Drug Toxicities, Dumping Syndrome vs. Hiatal Hernia

Question 1

What is the therapeutic range for Lithium?

Answer 1

0.4-1.4

Question 2

What is the toxic level of Lithium?

Answer 2

2.0+

Question 3

What is the therapeutic range for Digoxin?

Answer 3

0.8-2.0

Question 4

What is the toxic level of Digoxin?

Answer 4

2+

Question 5

What is the therapeutic range of Aminophylline?

Answer 5

10-20

Question 6

What is aminophylline used for?

Answer 6

Tx. relaxed muscles spasms in bronchospasms (for airway)

Question 7

What is the toxicity level of Aminophylline?

Answer 7

20+

Question 8

What is the therapeutic range of Bilirubin?

Answer 8

10-20
-Have parents bring baby to hospital if bilirubin around 14-15

Question 9

What is the toxicity level of Bilirubin in the body?

Answer 9

20+
-Kernicterus is bili in the brain nd CSF baby could die (aseptic sterile meningitis)
–> Place baby in OPISTHODOMS position (ON THEIR SIDE) because baby hyperextends w/ stiff back
—DO NOT PLACE SUPINE OR PRONE, Place baby on their SIDE

Question 10

What is lithium used for?

Answer 10

Bipolar and manic episodes (not depression)

Question 11

What is Digoxin used for?

Answer 11

Tx. Afib and CHF

Question 12

What is Phenytoin used for?

Answer 12

Tx. seizure med

Question 13

What is Dumping Syndrome?

Answer 13

GI contents dump to quickly into the duodenum
Speed Issue
Food moves in the RIGHT DIRECTION but the WRONG RATE

Question 14

What is the threptic level for Phenytoin

Answer 14

10-20
Toxicity= 30+

Question 15

S/S of Dumping Syndrome

Answer 15

Drunk + Shock+ Acute abd distress
-Drunk: staggered gate, delayed reaction. labile emotion, poor coordination
-Shock: HToN, Tachy, cool, clammy
-Abd distress: Borborygmi, doubling over, cramping distention, diarrhea

Question 16

What is the goal for Dumping Syndrome?

Answer 16

Get stomach to empty SLOWER

Question 17

TX Dumping Syndrome

Answer 17

HOB: Low HOB position eat lying down on side
H2O: Decrease H2O @meal drink 1hr before/after meals
CHO: Low CHO diet Decrease CHO, CHO digest fast
If you want stomach to be sLOW you want everything to be LOW

Question 18

What is Hiatal Hernia

Answer 18

Regurgitation of acid into esophagus because upper part of stomach herniates into the base of the esophagus (basically 2 stomachs)
**Direction Issue*
Food moves in the WRONG DIRECTION but at the Right Rate

Question 19

S/S of Hiatal Hernia

Answer 19

GERD: heart burn & indigestion that occurs when you Lie down, after you eat
-Depends on position & mealtime

Question 20

What is the goal for Hiatal Hernia

Answer 20

Get stomach to empty faster (nothing in the stomach means no reflux)

Question 21

Tx Hiatal Hernia

Answer 21

HOB: HIGH HOB position 1 hr post meal
H2O: High fluid intake @meals
CHO: High CHO diet (high CHO & low Protein)
In hiatial Hernia, you want everything to be High