This document provides a concise summary of key pediatric medical information including normal vital signs, common lab values, disease processes, medications, and other important clinical references organized by topic for quick reference. Key areas covered include normal heart rates, temperatures, electrolytes, endocrine labs, ABG values, common infections, newborn assessments, growth charts, and more.

1. Cardiac Rate- Peds
Remember: 311
(Fetal HR 120-160)
RR
-30 90-130 Infant 30-60
-10 80-120 Toddler 20-30
-10 70-110 Preschooler 16-22
Temperature
ºF = (1.8 * ºC) + 32
(Think of them as being ~ 2º apart)
37ºC = 98.6º F
38ºC=100.4º F
39ºC=102.2º F
40ºC =104 º F
Labs
á BUN/CR = Dehydration
â BUN/CR = Overhydration
El: Na (135-145) K (3.5-5) Mg(1.5-2.5) Ca (9-11) Cl (96-106)
Phos (3-4.5)
Endocrine
BUN (7-22 or to remember put thebuns in the oven for 10-20 min)
Cr (0.5-1.5)
Urine Spec Gravity (1.005-1.030)
Glucose:
Nml 80-110
Fasting <110
Infant BG 50-90 (<45=hypoglycemia-high pitch cry)
HgbA1c= 4-6% (or <7%)
Thyroid:
T3 (60-180)
T4 (5-11)
TSH (0.5-5) or 0.5-2 for hypothyroid pts
Free T4: 0.8-2.7 ( I remember it .8-2.8 easier to memorize)
Hypothyroid: - TSH ;¯ T3 & T4
Hyperthyroid: ¯ TSH ;- T3 &T4
ABGs:
PH 7.35-7.45
pO2 80-100
pCO2 35-45
HCO3 22-26
ROME:
With Acidosis the PH is always ¯ and PH is always - in Alkalosis
Respiratory Opposite;MetabolicEqual
RESP OPP:
PH ¯ PCO2 - = Resp Acidosis
PH - PCO2 ¯ = Resp Alkalosis
METABOLIC =
PH ¯ HCO3 ¯= Metabolic Acidosis
PH- HCO3 - = Metabolic Alkalosis
Blood:
RBC 4.2-6.1 million WBC 5000-10000 (or 4500-11000) Plt 150,000
– 450,000
Hgb F: 12-16 M:14-18 Hct F: 37-47% M:42-52%
Amylase: 53-123 Albumin: 3-4.3 Alk Phosphate:14-100 NH3 (35-
65)
Blood Osmol 280-300 Lipase 14-280
Bilirubin (Total: 0.3-1; Indirect: 0.2-0.8; Direct 0.1-0.3)
Phenylalanine: Newborn < 2 Adult < 6
Antidotes
Digoxin ® Digiband
Tylenol® Mucomist (17 doses + loading dose)
Heparin® Protamine Sulfate
Benzodiazepine ® Flumzaemil (Romazicon)
Coumadin®Vit K
DI ®¯ ADH, - u/o, ¯ Urine Specific Gr, - Na (think - Na = - urine
specgr)
SIADH® think syndrome of -ed diuretic hormone - ADH, ¯ u/o,
-urine specgr
Insulins
Rapid Reg Interm Very Long Long Acting
5-15m 30-60m 1-3h 1h 6-8h
1-2h 2-4h 6-12h peakless action 12-16h
4-6h 5-7h 16-20h 18-24h 20-30
Novolog Novolin R NPH Lantus Ultra Lente
Humalog Humulin R Lente
Vaccines
Hep B 0, 1-2, 6-18mo
Hib 2, 4, 6, 12-15
Pneumo 2, 4, 6,12-15
Dtap 2, 4, 6, 15-18, 4-6yrs;Td q 10 yrs
IPV 2, 4, 6-18, 4-6yr
Varicella 12-15, 4-6yr
MMR 12-15, 4-6yr
Hep A 12-23 mo (2 doses, 6 mo apart)
Mening 9-11 yrs
Rota 2, 4, 6
Influenza at 6 mo and then yearly after
Random Stuff
Thiazides - BG
Neupogen = - Neutrophil
Epogen = - RBC/Erythocyte
Lofenalac Formula = for PKU infants
Ototoxic drugs = loop diuretics (Lasix) and Platinol-AO
TB Meds (RISE)
Rifampin
INH
Streptomycin
Ethambutol
GCS
Eyes (4 points)
Verbal (5 points)
Motor (6 points)
Max = 15 (<8=coma)
APGAR Score
At 1 and 5 min after birth
(1st score is the transitional score and 2nd is planning care of
newborn)
8-10 = ok
2 1 0
Appearance [All pink, pink&blue, blue/pale]
Pulse [> 100, < 100, No Response]
Grimace [cough, grimace, no response]
Activity [flexed, flaccid, limp]
Resp [strong cry, weak cry, no cry]
INFECTION CONTROL
Airborne (My Chicken Hez TB)
Measles (Rubeola)
Chicken pox (Varicella)
Herpes Zoster (shingles in (immuno compromised ind, or
disseminated)
Tuberculosis
Management:
-privateroom
