Neutralize gastric acidity by a local effect, except sodium bicarbonate which is absorbed and can cause systemic electrolyte imbalance
Uses: Relief of heartburn, gas, and indigestion; treatment of peptic ulcers
Inhibits both daytime and nocturnal basal gastric acid secretion and inhibits gastric acid stimulated by food, stress, smoking, caffeine, and certain drugs by occupying H2 receptor sites on parietal cells
*Uses*: Active gastric and duodenal ulcers; Prevention of hyperacidity in hospitalized client
NC: Do not crush to dissolve; dissolves in water to form slurry
Blocks final step in gastric acid production to suppress gastric acid secretion
*Uses*: Treatment of active ulcers, GERD, and erosive esophagitis; prevention of peptic ulcer
NC: Reconstitute IV Protonix immediately before administration; Do Not Crush delayed-release capsules
Action: anticholinergic action on smooth muscles of GI tract
Many peptic ulcers are caused by a bacteria that can be detected with a culture of the gastric lining or by other diagnostic tests Adequate treatment with antimicrobials can cure the peptic ulcer disease and prevent re occurrence,
Two weeks of 3 drug treatment cures up to 90% of patients: omeprazole (Prilosic) clarithromycin (Biaxin), Metronidazole (Flagyl) Treatment for other 10% includes additional drug treatment with: metronidazole (Flagyl), tetracycline or amoxicillin, colloidal bismuth subcitrate (Pepto-Bismol) Must complete entire treatment program to avoid resistant
NC: May cause abdominal distention and flatulence
Lubricant Laxatives soften fecal mass
NC: May impair absorption of fat-soluble vitamins; swallow carefully to avoid lipid pneumonia
draw water into intestinal contents
NC: Administer Fleets PhosphoSoda over ice due to salty taste; Shake Milk of Magnesia thoroughly prior to administration
Action: Replaces exocrine secretions of pancreas in cystic fibrosis, chronic pancreatitis, etc.; acts directly in GI tractNC: Given with meal or snack (immediately prior to eating food)
Inadequate heat dissipation
pathologic and pharmacologic
bright red mm
melena, discolored urine
This can work in many ways.
1. increased concentration at the receptor.
2. increased concentration at the receptor
3. decreased metabolism
4. slow excretion
1. any decrease in effect
2. decrease in absorption (1st drug decreases absorption of 2nd drug).
3. decrease concentration at receptor
4. increase metabolism
5. increase excretion
less severe reaction: 0.3-0.5mg.
IM (SQ also recommended)
Airway management: intubation PRN, O2.
Antihistamine: diphenhydramine (benadryl) IV.
Fluid resuscitation: increasing blood volume will increase BP. Vasopressores (dopamine) and cardiac monitoring.
S/S: Skin rashes, edema, fever, joint pains. **anaphylaxis may follow if untreated**
Tx: stop drug, corticosteroids, anti inflammatory drugs (NSAIDS), antihistamines.
S/S: circular, edematous lesions, **target lesions, or bulls eye lesions**, necrosis of lesions may occur. (lesions are not typical hives. they have a dip in the middle of the hive)
Tx: stop the drug, corticosteroids (debatable), lesions may become necrotic (wound care)
S/S: target lesions that involve mucous membranes as well as skin, lesions erode (painful), joint pains, fever, malaise.
Tx: stop drug, symptom management, corticosteroids, antibiotics, wound care.
Death may result from infection of lesions.
Tx: stop drug, antibiotics, corticosteroids, wound care, isolation if needed.
Eczema- pruritis, edema
Contact dermatitis- skin irritation because of direct contact w/drug.
Tx: avoid sun exposure, wear proper clothing, sunscreen. teach clients to avoid sunburn. Some drugs increase sensitivity to sun and cause sunburn.
S/S: worsening diarrhea that is bloody and contains mucus. Tx: stop drug, hydrate.
Drugs: aspirin, loop diuretics (furosemide, lasix)
Children- excitement with some sedatives.
Elderly- similar reactions (agitation w/sedative)
2.reduced RBC- anemia, fatigue, lower O2 carrying capacity.
3. reduced platelets- risk of bleeding
2) dosage and administration
3) evaluating and promoting therapeutic effects
4) minimizing adverse effects
5) minimizing adverse interactions
6) making PRN decisions
7) managing toxicity
2) identifying high-risk patients
3) assessing the pts capacity for self-care.
injected = lower doses
-nature and time course of intended response
-used for two cardiovascular disorders
2) collection of baseline data needed to evaluate adverse effects
3) identification of high risk patients
4) assessment of the pts capacity for self care
-drugs taken for non-med purposes (alcohol, nicotine, caffeine, illicit drugs)
(allergic reaction to penicillin = contraindication to penicillin unless pt has a life threatening infection that can’t be controlled by another antibiotic)
2) interventions to enhance therapeutic effects
3) interventions to minimize adverse effects and interactions
4) pt education (encompasses info in first 3 groups)
-technique of admin
-duration of treatment
-method of drug storage
-measures to promote therapeutic effects
-measures to minimize adverse effects
2) pt education
3) interventions to promote therapeutic effects
4) interventions to minimize adverse reactions
1) therapeutic response
2) adverse drug reactions/interactions
3) adherence to prescribed regimen
4) satisfaction w/ treatment
ABDuction is away from the midline
Zone 2 – MP to PIP
Zone 3 – Thumb crease to MP
Zone 4 – Lower half of the palm
Zone 5 – Palmer crease and proximal
Flexor tendon injuries here have a poor prognosis – expert is needed to repair
Lateral part of thumb
Tips of fingers on the back
– Abduction and extension of thumbs
– Check ability to cross index and middle fingers
– Squeeze examier’s finger (proximal median nerve)
Use pressure then tourniquet for a definitive repair if bleeding does not cease
Nerves run with blood vessels
Treat with incision and drainage
Treat by incision and drainage
– Affected finger held in flexion
– Pain over volar aspect of affected tendon on palpation
– Swelling of affected finger (fusiform)
– Pain on passive extension
Administration of antibiotics
Leave wound open
(subungual – under the nail)
Visible 2 weeks later on Xray (NOT initially)
Can cause avascular necrosis
Place in cast if clinically suspected
Edema of pregnancy
Neoplasm (i.e. ganlioneuroma)
Pneumatic drill usage
Phalen’s test (flexion of wrist)
Wartenberg’s sign (hand resting on a surface – pinky finger rests in abduction compared to the other 4 digits)
Nerve conduction study
Propofol at 2 mg/kg and diazepam at 0.25 mg/kg
Ketamine at 5 mg/kg plus Valium at 0.25 mg/kg or combined Ket/Val at 1 ml/10 ikg
Butorphanol at 0.2 mg/kg
Ketamine at 5 mg/kg
– dog OHE: cranial third of the caudal abdomen
– cat OHE: middle (cranial) third of the caudal abdomen
– cystotomy: umbilicus to pubis
– gastrotomy: xyphoid to pubis
– Focal lesions (FNA, Tru-Cut, punch biopsy and excisional biopsy)
– Diffuse lesions – partial or total splenectomy
– wedge biopsy
cutting needle – used for hard tissues (skin, ligaments, etc)
reverse cutting needle – a midway for solid tissues
2) inhibit protein synthesis
3) inhibit folic acid synthesis
4) inhibit DNA / RNA synthesis
5) distinct mechanisms
2) penicillinase-resistant penicillin
4) antipseudomonal penicillin
penicillin v — oral
2) ineffective if combined with drugs that are bacteriostatic; bacteria must be replicating for penicillins to work
dalf — inhibits early phases of protein synthesis