meds.txt

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Author:
dodgybarnet
ID:
96338
Filename:
meds.txt
Updated:
2011-08-07 18:14:32
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EMR
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meds
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  1. ASA DOSE?
    160-325mg (generally start with the lowest dose)
  2. ASA INDICATIONS?
    Ischemic Chest Pain (angina or MI)
  3. ASA CONTRAINDICATIONS:
    • Allergy to ASA
    • Bleeding disorders (eg: hemophilia)
    • Unconscious
  4. ASA SIDE EFFECTS?
    • GI upset
    • N/V
    • Heart Burn
  5. ASA PRECAUTIONS?
    • Asthma - May produce bronchoconstriction in asthmatics
    • Active ulcer disease
    • Impaired renal or hepatic function
    • Children and adolescents with influenza or chickenpox infections as it may increase the risk of Reye's syndrome
  6. ASA PHARMACODYNAMICS?
    At low doses, appears to impede clotting by blocking prostaglandin synthesis, which prevents formation of platelet-aggregating substance (this is irreversible) called thromboxane A2
  7. ASA ADMINISTRATION?
    ASA must be chewed & swallowed for proper absorption rate
  8. ORAL GLUCOSE PROTOCOLS?
    Offline
  9. ORAL GLUCOSE DOSE?
    25g tube prn 10 minutes
  10. ORAL GLUCOSE INDICATIONS?
    • S/S of hypoglycemia with BGL <3.8mmol/L
    • --- hunger
    • --- shakiness
    • --- nervousness
    • --- sweating
    • --- dizziness or light-headedness
    • --- sleepiness
    • --- confusion
    • --- difficulty speaking
    • --- anxiety
    • --- weakness
  11. ORAL GLUCOSE CONTRAINDICATIONS?
    • Unconscious
    • Pt unable to follow commands
    • Hyperglycemia: (Blurred vision, Fatigue, Dry mouth, Dry or itchy skin)
  12. ORAL GLUCOSE SIDE EFFECTS?
    N/V
  13. ORAL GLUCOSE PRECAUTIONS?
    May cause N/V or Pt may gag when administered
  14. ORAL GLUCOSE PHARMACODYNAMICS?
    Monosaccharide given orally & readily absorbed
  15. ORAL GLUCOSE ADMINISTRATION?
    • Swallowed for proper absorption rate
    • Tongue depressor, or simply squeezed into mouth by Pt
  16. SALBUTAMOL PROTOCOLS?
    ONLINE! Must be Pt’s & have a Px
  17. SALBUTAMOL DOSE?
    • Adult: 6 to 20 puffs of MCI
    • Pediatric : 2 to 10 puffs of MCI
    • prn 10 mins
    • Each MCI = 100mcg/spray.
  18. SALBUTAMOL INDICATIONS?
    • Severe bronchospasm due to COPD, or
    • Dyspnea from Asthma
  19. SALBUTAMOL CONTRAINDICATIONS?
    Allergic to Salbutamol
  20. SALBUTAMOL SIDE EFFECTS?
    • Headache
    • N/V
    • Nervousness
    • Palpitations
    • Tachycardia
    • Transient muscle cramps
    • Muscle tremors
    • weakness
  21. SALBUTAMOL PRECAUTIONS?
    • NOT to be used on Pt. presenting with acute heart failure, or CVD
    • hyperglycemia: Risk in diabetics
    • Hypokalemia: - a lower-than-normal amount of potassium in the blood, which can be further lowered by this med.
  22. SALBUTAMOL PHARMACODYNAMICS?
    Binds to Beta-2 receptor sites promoting bronchodilation. Also activates cardiac Beta-1 receptor explaining increased Heart Rate and BP
  23. SALBUTAMOL ADMINISTRATION?
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  24. IPRATROPIUM BROMIDE PROTOCOLS?
    ONLINE! Must be Pt’s & have a Px
  25. IPRATROPIUM BROMIDE DOSE?
    • Adult: 4 to 10 puffs of MCI
    • Pediatric: 2 to 4 puffs of MCI
    • prn 10 mins
    • Each MCI = 20mcg/spray.
  26. IPRATROPIUM BROMIDE INDICATIONS?
    • Severe bronchospasm due to COPD, or
    • Dyspnea from Asthma
  27. IPRATROPIUM BROMIDE CONTRAINDICATIONS?
    • Allergic to Ipratropium or atropine
    • Allergic to soy lethicin or sooy, peanuts (it’s the propellant)
    • Children under 5
  28. IPRATROPIUM BROMIDE SIDE EFFECTS?
    • Headache
    • N/V
    • Nervousness
    • Palpitations
    • Tachycardia
    • Transient muscle cramps
    • Muscle tremors
    • weakness
  29. IPRATROPIUM BROMIDE PRECAUTIONS?
    • Pt’s with narrow angle glaucoma
    • Don’t spray in any Pt’s eyes!
  30. IPRATROPIUM BROMIDE PHARMACODYNAMICS?
    Inhibits Parasympathetic bronchoconstriction, resulting in open lower airway and bronchodilation.
  31. IPRATROPIUM BROMIDE ADMINISTRATION?
    • Shake for 30-60 seconds
    • Breath in and hold as per obvious
  32. EPINEPHRINE PROTOCOLS?
    ONLINE!
  33. EPINEPHRINE DOSE?
    • Adult: 0.3mg given IM at lateral aspect of thigh
    • Pediatric: 0.15mg
    • prn 5-10mins
  34. EPINEPHRINE INDICATIONS?
    Anaphylaxis
  35. EPINEPHRINE CONTRAINDICATIONS?
    None in emergent setting
  36. EPINEPHRINE SIDE EFFECTS?
    • PHD-PAN-HAC
    • Pallor
    • Headache
    • Dyspnea
    • Palpitations
    • Anxiety
    • N/V
    • Acute Hypertension
    • Angina
    • Cardiac arrhythmias
  37. EPINEPHRINE PRECAUTIONS?
    • Use with geriatrics
    • Acute hypertention (BP over 140/90 that doesn’t respond to meds)
    • Cardiac History
    • Pulmonary Edema
  38. EPINEPHRINE PHARMACODYNAMICS?
    • Binds to Alpha-1, Beta-1, and Beta-2 receptors of sympathetic system, resulting in bronchodilation and drying of bronchial mucus membranes.
    • Activation of Alpha & Beta receptors explains increased HR & BP
  39. EPINEPHRINE ADMINISTRATION?
    Injected into lateral aspect of thigh at 90deg angle, held in place for 10 seconds. Place needle in sharps container after. Massage site to encourage blood flow at site.
  40. NITROGLYCERIN PROTOCOLS?
    NOT ALLOWED!
  41. NITROGLYCERIN DOSE:
    0.4mg SL spray
  42. NITROGLYCERIN INDICATIONS:
    Suspected Angina or MI
  43. NITROGLYCERIN CONTRAINDICATIONS:
    • Systolic BP <100
    • Viagra within last 24hrs
    • Ciallis within last 36hrs
    • Levitra within last 48hrs
  44. NITROGLYCERIN SIDE EFFECTS:
    • Lightheadedness & Dizziness
    • Headache
    • N/V
    • Syncope
  45. NITROGLYCERIN PHARMACODYNAMICS:
    • Antianginal: relaxes vascular smooth muscle of both arterial and venous beds, causing net decrease of Myocardial O2 consumption.
    • Dilates coronary vessels: redistributing blood to ischemic tissue.
    • Vasodilating: Dilates peripheral vessels, decreasing venous return to the heart which treats pulmonary edema and heart failure. Also reduces left ventricular load aiding a failing heart.

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