-negative airflow pressure, minimum of 6-12 air exchanges per hour
-UV germicide irradiation/ high efficiency air filter is used, mask,
N95 mask for TB
Droplet (SPIDERMAn)
Sars
Scarlet fever
Sepsis
Streptococcal pharyngitis
Pertussis
Parvovirus B19
Pneumonia
Influenza
Diphtheria
Epiglottitis
Rubella
Mumps
Mycoplasmal/Meningeal Pneumonia
AdeNovirus
Management:
-privateroom
-mask (within 3 ft)
Contact (MRS.WEE)
Multi-resistant organism
Respiratory Syncitial Virus (RSV)
Skin Infections VCHIPS (e.g:
Varicella zoster

2. Cutaneous Diphtheria,
Herpes Simplex
Impetigo
Pediculosis
Staph infection
Scabies)
Alex = AIDS
Hez= Herpes Zoster
5=5th Dx
Coins=Croup
HeRe= Hepatitis and RSV
Wound Infection
Enteric Infection (Clostridium Difficile)
Eye Infection (Conjunctivitis)
Croup
Management:
-MRSA:gloves, gown, goggles, face shield
-patients should be in a private room
Donning
1 Gown
2 Mask
3 Goggle
4 Gloves
Removing
1 Gloves
2 Goggle
3 Gown
4 Mask
Addisons - hyponatremia, hyperkalemia
Cushings - hypernatremia, hypokalemia
REMEMBER: VEAL CHOP
Variable is Cord compression
Early is Head compression
Acceleration is Ok
Late is Placental Insufficiency
Hypoventilation => Resp Acidosis (- CO2) “Retain CO2”
Hyperventilation=> Resp Alkalosis (¯ CO2) “Blow off CO2” (think
of preg breathing)
Lasix/Bumex = K+ Wasting (can cause hypokalemia)
Aldactone = K+ Sparing (can cause hyperkalemia)
Tx of DIC = Heparin (safe during preg)
Post Masectomy Care: BREAST
BP NOT on affected side
Reach Recovery
Elevate affected side
Abduction and external rotation – no initial exercise (initial is
extension/flexion)
Self Breast Exam (1x month – 7 day after period)
Try to promotea (+) self-image
Autosomal Recessive:
CysticFibrosis,
PKU,
Tay-Sachs,
Albinism,
Sickle Cell Dx,
AlphaAnti-Trypsin Deficiency,
Galactetsemia
Autosomal Dominant:
Huntington’s Disease,
Marfan’s,
Polydactly,
Achandrophic Dwarfism,
PolycysticKidney Disease
X-Linked Recessive:
Duchenne’s Muscle Dystrophy,
Hemophilia A (Females are carriers in these diseases and males are
affected by thedisease)
Newborn At Term:
Nml = wt:6-9lbs, head circumference: ¼ body length, 13-14 in,
chest: 12-13in
Umbilical cord falls off in 1-2 weeks
Stool:
1st stool (Mecconium) – black + tarry (passes w/in 12-24 hrs),
thin/green/brown day 3,
formula feedings (1-2 pale yellow/light brown stools) or
breast feeding (loose golden yellow stools with sour milk odor)
Hypokalemia:
Flat T wave,
Depressed ST, and
Prominent U wave
Hyperkalemia:
Tall T wave,
Wide QRS,
Long PR Wave
5 P’s of Fracture: Pain, pallor, pulseless, paresthesia, paralysis
Cushing’s Triad: (Indicates -ed ICP) ¯ HR, ¯RR,- BP
CONVERSIONS:
1 lb = 16 oz ; 1 T = 3 tsp = 15 mL 1 t = 5 mL
1c = 8 oz = 240 mL 1 lb = 454 g = 16 oz
2 c = 1 pt = 16 oz
1 oz = 30 mL= 8 drams 1 mg = 1000 mcg
2 pt = 1 qt= 32 oz 1 g = 15 gr
4 qt =1 gal = 128 oz 1 gr = 60 mg
Med Trivia
§ Talwan and Stadol=> Avoid (opoid agonist antagonists) – much
less effective than opoid agonists
§ No Tagamet with Warfarin
§ Erogostat => For Migraine
§ No Quinolones/Tetracyclines with pregnancy
§ No ASA/NSAIDS in Hemophilia A patients
§ Lipitor = PM ONLY, no grapefruit juice
§ tPA= dissolves clots (heparin does not)
§ SLE Tx
o Cytotax, Imuran (Immunosupressants)
o NSAIDs
o Plaquinil (also an anit-malarial drug)
More Maternity
§ Fundal Height
o Top of Symphis Pubis to top of fundus
o Gross estimate of dates
o Use a non-stretchable tapemeasure
o 12-14 wks (at level of symphis)
