONE Action: Predominately glycocorticoid activity with low mineralo-corticoid activityIndications: Situations when a rapid hormonal effect is desired. Ex: Anaphylaxis
  51. Tx for Chest Pain  M.O.N.A. : Morphine
  52. ATROVENT/IPRATROPIUM   Action: Anticholinergic (parasympatholytic) bronchodilator.  As a derivative of atropine it acts locally in the lungs and exerts its effects by blocking acetylcholine at muscarinic receptors in the lungs (parasympathetic receptors).  This is achieved by inhibiting the increase of cGMP
    which occurs with parasympathetic activation.Respiratory: inhibits parasympathetic tone and relaxes bronchial smooth muscle. Indications: Asthma
  53. CV4 SET UP  Compliance CheckPneumotach 1.     Set Peak Pressure High (50mmHg)2.     Set Max Pressure (40mmHg) *Blow Off Valve3.     Lower Peak to Desired (30ish)Go to main menu and set orders 
  54. P.P.H. CAUSES and TREATMENT 4 T’s – Tone
  55. RULE OF THE NINES **Also can use Rule of the Hands" which roughly states that the palm of the patients hand is Approx. 1%"
  56. L.E.M.O.N. LOOK (1) Beard
    Buck Teeth
  57. S+S TENSION PNEUMOTHORAX Decline in O2 Saturation*Hypotension*↓Lung SoundsJVDSub-Q Emphysema AgitationRespiratory DistressCardiovascular Collapse (BP
    HR)P.E.A.VENTED PATIENTSFighting the Vent"Sudden ↑PIP'sCXRDeep Sulcus Sign"
  58. PEDIATRIC RSI PROTOCOL PreoxygenatePremedicate: Atropine 0.02mg/kg
    Fentanyl 1mcg/kgInduction: Midazolam 0.1mg/kg (SBP >80 mmHg)Muscle Relaxation: Succinylcholine 2mg/kgCricoid PressureIntubate and CONFIRM 
  59. CLASSES of ANTIDYSRHYTHMICS Class I - Sodium Channel Blockers (Dilantin
  60. DIGOXIN Action: Decreases conduction of electrical impulses through the AV Node
    thus causing increased contractility via inhibition of the Na+/K+ ATPase Pump.Indications:A-Fib
  61. DILTIAZEM/CARDIZEM Diltiazem is a member of the group of drugs known as benzthiazepines
    which are a class of Calcium Channel Blockers
  62. ARTERIAL BLOOD GASSES pH 7.35-7.45PCO2 35-45 mmHgHCO3- 21-28 mEq/LPo2 80-100mmHgSPO2 95-100%Base Excess 1 ± 2 mEq/L
  63. NITROGLYCERIN Class: VasodilatorAction: Vasodilation
     ↓Coronary Vasospasm
  64. DILANTIN/PHENYTOIN  Class: Anticonvulsant
    AntiarrhythmicAction: Sodium channel blocker in neurons.Indications: Seizure Suppression
  65. PRE-INTUBATION MEDICATIONS Succinylcholine 1.5mg/kg (2mg/kg Peds)Atropine 0.02mg/kgLidocaine 1.5 mg/kgFentanyl 1-2mg/kgVersed 0.1mgkg (MAP >80)Ketamine 1-2 mg/kgPropofol 1-2mg/kgEtomidate 0.2-0.3mg/kg *Fentanyl should be administered prior to etomidate to avoid myoclonus  Rocuronium 0.6mg/kg
    Maintenance 0.3mg/kg (Confirm ETT placement
  66. 7 P's of INTUBATION Preparation (SSLOPESS MDT)Pre-OxygenationPretreatment (Lidocaine
    Atropine)Paralysis with Induction (Versed
    Amphetamines Dilated PupilsDiaphoresisTachycardiaHypertensionSeizuresPsychomotor Agitation Tx ++Benzo’s
  68. CARBON MONOXIDE POISONING CO binds to iron containing compounds (hemo/myoglobin)
    respiratory enzymes
  69. OPIOID O.D. Morphine
  70. IRON O.D. Found in Vitamins Moderate Toxicity 20-60mg/kg0-6hrs post: N+V
    Abdominal pain6-24hrs: Latent period with few symptoms>24hrs: Shock with lactic acidosis
  71. CHOLINERGIC O.D./POISONIONG Organophosphates
    Carbamate Insecticides
  72. HEMABATE Class: OxytocicAction: Synthetic Prostaglandin which stimulates uterine contraction.Indications: Postpartum hemorrhage refractory to Oxytocin or  Uterine MassageContraindications: Patients with known active cardiac
  73. NORMAL RENAL OUTPUT 1-2cc/kg.hr Shows perfusion in patient (kidneys)2-4cc/kg/hr in children
  74. DIGITALIS/DIGOXIN Class: GlycosideAction: Positive Inotropic effect has 2 components: Inhibits the Na+/K+ ATPase (Sodium Pump) and increases inward current of Ca++
    therefore increases the force of myocardial contraction.  Slows conduction through the AV Node.Indications: CHF
  75. PEDS FLUID MAINTENANCE4-2-1 4cc x (0-10kg)2cc x (10-20kg)1cc x (20kg and greater) Add together and total equals cc’s to be delivered per hour 
  76. SALICYLATE O.D. Aspirin
    Vicks Vaporub
  77. DEXAMETHASONE/DECADRON Class: Corticosteroid
    AntiemeticAction: Glycocorticoid activity with low mineral-corticoid activityIndications: Situations when rapid and intense hormonal effect is desired
  78. TROPONINS Normal FindingsT<0.2ng/mlI <0.03ng/mlIndications: Performed on Chest Pain patients to determine M.I. Cardiac Specific Troponins are more specific for Cardiac Muscle injury.  CPK-MB can be evaluated with severe skeletal muscle injury or with brain and lung injury as well as renal failure.Markers begin to rise at 4-6 hours but will peak at 18-24 hours.
