This document provides information on commonly used emergency drugs, including their initial doses and indications. It also lists common antidotes for various agents. Additionally, it discusses drug name endings and what they may suggest about a drug's class or action. Finally, it provides a table of frequently asked medications including their classifications, desired effects, best times for administration, and other considerations.
An overview of atypical anti depressantsBrajesh Lahri
This powerpoint presentation deals with the pharmacology and psychiatric uses of atypical anti-depressants. TCAs and SSRIs are considered as typical anti-depressants, while other classes include SNRI, RIMAs and atypical antidepressants. In this presentation, i have briefly given an overview of atypical anti-depressants as well as of SNRIs and RIMAs.
This document discusses antibiotic dosing during renal failure. It explains the importance of dose adjustments with renal impairment due to decreased drug elimination. It compares methods to calculate glomerular filtration rate (GFR) and creatinine clearance, such as the Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault equations. It also describes different types of dialysis and considerations for dosing antibiotics in patients receiving dialysis or continuous renal replacement therapy.
Dopamine receptor agonists are important in the treatment of Parkinson's disease as they have fewer side effects than levodopa therapy. Key points:
- Dopamine agonists work directly on dopamine receptors and do not require metabolic conversion like levodopa. This avoids toxic metabolites.
- They are effective as initial therapy for mild Parkinson's and can be used alongside levodopa to smooth fluctuations and reduce dyskinesias in advanced disease.
- Common side effects include nausea, hypotension, hallucinations, impulse control disorders and sleep attacks. Ergot derivatives like bromocriptine and pergolide also carry risks of fibrosis and cardiac side effects.
- Apomorphine injections provide temporary
This document discusses organophosphate poisoning. It begins by introducing organophosphates as a group of chemicals used in domestic and industrial settings that act as acetylcholinesterase inhibitors. It then describes the chemical structure and mechanisms of organophosphates, their routes of entry into the body, and how they cause toxicity by inhibiting acetylcholinesterase. The document goes on to describe the clinical features, phases, and syndromes of organophosphate poisoning as well as their treatment, which involves stabilization, decontamination, administration of the antidotes atropine and pralidoxime, and supportive care.
1. The document discusses thyroid hormones and anti-thyroid drugs. It covers the production and effects of thyroid hormones, diseases related to thyroid hormones like hypothyroidism and hyperthyroidism, and therapeutic uses of thyroid drugs including levothyroxine and anti-thyroid drugs.
2. Common anti-thyroid drugs discussed are thioamides like propylthiouracil and methimazole which inhibit hormone synthesis, iodides which block hormone release, and radioactive iodine-131 which destroys thyroid tissue.
3. Adrenergic drugs like propranolol are also used as an adjuvant therapy to relieve symptoms of hyperthyroidism like tremors and palpit
Barbiturates are a class of drugs that act as central nervous system depressants and were one of the first intravenous anesthetic agents used clinically, with thiopental and methohexital being two examples that are ultra short-acting and can be used for anesthetic induction. Barbiturates work by enhancing the effects of the inhibitory neurotransmitter GABA in the brain and have a variety of clinical uses but also potential adverse effects like respiratory depression if overdosed.
Hypolipidaemics pharmacology with a note on Statins /Fibrates/ Sterol absorption Inhibitors/ CETP Inhibitors / Lipoprotein Lipase activators and Bile acid sequestrants
An overview of atypical anti depressantsBrajesh Lahri
This powerpoint presentation deals with the pharmacology and psychiatric uses of atypical anti-depressants. TCAs and SSRIs are considered as typical anti-depressants, while other classes include SNRI, RIMAs and atypical antidepressants. In this presentation, i have briefly given an overview of atypical anti-depressants as well as of SNRIs and RIMAs.
This document discusses antibiotic dosing during renal failure. It explains the importance of dose adjustments with renal impairment due to decreased drug elimination. It compares methods to calculate glomerular filtration rate (GFR) and creatinine clearance, such as the Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault equations. It also describes different types of dialysis and considerations for dosing antibiotics in patients receiving dialysis or continuous renal replacement therapy.
Dopamine receptor agonists are important in the treatment of Parkinson's disease as they have fewer side effects than levodopa therapy. Key points:
- Dopamine agonists work directly on dopamine receptors and do not require metabolic conversion like levodopa. This avoids toxic metabolites.