o show after week 14 (can tell preg)
o 20 wks (~ 20cm) at level of umbilicus
o rises 1 cm/wk till 36 weeks then varies
§ Quickening = fetal movement; 16-20 weeks
§ Fetal Heartbeat = 8-12 weeks (by Doppler) and 18-20 weeks by
auscultating with stethoscope
§ Preterm: 20-37 weeks
§ Term: 38-42 weeks
§ Post-term:42 weeks plus
§ Totalpreg weight gain: 11-14 kg (25-35 lb)
§ - 300 cal during preg (DAILY) and - 200-500 cal during
breastfeeding (DAILY)
§ Caffeine < 300 mg/day (500-750 mL/day => - risk of spontaneous
abortion or fetal intrauterine growth restriction
§ Uterine contractions can be felt after 4th month = Braxton Hicks
Contractions facilitate uterine blood flow through placenta and
promoteO2 delivery to fetus
§ AmnioticFluid:
o Nml: 800-1200 mL (transparent/clear, no odor)
o <300 mL = Olighydrimanos (low amniotic fluid) = Kidney
problems
o Polyhydrimanos (too much amniotic fluid)
§ Umbilical Cord: 2 arteries and 1 vein
§ Placenta: Fetal lungs in utero
§ Alcohol, caffeine, nicotine, meds = easily cross placenta (viruses
can cross, bacteria cannot; exs of viruses (HIV, AIDS, Herpes,
Measles, Toxoplasmosis, Hep)
§ AFP Test:measured at 16-18 weeks
o -ed Levels = - risk of neural tube/abd wall defects (ex. spinabifida)
o ¯ed Levels: - risk of Down Syndrome
§ Fetal Distress
o HR < 110 or > 160
o Fetal hyperactivity or no activity
o Fetal Blood pH < 7.2

3. OtherStuff
§ Immed after put pt on a Mech Vent check BP (hypotension)
§ Lesions of midbrain = decerebrate positioning
§ MorphineToxicity = Pinpoint pupils
§ Corticosteroid Effects: Acne, Hirituism, Mood Swings, ostoporosis
and adrenal suppression (in kids = delayed growth)
§ No Paxil with MAOI)
§ Beta Blockers = Mask Effect Of Hypoglycemia
§ SOMogyiEffect = BG sometimes up and sometimes down
§ Dawn Phenomenon = high BG in DAWN hrs (5-8am)
§ AFTER
o Post tracheostomy:keep O2 and Suction at bedside
o Post pleural biopsy:chest tube and drainage systemat bedside
o Post parathyroidectomy:tracheostomy at bedside
o Tonic Clonic Seizures: Suction apparatus at bedside
o Paracentesis: BP Cuff at Bedside
§ RACE-Priority in a fire
o R-Rescue
o A-Alarm
o C-Confine
o E-Extinguish
§ PASS – To use a fire extinguisher
o P-Pull Pin
o A-Aim at Base Fire
o S-Squeeze Handle
o S-Sweep fire from side to side
§ FolicAcid Rich Foods (FOL)
o F= Fish
o O=Organ Meats, Oranges
o L=Leafy green veggies
§ K+ Foods (ROYGBIV-Rainbow colors)
o Red= Strawberries, Tomatoes (not apples)
o Orange= Oranges
o Yellow=Banana
o Green= Avocado, green veggies
o Blue= Fish from the BLUE sea
o Indigo/Violet= Raisins
§ Cretenism = Congential Hypothyroidism(appears 3-6 mo in
bottlefed infants and later in breastfed infants)
§ Hepatitis: low fat, high cal/carbs/protein, no alcohol
§ Hypothryoid: High Protein, low cal diet
§ CysticFibrosis: High Protein Diet and Pancr enzyme replacement
§ Hital Hernia:Fundopliction (tighten cardiac sphincter on stomach)
don’t lie down for 1 hr after meals, - HOB 4-8 in when sleepy, no
food before bed
§ Papable olive shaped tumor in epigastrim = pyloricstenosis
(projectile vomiting)
o In adults from pepticulcers; in infants from hypertrophy of
pylorous (symp 2nd-4th wk after birth)
PEDS
§ Toddler: Fear of separation (give simple directions)
§ Preschooler: Fear mutilation (Allow to play with equipment)
§ School Agers: Fear loss of control (allow to play with equipment)
§ Adol: Fear loss of independence
§ Pneumothorax Symp (P-Thorax)