  79. DIMENHYDRINATE Gravol/Dramamine Class: Antiemetic
    AntivertigoAction: Decreases sensitivity of the labyrinth apparatus that relays the stimulus to the chemoreceptor trigger zone and stimulates the vomiting center of the brain.Indications: N+V
  80. DIPHENHYDRAMINE BenadrylClass: AntihistamineAction: H1 receptor blocker antagonizing actions of histamine (Not H2)Indications: Tx of severe allergic reactions/prevention of allergic reactionsReactions: CNS depression
    Anticholinergic effects (benaDRYl) dry mouth
  81. ANTIZOL/FOMEPIZOLE Class: Alcohol Dehydrogenase InhibitorAction: Inhibits uptake of alcohol dehydrogenaseIndications: Ethylene glycol or Methanol poisoningConsiderations: When antizol crystallizes it should be liquefied by running it under warm water or in your hands (solidification does not effect efficacy) Dosage: 15mg/kg IV over 30 minutes 
  82. MORPHINE SULPHATEMSO4 Narcotic AnalgesicAction: Analgesic
  83. MAGNESIUM SULPHATE Class: Tocolytic
  84. B.U.N./UREA Normal value: 3-7Indications: Measurement of renal function and GFR (if no hepatic problem)Explanation: BUN measures amount of urea nitrogen in blood (ammonia).  Urea is a metabolic byproduct of the liver.  If there is no hepatic involvement and BUN is elevated this would indicate decreased renal function.
  85. IMMUNE GLOBULIN INTRAVENOUSHUMAN (10%) IGIVSterile solution of human immune globulin protein made from plasma.  Indications: Idiopathic Thrombocytopenic Purpa to rapidly raise platelet counts
    to prevent bleeding or to allow a patient with ITP to undergo surgery. Adverse Effects: TRALI
  86. RIGHT LUNG ATELECTASIS Collapse of the lung leads to a loss of volume of the lung
    therefore radiological landmarks will be distorted.Liquid DensityLoss of lung volumeTrachea Shifted to Right*If Left side of a CXR is homogeneous a right mainstem intubation should be suspected (look for ETT placement)* 
  87. BILATERAL INFILTRATESPulmonary Edema is divided into two categories:Cardiogenic or Non-Cardiogenic Non-Cardiogenic edema is caused by changes in the capillary permeability (ARDS
  88. TENSION" Pneumothorax Right SideA tension pneumo can not be diagnosed by a Chest X-Ray as the "tension" diagnosis means cardiovascular collapse (↓BP).Trachea shift to the left
  89. RIGHT SIDED PNEUMOTHORAXVascular shadows disappear as the lung is replaced by air.This patient must have a chest tube(s) inserted prior to transport with a confirmation CXR post procedure.
