Disease management Flashcards
What is the treatment of ACS?
-Morphine
-Oxygen 15L
-Nitrates
-Aspirin 300mg
-Ticagrolol 180mg then 90mg
NSTEMI: PCI in 14days PLUS Echo
STEMI: PCI within 2hours
What is the treatment of an aortic dissection?
Unstable: 0.5-1micro NorA/Dobutamine & resus
Acute: 1-5mg IV Labetalol, Morphine, Vasodilators, surgery
Ongoing: Metoprolol
What is the treatment of PE?
High Suspicion: 15L high flow O2 & ventilation 500ml fluids 15mg Rivaroxaban/ 1mg Enoxaparin CTPA: Alteplase 0.5-1micro IV NorA/Dobutamine
Acute confirmed PE: 15L high flow & ventilation 500ml fluids 100mg IV Alteplase over 2hours 15mg Rivaroxaban 0.5-1micro IV NorA/Dobutamine
Failed Thrombolysis:
Above
IVC filter placement&Surgery
Fondaparinux/LMWH for 5days till INR>2 for 24hours
First Unprovoked no RF: 3months anticoagulation
First Unprovoked w/RF: 3months anticoagulation then review
What is the treatment of DVT?
Proximal & distal DVT of the leg: 15mg Rivaroxaban Physical Activity Gradient stockings Pregnancy: LMWH (Enoxaparin/Heparin) Active bleeding: IVC filter
What is the treatment of tension pneumothorax?
Thoracocentesis- 14G catheter into 2nd intercostal space, mid-clavicular
Chest drain- Safety triangle, 5th intercostal space, mid-axillary
15L/min high flow oxygen
What is the treatment of acute exacerbation of COPD?
Short acting bronchodilator: 2.5-5mg Salbutamol, 0.25-0.5mg ipratropium
Systemic Corticosteroids: 30-60mg Prednisolone
Inhaled corticosteroids (50-100micro Beclometasone)
Assist ventilation: NIV, mechanical/invasive ventilation
Oxygen
Antibiotics: 100mg Doxycycline/250mg Tetracycline
Consider: MI, PEN, CCF
What is the treatment of CAP?
CURB 0-1= Amoxicillin (allergy: Doxycycline)
CURB 2= Amoxicillin & Clarithromycin (allergy: Doxycycline/Levofloxacin)
CURB >3= IV Co-Amox & IV Clarithromycin (allergy: Cefuroxime & Clarithromycin)
What is the treatment for HAP?
Early: Doxycycline/ Co-Amox (allergy: Doxycycline/Levofloxacin)
Late: Co-Trimoxazole/ Amoxicillin & Temocillin (allergy: Linezolid & Ciprofloxacin)
What is the treatment for pseudomonas pneumonia?
IV Piperacillin/Tazobactam
Allergy: Linezolid & Ciprofloxacin
What is the treatment for pre-renal AKI?
Fluids: Crystalloid (Saline)
Vasopressor: 1 micro Dopamine/Epinephrine, NorE
Vol Overload: 20-40mg Furosemide
Renal replacement
What is the treatment for intrinsic AKI?
Treat underlying condition
Crystalloid
Vol Overload: 20-40mg Furosemide
Renal replacement therapy
What is the treatment for post-renal AKI?
Catheterization
Relieve obstruction: Stenting, lithotripsy, nephrostomy
Diuretic: 20-40mg Furosemide
Renal replacement therapy
What is the treatment for DKA?
Acute:
1-1.5L Fluids (Isotonic saline)
5% Dextrose w/0.5% NaCl when glucose= 11.1
IV insulin
IV 20-30mEq/L potassium phosphate w/fluids
5-10micro Dopamine
Mild: Isotonic Saline for 1hour then add potassium phosphate if K<3.3
What is the treatment for hyponatraemia?
Acute: 100-300mL Hypertonic 3% saline infusion
Supportive
Chronic/Asymptomatic: Isotonic 0.9% saline, Spironolactone
hypovolaemic: 250-1000ml 0.9% normal saline
What is the treatment for hyperkalaemia?
Significant: IV 10% CaCl/ 10% Ca gluconate
Nebulised Salbutamol 5mg
IV Insulin Dextrose 10u in 50mls w/50% dextrose
IV sodium bicarb
IV Furosemide
Severe: Haemodialysis
Emergency: Cardioversion