o P-Pleurtic Pain
o T-Trachea Deviation
o H-Hyperresonance
o O-Onset Sudden
o R-Reduced breath sounds (dyspnea)
o A-Absent Fremitus
o X-X-Rays show collapse
§ Pul Edema Tx (MAD DOG)
o M-Morphine
o A-Aminophylline
o D-Digitalis
o D-Diuretics
o O-O2
o G-Gasses in blood (ABGs)
§ Cholecystisis: Gallbladder inflammation (RUQ pain)
§ Cholelithiasis: GallStones
§ Pancreatitis
o TURNER’S SIGN: Flank echymosis
o CULLAN’s SIGN: Bluish periumbical (around thebelly button)
Who needs Dialysis?
Vowels: AEIOU
A: Acid/Base Problems
E: Electrolyte Problems
I: Intoxications
O: Overload of fluids
U: Uremic Symptoms
§ Cushing’s Dx
o (Cushion – too much Cortisone)
o (3 S’s = high Steriods, high Sugars (hyperglycemia), high Sodium
o Moon Face, Buffalo Hump, Trunkal obesity, thin skinny
extremities, slow wound healing, osteoporosis, HTN, muscle wasting
o ¯ K+
§ Addison’s Dx
o Need to ADD steroids
o (3 S’s = Low Steroids, Low Sugars, Low Sodium)
o Low vascular volume (Not holding salt and H20 like in Cushing’s),
low BP
o Hyperkalemia (- K+)
o Bronze Skin, Hyperpigmentation
§ ALLEN TEST
o B4 drawing ABGs do an Allen’s Test
o Compress both radial and ulnar arties (wrist) at same time on 1
hand
o Release the ULNAR side (pinky side) and hand should turn
discolored and should be able to see blood flow back into it
§ (Radial – is located on the thumb side and ulnar is on thepinky
side)
o Minutes of press on the ABG site after drawing blood?
§ 5-10 min or 15-20 min if on anti-coagulants
§ After a liver biopsy placepatient on theRIGHT Side
§ Mobility
o Cane
§ COAL = Cane Opp Affected Leg
o 2 point gait
§ One leg and 1 crutch touch ground at same time
§ Weight bearing
o 3 point gait
§ Both crutches and 1 foot are on theground
§ Non-weightbearing
o 4 point gait
§ Both legs and both crutches touch the ground
§ Weight bearing
o Swing through gait
§ Advancing both crutches, then both legs, and requires weight
bearing
§ Not as stable as other gaits
§ Laminectomy = removal of 1 or more vertebral laminae – need
straight back after = LOGROLL and
KEEP BACK STRAIGHT (so flat bed)
§ Intussceptation
o Seen in Non-Hodgkin’s Lymphoma
o Hot dog mass in RUQ
o Red Currant Jelly Like mucous and bloody stool
§ Sweat Chol
o > 60 = CF
o 40-60 = Borderline CF
§ Ostomy = pouch opening 1/8 in larger than stoma
§ Macule = flat and round
§ Papule = rounded and red
§ Vesicle = filled with fluid
§ Impetigo = 1:20 Burrow’s Soln, honey colored crusts
§ Permethrin [NIX] => 10% for lice tx and 5% for Scabies tx
o (Scabies = mites bury under skin)
RUQ: Right upper quadrant
§ Cholelithiasis (gallstones)
§ Cholecystitis (inflamm of gallbladder)
§ Hepatitis
§ Pancreatitis (severe knifelike pain; worse with eating/lying down;
some relief with fetal position)
RLQ:
§ Crohn’s Dx (Ileum, Rt Colon; pain after meals)
§ Appendicitis
o Pain at McBurney’s Point
§ (1/2 b/w umbilicus and right iliac crest)
LLQ:

4. § Ulcerative Colitis (Rectum, left colon; pain pre-defecation)
§ Diverticulitis
o Relieved by passage of stool/flatulus
Duodenal Ulcer: Pain 2-3 hrs after meals and nighttime (relieve pain
with FOOD INTAKE)
Gastric Ulcer: Pain 1 hr after meal/when fasting; relieve pain with
vomiting, not with food intake
(Starve the gastric ulcer and feed the duodenal)
Diverticular Dx: Cramping in LLQ relived by passage of stooland
flatus (constipation alternates with diarrhea (from def in diet fiber)
high fiber diet
Meckel’s Diverticulum: congen sac or pouch in ileum, symp seen by