  90. EMPHYSEMA/COPD Lung fields very dark (make sure not over-exposed)Large amounts of air due to loss of interstitial tissueFlattened diaphragms due to air trappingAvascular areas represent bullae  
  91. LUNG MASS-Left side above cardiac shadowDensity
    round or ovalNo respect for anatomyDiagnosis for unexplained masses could be: Cancer
  92. CONSOLIDATION left lower lungThe state in which the alveoli are filled with fluid produced by inflamed tissue.  There is little loss of volume
    no mediastinal shift
  93. S.S.L.O.P.E.S.SM.D.T. SuctionStyletLaryngoscopePositioning/PillowETT One larger/smaller/cuffSyringe-on ETTStylet-in ETTMagillsDifficult Airway KitTape/Tube Tie 
  94. **DISCLAIMER** *These are my own personal notes that I have collected over the years* All medications
  96. GLUCAGON Class: Hyperglycemic AgentAction: ↑blood glucose by catalyzing liver glycogen stores to glucose.Indications: Hypoglycemia
     β Blocker toxicity
  97. DOBUTAMINE  Class: SympathomimeticAction: Affects B1 receptors
    Increases Inotropic
  98. FENTANYL Class: Narcotic AnalgesicAction: Synthetic opioid that blocks pain receptors. Fentanyl is 80-100x more potent than morphine and has less histamine response thus less likely to cause N+V and Decrease BP.  Fentanyl is shorter acting than Morphine.Indications: Analgesia
    facilitates intubationReactions: Respiratory depression *monitor RR
  99. LABETOLOL   Class: Antihypertensive Action: Alpha and Beta Blocker (non-selective)Blocks Alpha
    decreases sympathetic stimulation
  100. MEAN ARTERIAL PRESSURE CALCULATIONS MAP = (CO x SVR) + CVP1Systolic + 2Diastolic / 3 = MAPorDiastolic + 1/3 Systolic = MAPThe MAP is considered to be the Perfusion Pressure delivered to the organs of the body.A MAP >60 is needed for adequate perfusion of organs.  Any sustained period below this will cause end-organ ischemia.
  101. CAUSES OF COMA Structural Causes: Bleeding
    Head Trauma
  102. PEDS WEIGHT CALCULATION Age x 2 + 8 = kgAge 11 and up: Multiply age x 3 =kg
  103. ADENOSINE Class: Antiarrhythmic  Action: Endogenous purine nucleoside that slows conduction through the AV node and interrupts AV-nodal reentry. Can restore NSR in PSVT via modulation of K+ currents and blunting of catecholamine response.Indications: PSVT
    Wolff-Parkinson White Syndrome
  104. OXYTOCIN Class: Synthetic OxytocicAction: Increases uterine contraction by increasing free intracellular calcium.  This also stimulates vasoconstriction and lactation.Indications: Stimulate uterine contractions in Post Partum Hemorrhage. Therapeutic induction of labour at full term.Reactions: Hypotension
  105. I.N.R. International Normalized RatioINR measures the extrinsic pathway factors.  Used to determine clotting in the blood from Coumadin/Warfarin and Vitamin K stores.Normal 0.8-1.2This number should be 1.5-2.5 times greater than normal if adequately medicated.OCTOPLEX: quickest way to reverse Coumadin Effects.  Vitamin K-6 hours
  106. 30 SECOND STROKE EXAM Motor: Arms straight out
    eyes closed
  107. WHITE BLOOD CELL COUNT Normal Findings: 4-11WBC's main function is to fight infection and react against foreign bodies.Increased Leucocytes indicates possible infection of injury (Leukocytosis).Decreased Leucocytes indicates possible drug toxicity
    or bone marrow failure (Leukopenia).
  108. SODIUM BICARBONATENaHCO3 Action: Neutralizes and Buffers excessive body acidsIndications: Tx Metabolic Acidosis
  109. Solu-medrolMethylprednisolone Class: Glucocorticoid Action: Prolonged anti-inflammatory
    immunosuppresive and anti-allergic.  Steroids decrease inflammation by reversing mucosal edema
  110. SUCCINYLCHOLINEQUELICIN Class: Depolarizing neuromuscular blocking agent.Action: Combines with cholinergic receptors of the motor end plate to produce depolarization (observed as fasiculations).  Attaches to nicotinic receptor and acts like Acetylcholine to depolarize the junction.Indications: As an adjunct with anesthesia for intubation-RSI. Contraindications: Hyperkalemia
    Post acute phase of injury >24hours (Burns
  111. 12 Lead areas of Infarct Blue: LateralRed: InferiorYellow: SeptalGreen: Anterior
  112. OXYHEMOGLOBIN DISASSOCIATION CURVE  Drowning in a Hot Tub of Acid or Floating in a Cool Pool of Alkaline""
  113. INTERNAL STRUCTURE OF THE BRAIN-with Functions Hypothalamus: Body temp
    H2O Balance
  114. PHENYLEPHRINE Phenylephrine IV is an α1 adrenergic receptor agonist used to increase blood pressure(vasopressor). Can be used to mitigate responses from anesthetic drugs for sedation.Dose: 50-200mcg IVP
    dilute 1mg of 1% (10mg/ml) into 100cc to make 100mcg/ml. q 10-15 min PRNInfusion: 100-200mcg/minAlso used in spray form for nasal intubation (decongestant).