- They are effective as initial therapy for mild Parkinson's and can be used alongside levodopa to smooth fluctuations and reduce dyskinesias in advanced disease.
- Common side effects include nausea, hypotension, hallucinations, impulse control disorders and sleep attacks. Ergot derivatives like bromocriptine and pergolide also carry risks of fibrosis and cardiac side effects.
- Apomorphine injections provide temporary
This document discusses organophosphate poisoning. It begins by introducing organophosphates as a group of chemicals used in domestic and industrial settings that act as acetylcholinesterase inhibitors. It then describes the chemical structure and mechanisms of organophosphates, their routes of entry into the body, and how they cause toxicity by inhibiting acetylcholinesterase. The document goes on to describe the clinical features, phases, and syndromes of organophosphate poisoning as well as their treatment, which involves stabilization, decontamination, administration of the antidotes atropine and pralidoxime, and supportive care.
1. The document discusses thyroid hormones and anti-thyroid drugs. It covers the production and effects of thyroid hormones, diseases related to thyroid hormones like hypothyroidism and hyperthyroidism, and therapeutic uses of thyroid drugs including levothyroxine and anti-thyroid drugs.
2. Common anti-thyroid drugs discussed are thioamides like propylthiouracil and methimazole which inhibit hormone synthesis, iodides which block hormone release, and radioactive iodine-131 which destroys thyroid tissue.
3. Adrenergic drugs like propranolol are also used as an adjuvant therapy to relieve symptoms of hyperthyroidism like tremors and palpit
Barbiturates are a class of drugs that act as central nervous system depressants and were one of the first intravenous anesthetic agents used clinically, with thiopental and methohexital being two examples that are ultra short-acting and can be used for anesthetic induction. Barbiturates work by enhancing the effects of the inhibitory neurotransmitter GABA in the brain and have a variety of clinical uses but also potential adverse effects like respiratory depression if overdosed.
Hypolipidaemics pharmacology with a note on Statins /Fibrates/ Sterol absorption Inhibitors/ CETP Inhibitors / Lipoprotein Lipase activators and Bile acid sequestrants
The document discusses the sympathetic nervous system and adrenergic receptors. It describes:
1) How catecholamines like norepinephrine and epinephrine are synthesized from phenylalanine and tyrosine and stored in vesicles for release.
2) The different types of adrenergic receptors - alpha1, alpha2, beta1, beta2, and beta3 - and their locations and effects.
3) How catecholamines are released from neurons upon stimulation and their actions on various organs via receptor activation or reuptake.
This document discusses opioid analgesics and provides details about morphine. It defines opioids as any drug that binds to opioid receptors in the central nervous system and can be antagonized by naloxone. Morphine is described as the prototypical opioid analgesic. Its mechanisms of action include inhibiting neurotransmitter release in the spinal cord and brain. Adverse effects include respiratory depression, sedation, constipation, and dependence with repeated use. Morphine has therapeutic uses for relieving various types of pain but also carries risks in certain patient populations like those with head injuries. The document outlines various opioid classifications and compares properties of representative opioids like morphine, codeine, pethidine, and buprenorphine.
Anticholinergic drugs block the effects of acetylcholine at muscarinic receptors in the central and peripheral nervous system. Prototype anticholinergic is atropine, which is highly selective for muscarinic receptors. Anticholinergic drugs have many therapeutic uses including treatment of Parkinson's disease, motion sickness, respiratory disorders, ophthalmological disorders, and poisonings. However, they can cause adverse effects such as dry mouth, blurred vision, tachycardia, constipation, and delirium at high doses.
Sympatholytics, also known as adrenergic antagonists or blocking agents, work in opposition to adrenergic agents by blocking alpha and beta receptor sites. They are classified based on the type of adrenergic receptor they block, including alpha1, alpha2, beta1, beta2, and beta3 receptors. Common alpha blockers include phenoxybenzamine, ergot alkaloids, phentolamine, tolazoline, prazosin, terazosin, doxazosin, and tamsulosin. Common beta blockers mentioned include propanolol, acetabutolol, atenolol, betaxolol, carvedilol, metoprol
Hemorrhagic Transformation after Intravenous Thrombolysis in Acute Ischaemic ...Ade Wijaya
Hemorrhagic transformation is a risk after intravenous thrombolysis for ischemic stroke. Symptomatic intracranial hemorrhage occurs in 2-7% of patients, with older age, greater stroke severity, and medical comorbidities increasing the risk. The bleeding results from coagulopathy, reperfusion injury, and breakdown of the blood-brain barrier occurring within 36 hours. Repeat imaging is recommended within 24 hours or with neurological deterioration to diagnose bleeding complications.