age 2; painless rectal bleeding, abd, hematechezia, (currant jelly like
stool), s/s of appendicitis (tx = remove diverticulum)
Cirrhosis:
§ Biliary obstruction, alcohol, Hepatitis
§ Early stage: high protein/carbs and Vit B
§ Adv stage: low fiber/salt/fat/protein, high cal, fluid restriction
§ Esophageal Varices
o Sengstaken Blakemore Tube or MinnesotaTube
§ Balloon on Esophagus and stomach to apply direct press on
bleeding veins
o TIPS (transesophegal intrahepatic post systemicshunt)
§ Balloon Catheter inserted via jugular vein with angiography to
create a metal stent b.w portalvein to vena cava channel (provides a
pathway for blood b/w portalvein and hepatic vein = bypasses
cirrhotic liver) and relieves press on esoph varicies
Jaundice (Icterus)
§ Hemolytic
o RBCs are destroyed (release bilirubin)
§ Hemolytic transfusion rxn
§ Hemolytic Anemia
§ Sickle Cell Crisis
§ Hepatocellular
o The impaired liver cell (hepatocyte) doesn’t allow bilirubin to
convert from the unconjugated to the conjugated form
§ Obstructive
o Bile flow is obstructed
§ Tumors
EKGS
§ Nml Sinus
o 60-100
o PQRST nml EKG Strip
§ Sinus Brady
o < 60
o Tx: Atropine
o (can be nml in physically fit/trainer person = then no tx needed)
§ 1st degree AV © Block
o Prolonged PR interval
o Nml PR interval: 0.12-0.20
o Conduction Problem
o Drugs (Dig, Beta Blockers, Ca Channel Blockers) can cause by
slowing conduction system(slows conduction from SA node to AV
node to Purnjee Fibers = see slowed PR (Atrial Response)
o Usu don’t see symp, so usu not treated
§ Atrial Flutter
o Saw Tooth Appearance
o Atrium racing away, blood pools and can throw a clot => stroke
o Treat with Cardioversion 20-50 Jules (NURSE must hit
Synchronize button)
o Ventricle beats are regular
§ Atrial Fib
o Ventricle beats are irregular
o Atrium quivers, not good pump
o Cardiovert 50-100 Jules
o If in hospitaland were stable b4 going into a fib = give cardizem
drip and beta blockers b4 cardioversion
§ V-Tach
o Wide QRS complexes
o V Tach and awake drugs I must take (Amiodarone or Lidocaine)
o V Tach and a nap (unconscious) zap zap zap (defibrillate)
o Can only stay in for 2-3 min (can die)
§ V Fib
o Irreg makes no sense
o Only way to tx = defribillate start at 360 Jules
o Epi (to - HR)
Stroke
RightSided: Impatient, easily distracted, impulsive, less concerned
about life events, safety is a big issue (impulse)
Left Sided: Slow, cautious, particular, very aware of deficits, greater
depression/anxiety
(Think rt brain = creative, left brain = logical, math, science)
Pharm Facts
·Don’t give non-selective beta-blockers NSBB to patients
w/respiratory problems
·Vitamin C can cause false +ive occult blood
·Avoid the ‘G’ herbs (ginsing, ginger, ginko, garlic) when on anti-
clotting drugs (coumadin, ASA, Plavix, etc)
·ASA toxicity can cause ringing of theears Ototoxicity
·No narcotics to any head-injury victims
·Mg2+ toxicity is treated with Calcium Gluconate
·Do not give Calcium-Channel Blockers with Grapefruit Juice
·Oxytocin is never administered through theprimary IV
·Lithium (Mood) patients must consume Na extra sodium to
prevent toxicity
·MAOI Patients should avoid thyramine: (Aacados, bananas,
beef/chicken liver, caffeine, red wine, beer, cheese (except cottage
cheese), raisins, sausages, pepperoni, yogurt, sour cream)
·Don’t give atropinefor glaucoma – it increases IOP
·Don’t give ant-acids with food -- b/c it delays gastric emptying.