  115. VOLUVEN Voluven (6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride injection) is indicated for the treatment and prophylaxis of hypovolemia. It is not a substitute for RBC's or coagulation factors in plasma.Electrolytes (mEq/L): Sodium 154
    Chloride 154. pH 4 to 5.5. Calculated osmolarity 308 mOsmol/L.Dose: 50ml/kg maximum daily doseEmergent correction of hypovolemia use one 500ml bag at a time.*Infuse first 20ml slowly and watch for anyphalactiod reactions*
  116. VIRCHOW'S TRIAD Virchow's Triad is the three broad categories of factors that are thought to contribute to thrombosis.HYPERCOAGULABILITY: Pregnancy
  117. ANION GAP Na - (Cl+ HCO3)*Normal: 8-16*A high Anion Gap means Bicarbonate (HCO3) is replaced by an unmeasured anion.MUD PILES"MethanolUremiaDKAParaldehyde
  118. OSMOLAR GAP If Anion Gap is elevated figure out Osmolar Gap.>10 should be investigatedFrom this measurement
    the clinician can calculate the plasma osmolarity of a patients blood.If the calculated gap is above an acceptable range
  119. ACETAMINOPHEN / TYLENOL Action: Analgesic and antipyretic effects are believed to be related to the inhibition of prostaglandin synthetase (shared by ASA)
    with antipyretic effects produced through action on the hypothalamic heat-regulating centre.Indications: Patients who are febrile with temp >38°C as an increase in temp can use in excess of 5-10% O2 consumtion.Dose: >60kg 100mg PO/PR q 4hrsPeds: 15mg/kg 
  120. METOPROLOL Action: β Blocking agent with a preferential effect on β1 adrenoreceptors primarily located in cardiac muscle.*At higher doses inhibits β2 located in bronchial and vascular muscle so CONTRAINDICATED in the presence of Asthma or COPD.Indications: Mild to moderate HTN
  121. VENTILATOR STRATEGIES TO:↑Oxygenation↑Ventilation ↑OxygenationFiO2 of 1.0↑PEEPProlong I Time (↓flow)↑ Peak Inspiratory PressureInspiratory Hold↑Ventilation↑ frequency↑Tidal Volume(f and Vt ↑'s minute volume)↑E time-in Asthma
  122. SIMV vs A/C SIMV: Syncronized Intermittent Mandatory Ventilation -Between machine breaths patient can breath spontaneously at their own Vt.If patient breathes on their own in a set time then vent will not give the set breath.*Set backup rates in case Pt stops breathingA/C: Assist Control -Patient may trigger WHOLE BREATH
    this may cause breath stacking and potentially injure the patient from volutrauma.  Ensure adequate sedation or paralysis.  Pressure support is not required.
  123. ONDANSETRON The 5-HT3 receptor antagonists are the primary drugs used to treat and prevent chemotherapy induced nausea and vomiting (CINV) but can also be used to control N+V in Peds. Peds Dose: 0.15mg/kg 
  124. VALPROIC ACID As an anticonvulsant
    valproic acid is used to control absence seizures
  125. ACETYLCYSTEINE SODIUM Mucomyst Action: • Protects the liver by maintaining or restoring glutathione levels
    or by acting as an alternative substrate for conjugation with and thus detoxification of the reactive metabolite Indications: • Antidote to prevent or lessen hepatic injury following ingestion of potentially hepatotoxic quantity of acetaminophen • Adjuvant therapy for patients with abnormal
  126. FLUMAZENIL Anexate   Classification: Benzodiazepine AntagonistAction: • Flumazenil is a competitive antagonist for benzodiazepine receptors in the CNS • It is metabolized in the liver to inactive metabolites Indications: • Iatrogenic benzodiazepine over sedation Contraindications: • Hypersensitivity to the medication • Patients presenting with ingestions/overdoses • TCA overdose
    mixed overdose
  127. THIAMINE Vitamin B1 Action: • Vitamin B1 is a water-soluble B complex vitamin   • Vitamin B1 combines with adenosine triphosphate to form thiamine pyrophosphate also known as cocarboxylase
    a coenzme   • Its role in carbohydrate metabolism is the decarboxylation of pyruvic acid and alpha-ketoacids to acetaldehyde and carbon dioxide.  Increased levels of pyruvic acid in blood indicate B1 deficiency Indications: • B1 deficiency especially in alcoholics prior dextrose administration to prevent Wernicke's encephalopathy and Korsakoff's syndrome o Wernick’s: An overload of carbohydrates with the lack of B1   Symptoms include (sluggishness