This document discusses antibiotic allergy and provides key messages from several guidelines and expert opinions on the diagnosis and management of adverse drug reactions. It defines different types of drug hypersensitivity reactions and classifications. It also discusses approaches to evaluating antibiotic allergies, including skin testing and drug provocation tests. Specific sections focus on penicillin allergy testing and management. The document is a comprehensive review drawing from multiple guidelines and studies.
cholingeric and Anticholinesterase drug in detail .this ppt contains introduction ,mechanism of action ,pharmacological action ,uses and adverse effect of the drug
This document discusses prokinetics, which are drugs that enhance gastrointestinal motility. It describes the normal control pathways of GI motility, including hormonal and neural pathways. It then discusses various phases of GI motility including the cephalic, gastric, and intestinal phases. The document outlines several prokinetic drug categories and examples, including muscarinic agonists, anticholinesterases, dopamine D2 blockers, 5-HT4 agonists, and motilin agonists. It discusses the mechanisms of action and advantages/disadvantages of various prokinetic drugs. Novel therapies for improving GI motility in critically ill patients are also mentioned.
Please find the power point on Paracetamol poisoning. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Sedatives calm without sleep, hypnotics induce sleep. Benzodiazepines like diazepam are commonly used sedative-hypnotics with high safety indices. They act by enhancing GABA inhibition. Newer drugs like zolpidem act similarly but with less residual effects. Barbiturates were widely used previously but are no longer preferred due to risks of overdose and dependence. The goal of treatment is to reduce anxiety, induce sleep, and have minimal daytime effects.
- GABA is the major inhibitory neurotransmitter in the mammalian brain. It acts through GABAA, GABAB, and GABAC receptors.
- GABAA receptors are ligand-gated chloride channels modulated by drugs like benzodiazepines, barbiturates, and general anesthetics. GABAB receptors are G-protein coupled receptors that inhibit neurotransmitter release and hyperpolarize neurons.
- Drugs that enhance GABAergic transmission through GABAA receptors like benzodiazepines are used as sedatives, anxiolytics, and anticonvulsants. The GABAB agonist baclofen is used as a muscle relaxant for spastic
Paracetamol was developed in the late 1880s as a less toxic derivative of acetanilide. It is metabolized in the liver to a toxic intermediate called NAPQI, which is normally detoxified by glutathione. An overdose can deplete glutathione stores, allowing NAPQI to damage liver cells. Paracetamol poisoning has few early symptoms but can cause liver failure and death. Treatment involves N-acetylcysteine to replenish glutathione within 8-24 hours of ingestion. Prognosis depends on factors like time to treatment, dose ingested, and underlying liver health.
Migraine is a neurological disorder characterized by recurrent headaches that can last from 4 to 72 hours. It is often accompanied by nausea, vomiting, sensitivity to light and sound. There are two main types - migraine with aura and migraine without aura. Treatment involves using over-the-counter pain relievers for mild migraines, prescription triptans or ergotamines for moderate migraines, and preventative medications for severe or frequent migraines. Preventative medications taken daily include beta blockers, antidepressants, anticonvulsants, and calcium channel blockers, and aim to reduce migraine frequency within 2-6 months.
Neuromuscular blocking agents and ganglionic blockers AZCPh
The document discusses the results of a study on the impact of COVID-19 lockdowns on air pollution. Researchers analyzed data from dozens of countries and found that lockdowns led to an average decline of nearly 30% in nitrogen dioxide levels across major cities. However, they also observed that the reductions in air pollution were temporary and that levels began to rise again as restrictions eased and human activity increased.
This document discusses adrenergic drugs and their mechanisms of action. It describes how adrenergic receptors are classified into alpha and beta receptors, which have subtypes. It explains how various drugs like adrenaline, isoprenaline, dopamine, dobutamine, phenylephrine, and alpha methyl dopa act as agonists at these receptor subtypes, and outlines their therapeutic uses and adverse effects. Selective beta-2 agonists like salbutamol are also covered, which are used for conditions like bronchial asthma and premature labor.