·Don’t give Stadol to Methadone/Heroin Preggo’s -- cause instant
withdrawal symptoms
·Insulin – clear before cloudy
·Don’t give Meperidine(Demerol) to pancreatitis patients
·Always verify bowel sounds when giving Kayexelate
·Hypercalcemia Ca = Phos hypophosphatemia
·Radioactive Dye– urine excretion
·Signs of toxic ammonia levels is Asterixis (hands flapping)
·D10W can be substituted for TPN (temporary use)
·Dopamine and Lasix are incompatible
·Hypoglycemic shivers can be stopped by holding thelimb, seizures
cannot (infants)
·Common symptomof Aluminum hydroxide – constipation
·Thiazide diuretics may induce hyperglycemia
·Take Iron with Vit C – it enhances absorbtion – Do not take with
milk
·B1 - For Alcoholic Patients (to prevent Wernicke’s encephalopathy
& Korsakoff’s syndrome)
·B6 - For TB Patients
·B9 - For Pregnant Patients
·B12 - Pernicious anemia, Vegetarians.
·Complications of Coumadin - 3H’s - Hemorrhage, hematuria &
hepatitis
·FFP is administered to DIC(disseminated intervascular coagulation)
b/c of theclotting Fx
·Mannitol(osmotic diuretic [Head injury]) crystallizes at room temp
– use a filter needle
·Antianxiety medication is pharmacologically similar to alcohol –
used for weaning Tx
·Administrate Glucagon when pt is hypoglycemia and unresponsive
·Phenazopyridine( Pyridium)--Urine will appear orange
·Rifampicin -- Red-urine, tears, sweat)
·Hot and Dry = sugar high (hyperglycemia)
·Cold and clammy = need some candy (hypoglycemia)
·Med of choice for V-tach is = lidocaine
·Med of choice for SVT = adenosine or adenocard
·Med of choice for Asystole= atropine
·Med of choice for CHF is = Ace inhibitor.
·Med of choice for anaphylactic shock= is Epinephrine
·Med of choice for Status Epilepticus = is Valium.
·Med of choice for bipolar is =lithium.
·Give ACE inhibitors w/food to prevent stomach upset
·Administer diuretics in themorning
·Give Lipitor at 1700 since the enzymes work best during the
evening
·Common TricyclicMeds - 3 syllabes (pamelor, elavil)
·Common MAOI’s - 2 syllables (Parnate, marplan, emsan, nardil, ,)
·TPN has a dedicated line & cannot be mixed ahead of time
·RHoGAM -- Given at 28 weeks & 72 hrs postpartum
·Do not administer erythromycin to MultipleSclerosis pt
·Benadryl and Xanax taken together will cause additive effects.
·Can't take Lasix if allergic to Sulfa drugs.
·Acetaminophen can be used for headache when the client is using

5. nitroglycerin.
·Dilantin - can not give with dextrose. Only give with NS.
Addison is skinny ( hypoglycemic, you get weight loss, you got
weakness, and you get posturalhypotonic)
Cushing is fat ( hyperglycemic, you get moon face, big cheeks, and
you retain a lot of Na and fluid,  weight)
·Never Give via IVP:
oKCL
oHeparin
oIbuprofen
oInsulin
oDobutamine
oASA
oAlbumin
oAcetaminophen
·Insulin:
oRapid: (lispro/humalg) onset <15 min. Peak: 1hr. Dur 3hr
oShort: Reg (humulin/novolin) onset ½ - 1hr. Pk: 2-3hr. D:4-6
oInt: (NPH/Lente)–onset:2hr. Peak 6-12 hr. Duration: 16-24hr
oLong: (Ultralente ) onset 4-6 hr. Peak: 12-16 hr. Dura: >24hr
oV.Long: (Lantus/glargine) onset 1hr. Peak: None. Dur: 24hr
AcetylcholineNeurotransmitter
(PNS muscle mov CNS Alzheimers)
ACh Receptor Agonists are used to treat myasthenia gravis and
Alzheimer's disease.
