random abv and weekly meds Flashcards
PH
7.35-7.45
HCO3
bicarbonate HCO3 released if PH is too acidic 22-26MEq/l
Pa O2
partial pressure oxygen 80-100mm HG
PacO2
partial pressure carbon dioxide 34-45 mm Hg
PH <7.35
resp or meta acidosis
PH>7.45
resp or meta alkalosis
CO2
carbon dioxide 23-29mmol/L
pneumonia
resp acid
COPD
resp acid
heart failure
meta alka
cardiovascular testing for?
heart cells damaged release enzymes: greater the level greater the damaged area. troponin= high levels indicate recent heart attack. lactate. AST.
nebulisers
Nebulisers
Compressed air/oxygen
Fine mist in aerosol form from a solution
Can deliver large doses of drug over long periods
Be aware – drug can irritate skin on face
Considerations
Lungs absorbent due to highly vascular pulmonary capillary system
Rapid absorption of drug into systemic circulation
Considerable proportion of the drug swallowed and can therefore metabolise rapidly
Salbutamol
Otherwise known as? Bronchodilator Beta2-adrenoreceptor agonist Acts quickly and directly on the smooth bronchial muscle Acts in 5-15 minutes Half life 2.7 – 5hrs Contraindications Previous sensitivity Reactions Tremor Tachycardia Cardiac arrhythmias Headaches, nausea, palpitations, feelings of warmth Dosage Adults – 5mg Children – 4-12yrs – 2.5mgs Repeat 4-6hrs PRN – Emergency
Know the 2 different types of oxygen delivery systems
High flow oxygen system – Venturi mask
Guarantees FIO2 irrespective of breathing pattern
High & low concentrations possible
Low flow oxygen system – all other devices
Mixes with room air
Influenced by breathing pattern
Amoxicillin
Contraindications
Penicillin or cephalosporin sensitivity
Reactions
Anaphylaxis (usually following parental (IV) therapy but can occur following PO Rashes, urticaria nausea, vomiting, diarrhoea Dosage Adults – 250mg 8 hourly Children – 20mg/kg/day divided into 8 hourly doses Repeat 4-6 hrs PRN – Emergency
Paracetamol (PO)
Analgesic, Antipyretic Inhibits prostaglandin synthesis in the CNS Peaks 20-120 mins average 51mins Half life 6 hrs Contraindications Other paracetamol containing drugs Reactions Rare Allergic reactions Dyspepsia Nausea heamatological Dosage Adults – 1G every 4 hours (Maximum daily dose of 4G) Children – 15mg/KG (max 60 - 90mg/kg/day)
Morphine
Analgesia
Opium – binds to receptors in brain, spinal cord and other tissues
Primary effects on CNS and other smooth muscle
Peak analgesia 30 – 60 minutes
Contraindications
Previous sensitivity
Opioid sensitivity
Bronchial asthma/COPD
Reactions
Sedation
Nausea
Vomiting
Constipation
Blurred vision
Local issue irritation (at site of injection)
Dosage
Adults – 5 - 20mg every 4 – 6 hourly max
Children – 0.1 to 0.2 mg/kg bodyweight Max 15mgs
Glyceryl trinitrate (GTN)
Otherwise known as Vasodilator Increases blood flow from epicardial to endocardial regions Coronary vasodilation Peak plasma levels 4 minutes Contraindications Cerebral haemorrhage Head injury Hypersensitivity Angina caused by obstructive cardiomyopathy Reactions Hypotension Headache Sedation Nausea Vomiting Blurred vision Syncope Tachycardia Dosage 600-900mcgs as soon after onset of symptoms Elderly 300mcgs as starting dose Buccal mucosa under tongue or in cheek
Aspirin
Inhibition of platelet aggregation Used in patients with known cardiovascular/cerebrovascular disease Prophylaxis for AMI, Unstable Angina, TIA, CVA Therapy should cease 1/52 prior to surgery Contraindications Hepatic/renal disease Bleeding disorders Gastric/peptic ulcers Hypersensitivity Reactions GI Distress Nausea Vomiting Occult blood loss Dizziness
Dosage
75-300mg PO OD
Tazopip
Antibacterial combination medication
Broad spectrum semisynthetic penicillin
Active against Gram-positive and Gram-negative aerobic and anaerobic bacteria
Used for: LTI’s, UTI’s, intra abdominal infections, skin infections, gynae infections
Peak plasma levels immediately following IV infusion
Contraindications
Previous allergic reactions to penicillin/cephalosporins
Reactions
Anaphylactic/anaphylactoid
Bleeding manifestations including clotting problems
Raised liver enzymes
Resistance to therapy in prolonged use
Interactions
Other antibiotics
Vecuronium
Methotrexate
Heparin and anticoagulants
False positives for glucose in urine
Dosage
Slow IV infusion (20-30mins)
4g piperacillin/0.5g tazobactum (Tazopip)
Every 8 hours
Max daily dose 12G (4G TDS)
Minimum 5 day therapy – continued for 2 days resolution of symptoms
Paracetamol IV
Analgesic, Antipyretic Not sure why it works – may involve central and peripheral actions Onset of pain relief 5 -10 mins peak analgesic effect 1 hour Reduces fever within 30mins – effect at least 6 hrs Contraindications Other paracetamol containing drugs Reactions Dizzyness Allergic reactions Vomiting Nausea Constipation Pruritis And others…….. 1g dose 4g max daily
Enoxaparin S/C
Otherwise known as? Prevention of VTE Not for IM route Contraindications Heparin Haemorrhagic risk Haemorrhagic stroke Reactions Haemorrhage Anaemia GI Upset Headache Skin necrosis Pain Haematoma at site Allergic reaction Dosage High risk patients – 40mg OD Moderate risk patients – 20mg OD Duration dependent on prophylaxis or treatment of condition
Adrenaline (Epinephrine)
Peripheral vasoconstriction
Each ml of solution for injection contains 1 mg of adrenaline (epinephrine)