This document summarizes various sedative-hypnotic drugs including benzodiazepines, barbiturates, and other agents like buspirone and ramelteon. It describes their mechanisms of action, with benzodiazepines and barbiturates facilitating GABA activity while buspirone acts on serotonin receptors. It also lists their medical uses for conditions like anxiety, insomnia, seizures and muscle spasms. Side effects include cognitive impairment, respiratory depression and tolerance with long-term use.
This document discusses paracetamol (acetaminophen) poisoning. It covers the introduction, metabolism, mechanism of toxicity, clinical features, diagnosis, management, postmortem findings, and medicolegal importance of paracetamol poisoning. Paracetamol is metabolized in the liver and can cause toxicity when levels of its toxic metabolite NAPQI exceed levels of glutathione in the liver, leading to liver and sometimes kidney damage. Management involves gastric decontamination and use of the antidote N-acetylcysteine to prevent binding of NAPQI if administered early. Fulminant liver failure may require liver transplantation.
Managers control hospital costs through various budgeting processes including fixed, flexible, operating, and strategic budgets. Fixed budgets do not change with volume while flexible budgets change based on actual activity levels. Operating budgets project annual expenses and strategic budgets focus on long-term trends. Organizations deal with changes in the short, intermediate, and long-run through measures like adjusting staffing levels. Hospital costs vary due to differences in services, cost-shifting, patient illness, and production efficiency. Regulatory approaches to controlling costs include certificate of need laws, utilization review, professional standards review organizations, and administered pricing systems like DRGs and PPS.
Ointment, cream, gel , pastes, plasters, glycerogelatinCristina Joy Reyes
Ointments, creams, gels, pastes, plasters, and glycerogelatins are different topical semisolid dosage forms. Ointments are semisolids for application to the skin or mucous membranes and can be medicated or unmedicated. Creams are emulsions that can be water-in-oil or oil-in-water. Gels are dispersions of molecules in an aqueous liquid made jelly-like with a gelling agent. Pastes are stiffer than ointments and contain more solids. Plasters are adhesive solid or semisolid masses spread on a backing. Glycerogelatins contain gelatin, glycerin, water,
The document discusses the sympathetic nervous system and adrenergic receptors. It describes:
1) How catecholamines like norepinephrine and epinephrine are synthesized from phenylalanine and tyrosine and stored in vesicles for release.
2) The different types of adrenergic receptors - alpha1, alpha2, beta1, beta2, and beta3 - and their locations and effects.
3) How catecholamines are released from neurons upon stimulation and their actions on various organs via receptor activation or reuptake.
This document discusses opioid analgesics and provides details about morphine. It defines opioids as any drug that binds to opioid receptors in the central nervous system and can be antagonized by naloxone. Morphine is described as the prototypical opioid analgesic. Its mechanisms of action include inhibiting neurotransmitter release in the spinal cord and brain. Adverse effects include respiratory depression, sedation, constipation, and dependence with repeated use. Morphine has therapeutic uses for relieving various types of pain but also carries risks in certain patient populations like those with head injuries. The document outlines various opioid classifications and compares properties of representative opioids like morphine, codeine, pethidine, and buprenorphine.
Anticholinergic drugs block the effects of acetylcholine at muscarinic receptors in the central and peripheral nervous system. Prototype anticholinergic is atropine, which is highly selective for muscarinic receptors. Anticholinergic drugs have many therapeutic uses including treatment of Parkinson's disease, motion sickness, respiratory disorders, ophthalmological disorders, and poisonings. However, they can cause adverse effects such as dry mouth, blurred vision, tachycardia, constipation, and delirium at high doses.
Sympatholytics, also known as adrenergic antagonists or blocking agents, work in opposition to adrenergic agents by blocking alpha and beta receptor sites. They are classified based on the type of adrenergic receptor they block, including alpha1, alpha2, beta1, beta2, and beta3 receptors. Common alpha blockers include phenoxybenzamine, ergot alkaloids, phentolamine, tolazoline, prazosin, terazosin, doxazosin, and tamsulosin. Common beta blockers mentioned include propanolol, acetabutolol, atenolol, betaxolol, carvedilol, metoprol
Hemorrhagic Transformation after Intravenous Thrombolysis in Acute Ischaemic ...Ade Wijaya
Hemorrhagic transformation is a risk after intravenous thrombolysis for ischemic stroke. Symptomatic intracranial hemorrhage occurs in 2-7% of patients, with older age, greater stroke severity, and medical comorbidities increasing the risk. The bleeding results from coagulopathy, reperfusion injury, and breakdown of the blood-brain barrier occurring within 36 hours. Repeat imaging is recommended within 24 hours or with neurological deterioration to diagnose bleeding complications.