·AnticholergicS/E: given for Ach S/E
(dicycloverine/atropine)
oCan’t See (blurred vision)
oCan’t Pee (anuria)
oCan’t Spit ( oral secretions)
oCan’t Sh*t ( peristalsis vagus nerve)
·
HypoCalcemia Ca+ – CATS
oConvulsions
oArrythmias
oTetany
oSpasms & Stridor
Hyper Kalemia Causes K+: ‘MACHINE’
oMedicational (ace inhibitors, NSAIDS)
oAcidosis (metabolic & repiratory)
oCellular destruction (burns, traumatic injury)
oHypoaldosteronism, Hemolysis
oNephrons, renal failure
oExcretion (impaired)
·Signsof increased K ‘ Murder’
oMuscleweakness
oUrine – olyguria, anuria
oRespiratory distress
oDecreaed cardiac contractility
oECG Changes
oReflexes – hyperreflexia, or flaccid
·Substance Poisoning and Antidotes
oMethanol-- Ethanol
oCO2 -- Oxygen
oDopamine -- Phentolamine
oBenzo’s (Versed) -- Flumazenil
oLead -- Succimer, Calcium Disodium
oIron -- Deferoxamine
oCoumadin -- Vitamin K
oHeparin -- Protamine Sulfate
oThorazine -- Cogentine
oWild Mushrooms - Atropine
oRat Poison - Vit K
·Parkland Formula: 4cc * Kg * BSA Burned= Total Volume
Necessary
o1st 8hrs – ½ totalvolume
o2nd 8hrs – ¼ totalvolume
o3rd 8 hrs – ¼ totalvolumes
1. Alpha 1-adrenergic Blockers end in zosin andlosin.
SE are dizziness, weakness may occur when changing position.
Should teach pt to change position slowly and lie down if dizziness
occurs. GI upset may occur, teach pt to eat smaller more frequent
meals. Should tell the pt to report FREQUENT faintness or dizziness.
2. Aminoglycosides end in mycin and another imp. that they try to
throw in to confuse you is amikacin sulfate..
teach pt to take full course of drugs and drink plenty of fluids,tell
them they may report these
SE..RINGING IN EARS, headache, dizziness, N/V, loss of appetite.
They should report pain at theinjection site and severe headache,
dizziness, loss of hearing, changes in urine pattern, difficulty
breathing, rash or skin lesions,
3. ACE inhibitors end in pril take thesedrugs 1 hour before or 2
hours after meals, do NOT take w/ food (captopril, moexipril).
SE Thesedrugs will give a false pos. for urine acetone, NOT
pregnant women can cause serious fetal effects. patient may
experience GI upset, appetiteloss, dizziness fast heart rate, change in
taste. Teach pt to report sore throat, fever, chills swelling of hands
and feet, chest pain and irregular heart beats swelling of face and
eyes lips tongue difficulty breathing
4. ARBS (Angiotensing II receptor blockers) end in SARTAN.
Teach pt they must use an alternate method to birth control while
using these drugs.
SE May experience dizziness, nausea, abdominal pain, symptoms of
URI, cough. Report fever, chills, dizziness and pregnancy
5. Anti migraine Drugs end in triptan. NO take while pregnant
Contact MD IMMED. if you experience chest pain or pressurethat
doesn’t go away, Report feelings of heat flushing tiredness, sickness
swelling of lips and eyelids.
SE you may experience are: dizziness and drowsiness, numbness
feelings of tightness or pressure
6. Antivirals end in VIR.
SE pt may experience are n/v/d, loss of appetite, HA, dizziness.
REPORT:difficulty urinating, skin rash, or freq. recurrences.
7. Barbituates end in barbital. Teach pt that thesedrugs make you
drowsy and less anxious don’t try to get up after receiving this drug
and they may experience drowsiness, dizziness , impaired thinking,
hangover, ...AVOID DRIVING. GI upset, dreams (nightmares) diff.
concentrating, fatigue.
SE Report severe dizziness, drowsiness, and weakness and
pregnancy
8. Benzodiazepines end in pam and lam and in the middle have
either azo or aze.