This document discusses antibiotic allergy and provides key messages from several guidelines and expert opinions on the diagnosis and management of adverse drug reactions. It defines different types of drug hypersensitivity reactions and classifications. It also discusses approaches to evaluating antibiotic allergies, including skin testing and drug provocation tests. Specific sections focus on penicillin allergy testing and management. The document is a comprehensive review drawing from multiple guidelines and studies.
cholingeric and Anticholinesterase drug in detail .this ppt contains introduction ,mechanism of action ,pharmacological action ,uses and adverse effect of the drug
This document discusses prokinetics, which are drugs that enhance gastrointestinal motility. It describes the normal control pathways of GI motility, including hormonal and neural pathways. It then discusses various phases of GI motility including the cephalic, gastric, and intestinal phases. The document outlines several prokinetic drug categories and examples, including muscarinic agonists, anticholinesterases, dopamine D2 blockers, 5-HT4 agonists, and motilin agonists. It discusses the mechanisms of action and advantages/disadvantages of various prokinetic drugs. Novel therapies for improving GI motility in critically ill patients are also mentioned.
Please find the power point on Paracetamol poisoning. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Sedatives calm without sleep, hypnotics induce sleep. Benzodiazepines like diazepam are commonly used sedative-hypnotics with high safety indices. They act by enhancing GABA inhibition. Newer drugs like zolpidem act similarly but with less residual effects. Barbiturates were widely used previously but are no longer preferred due to risks of overdose and dependence. The goal of treatment is to reduce anxiety, induce sleep, and have minimal daytime effects.
- GABA is the major inhibitory neurotransmitter in the mammalian brain. It acts through GABAA, GABAB, and GABAC receptors.
- GABAA receptors are ligand-gated chloride channels modulated by drugs like benzodiazepines, barbiturates, and general anesthetics. GABAB receptors are G-protein coupled receptors that inhibit neurotransmitter release and hyperpolarize neurons.
- Drugs that enhance GABAergic transmission through GABAA receptors like benzodiazepines are used as sedatives, anxiolytics, and anticonvulsants. The GABAB agonist baclofen is used as a muscle relaxant for spastic
Paracetamol was developed in the late 1880s as a less toxic derivative of acetanilide. It is metabolized in the liver to a toxic intermediate called NAPQI, which is normally detoxified by glutathione. An overdose can deplete glutathione stores, allowing NAPQI to damage liver cells. Paracetamol poisoning has few early symptoms but can cause liver failure and death. Treatment involves N-acetylcysteine to replenish glutathione within 8-24 hours of ingestion. Prognosis depends on factors like time to treatment, dose ingested, and underlying liver health.
Migraine is a neurological disorder characterized by recurrent headaches that can last from 4 to 72 hours. It is often accompanied by nausea, vomiting, sensitivity to light and sound. There are two main types - migraine with aura and migraine without aura. Treatment involves using over-the-counter pain relievers for mild migraines, prescription triptans or ergotamines for moderate migraines, and preventative medications for severe or frequent migraines. Preventative medications taken daily include beta blockers, antidepressants, anticonvulsants, and calcium channel blockers, and aim to reduce migraine frequency within 2-6 months.
Neuromuscular blocking agents and ganglionic blockers AZCPh
The document discusses the results of a study on the impact of COVID-19 lockdowns on air pollution. Researchers analyzed data from dozens of countries and found that lockdowns led to an average decline of nearly 30% in nitrogen dioxide levels across major cities. However, they also observed that the reductions in air pollution were temporary and that levels began to rise again as restrictions eased and human activity increased.
This document discusses adrenergic drugs and their mechanisms of action. It describes how adrenergic receptors are classified into alpha and beta receptors, which have subtypes. It explains how various drugs like adrenaline, isoprenaline, dopamine, dobutamine, phenylephrine, and alpha methyl dopa act as agonists at these receptor subtypes, and outlines their therapeutic uses and adverse effects. Selective beta-2 agonists like salbutamol are also covered, which are used for conditions like bronchial asthma and premature labor.
This document summarizes various sedative-hypnotic drugs including benzodiazepines, barbiturates, and other agents like buspirone and ramelteon. It describes their mechanisms of action, with benzodiazepines and barbiturates facilitating GABA activity while buspirone acts on serotonin receptors. It also lists their medical uses for conditions like anxiety, insomnia, seizures and muscle spasms. Side effects include cognitive impairment, respiratory depression and tolerance with long-term use.
This document discusses paracetamol (acetaminophen) poisoning. It covers the introduction, metabolism, mechanism of toxicity, clinical features, diagnosis, management, postmortem findings, and medicolegal importance of paracetamol poisoning. Paracetamol is metabolized in the liver and can cause toxicity when levels of its toxic metabolite NAPQI exceed levels of glutathione in the liver, leading to liver and sometimes kidney damage. Management involves gastric decontamination and use of the antidote N-acetylcysteine to prevent binding of NAPQI if administered early. Fulminant liver failure may require liver transplantation.
Managers control hospital costs through various budgeting processes including fixed, flexible, operating, and strategic budgets. Fixed budgets do not change with volume while flexible budgets change based on actual activity levels. Operating budgets project annual expenses and strategic budgets focus on long-term trends. Organizations deal with changes in the short, intermediate, and long-run through measures like adjusting staffing levels. Hospital costs vary due to differences in services, cost-shifting, patient illness, and production efficiency. Regulatory approaches to controlling costs include certificate of need laws, utilization review, professional standards review organizations, and administered pricing systems like DRGs and PPS.
Ointment, cream, gel , pastes, plasters, glycerogelatinCristina Joy Reyes
Ointments, creams, gels, pastes, plasters, and glycerogelatins are different topical semisolid dosage forms. Ointments are semisolids for application to the skin or mucous membranes and can be medicated or unmedicated. Creams are emulsions that can be water-in-oil or oil-in-water. Gels are dispersions of molecules in an aqueous liquid made jelly-like with a gelling agent. Pastes are stiffer than ointments and contain more solids. Plasters are adhesive solid or semisolid masses spread on a backing. Glycerogelatins contain gelatin, glycerin, water,
The Philippine Pharmacists Licensure Exam is composed of six modules covering different categories: Pharmaceutical Chemistry (20%), Pharmacognosy (17.5%), Practice of Pharmacy (17.5%), Pharmacology and Pharmacokinetics (15%), Pharmaceutics (17.5%), and Quality Assurance and Quality Control (15%). Each module focuses on specific topics within its category and questions are gathered from key sources and textbooks.
General Chemistry and Inorganic Pharmaceutical Chemistry Module 1 Pharmacist ...Senyora Ouf'ra
This document provides an overview of Module 1 of the pharmacist licensure exam, which covers various topics in pharmaceutical chemistry. It will be the first module administered on the first day of the exam from 8-10 AM. The module will include questions from general chemistry, inorganic and organic medicinal chemistry, analytical chemistry, and other related chemical topics. The document emphasizes that Module 1 will be the most difficult and important module to study for. It then provides examples of key topics covered, such as atomic structure, types of chemical bonds, gas laws, and thermodynamics.
This document discusses ophthalmic drug delivery systems and contact lens care. It describes various types of ophthalmic dosage forms including eye drops and suspensions. It outlines pharmaceutical requirements for these formulations such as sterility, isotonicity, buffering and viscosity. It also discusses different types of contact lenses, solutions used for cleaning, soaking and disinfecting soft and hard contact lenses, as well as products used for caring for rigid gas permeable contact lenses.
The document discusses biopharmaceutics and factors influencing drug absorption. Biopharmaceutics studies how the chemical and physical properties of drugs and dosage forms affect drug absorption rates and levels based on the route of administration. Drug absorption is influenced by physiological factors like membrane transport mechanisms, gastrointestinal physiology, gastric emptying time, and the effect of food. Absorption also depends on chemical-physical properties of the drug and formulation factors. The goal of biopharmaceutics is to understand how these factors impact drug bioavailability, protection/stability, release rates, and pharmacologic effects.
1. Biopharmaceutics is concerned with the relationship between a drug's physicochemical properties, its dosage form, and the resulting therapeutic response after administration.
2. Factors like a drug's properties, dosage form characteristics, administration route and site of absorption influence the time course of the drug in plasma and its bioavailability.
3. Drug absorption can be influenced by physiological factors like membrane permeability, as well as physicochemical drug properties and dosage form design features.