SE are same as above drowsiness, dizziness etc. REPORT:SEVERE
drowsiness, dizziness, swelling in extremities, diff. voiding,
palpitations
9. Beta Blockers end in LOL.
SE You may experience dizziness, drowsiness, light headed, blurred
vision, n/v, loss of appetite, impotence, depression. REPORT:diff.
breathing, night cough, swelling of extremities, slow pulse,
confusion, depression, rash and sore throat.
MentalHealth:
Clozaril, Cogentin, Dalamane, Dexedrine, Elavil, Eskalith, Haldol,
Luminal, Navane, Phenergan, Ritalin, Serax, Sinequan, Surfak,
Thorazine
OB:
Aldomet, Ampicillin, Cortef, Ergometrine, Magnesium sulfate,
Pitocin, Premarin, Primaxin, Yutopar
Peds:
Kewll, Nix, Oncovin (plus themed-surg drugs)

6. -ase = thrombolytic
-azepam = benzodiazepine
-azine = antiemetic; phenothiazide
-azole = proton pump inhibitor, antifungal
-barbital = barbiturate
-coxib = cox 2 enzymeblockers
-cep/-cef = anti-infectives
-caine = anesthetics
-cillin = penicillin
-cycline = antibiotic
-dipine = calcium channel blocker
-floxacin = antibiotic
-ipramine = Tricyclic antidepressant
-ine = reverse transcriptaseinhibitors, antihistamines
-kinase = thrombolytics
-lone, pred- = corticosteroid
-mab = monoclonal antibiotics
-micin = antibiotic, aminoglycoside
-navir = proteaseinhibitor
nitr-, -nitr- = nitrate/vasodilator
-olol = beta antagonist
-oxin = cardiac glycoside
-osin = Alphablocker
-parin = anticoagulant
-prazole= PPI’s
-phylline= bronchodilator
-pril = ACE inhibitor
-statin = cholesterol lowering agent
-sartan = angiotensin II blocker
-sone = glucocorticoid, corticosteroid
-stigmine = cholinergics
-terol = Beta 2 Agonist
-thiazide = diuretic
-tidine = antiulcer
-trophin = Pituitary Hormone
-vir = anti-viral, proteaseinhibitors
-zosin = Alpha1 Antagonist
-zolam = benzo/sedative
-zine = antihistamine
Actonel.
Avodart.
Boniva.
Celebrex.
Cialis.
Coreg.
Crestor.
Detrol.
Ditropan.
Enbrel.
Fosamax.
Humira.
Levitra.
Lunesta.
Nexium.
Paxil.
Plavix.
Premarin.
Prilosec.
Procrit
Strattera.
Valtrex
Vesicare.
Viagra.
Vioxx.
Vytorin.
Wellbutrin.
Zelnorm.
Zocor.
Zyprexa.
Abilify
Alavert
Amitiza
Aricept
Caduet
Cymbalta
Effexor
Enablex
Evista
Flowmax
Gardasil
Imitrex
Januvia
Lyrica
Mirapex
Mirena
Nasonex
Neulasta
Orencia
Reclast
Requip
Restasis
Rozerem
Singulair
Spiriva
Symbicort
Some OtherInteresting Facts Likely To Be On The Test
Thiazide Diuretics BS
Diabetics need food K like oranges, bananas and brocholli
Vitamine K is a natural coagulant Foods high in Vitamin K like
green leafy vegatables should be avoided with blood thinners.
Normal potassiumlevels 3.5 to 5.0 mEq/liter
Potassiumlevels under 3.5 is Hypokalemia
Vasodilators: (esp nitroglyerine) innitially have orthostatic
hypotension sideeffect which wears off over time
Diuretic – Loop: All listed treat Hypertension
Calcium Channel Blocker All Treat Hypretension and Angina
AngioTension II Receptor Antagonist All listed treat HTN
ACE- Inhibitors:
1) Are the primary drug of choice for vasodilation in Heart Failure
2) One side effect of ACE-I is orthostatichypotension.
3) All ACE-I Listed all treat Hypertension &CHF some, treat MI
Beta Blockers :
1) All listed treat Hypertension &Angina
2) Most Treat CHF & Arrythmia
3) Must betaper slowly when discontinued to avoid Angina.
"Complications of Hypertension are:
1) Angina 2) stroke 3) Renal failure 4) Heart failure"
If digitalis is order "Give digitals if 60 < HR < 120
Hold digitalis if 60 > HR > 120"