This document provides information on common diagnostic procedures including noninvasive procedures like electrocardiograms, echocardiograms, electroencephalograms, and x-rays; as well as fluoroscopy procedures that require contrast agents. Key nursing responsibilities for these procedures include explaining the procedure to reduce anxiety, ensuring specimens are collected without contamination, protecting patients from radiation as needed, monitoring for allergic reactions, and following post-procedure dietary guidelines.
I just wanted to share some of my Clinical Instructors lecture materials. I don't own this document, I wish to help you guys with the summary of Commonly asked emergency drugs.
The document discusses pancreatitis, including:
1. It describes the parts and functions of the pancreas, including exocrine and endocrine functions.
2. It covers the causes, signs, symptoms, investigations, and treatment of acute and chronic pancreatitis. Conservative treatment includes hydration and antibiotics, while surgery may be needed for complications.
3. It lists complications of pancreatitis such as shock, respiratory failure, infections, and pancreatic insufficiency. Chronic pancreatitis involves permanent structural damage and its treatment aims to control pain and manage complications.
This document provides an overview of pulmonary embolism (PE), including its definition, risk factors, types, natural history, symptoms, signs, investigations, diagnosis, and management. PE is defined as obstruction of the pulmonary artery or its branches by material such as thrombus. It discusses diagnostic tests like CT, VQ scan, echocardiogram and their role in determining pretest probability. Management involves anticoagulation with drugs like heparin, warfarin, rivaroxaban. Thrombolysis may be used for massive PE while inferior vena cava filters can be placed in patients who cannot receive anticoagulation.
This document discusses several key facts about heart disease:
- Living with others can lower heart attack risk by reducing stress and depression. Many heart attacks occur on Monday mornings when stress hormones spike in the morning. Sexual activity rarely causes heart issues due to its short duration.
It then provides information on coronary artery disease including non-modifiable risk factors like age and family history, and modifiable factors like smoking, obesity, and high cholesterol. Care and management of coronary artery disease includes lifestyle changes, medications like statins, and possible surgical interventions.
It concludes with sections on angina pectoris including types, symptoms, and drug treatments like nitroglycerin. Diagnostic tests and the nursing management of
1. The document discusses the key principles of emergency nursing including establishing an open airway, controlling hemorrhage, maintaining circulation, assessing neurological status, and rapidly assessing patients.
2. Common medical emergencies covered include acute abdomen, shock, respiratory issues, cardiac emergencies, neurological emergencies, trauma, and poisoning. Signs, symptoms, diagnostic tests, and treatment approaches are described for each condition.
3. The principles of emergency management are also summarized, which include early detection, reporting, response, providing good on-scene care and transportation to definitive care.
Clinical approach to urinary incontinenceYasmin Saidat
This document discusses the definition, pharmacology, history taking, physical exam findings, investigations, and management of different types of urinary incontinence. It defines stress, urge, overflow, sensory, and bypass fistula incontinence. For each type, it describes the etiology, history, exam findings, investigation results, and management approaches including behavioral modifications, medications, injections, and surgeries. Key investigations discussed are urinalysis, bladder diary, urodynamic studies measuring post-void residual volume, uroflow, pressure flow studies, and cystometrogram. The goal of management is to treat any underlying causes and reduce symptoms through conservative or surgical methods depending on the incontinence type and severity.
This document provides an overview of gastrointestinal disorders, including anatomy and physiology of the GI tract, physical assessment techniques, common GI conditions like peptic ulcer disease, and nursing interventions. It describes the functions of the GI organs and accessories like the liver and pancreas. Diagnostic tests and procedures like endoscopy are outlined. Complications of tube feedings and acute GI bleeding from sources like stress ulcers are reviewed.
This document outlines the course objectives and topics for a pharmacology course for advanced practice nurses. The course covers drugs that influence pain, infection, hematologic disorders, cardiovascular disorders, cancer, and renal disorders. Key topics include therapeutic options for conditions like bacterial infections, congestive heart failure, hypertension, and renal failure. The course evaluation is based on presentations, quizzes, and a final exam. Recommended textbooks are also provided.
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
Overactive bladder is defined as urgency, usually with frequency and nocturia, with or without incontinence, in the absence of infection or other pathology. It affects 16.9% of people in North America and prevalence increases with age. Detrusor overactivity is seen in 64% of OAB patients and 83% of patients with detrusor overactivity have OAB. Treatment involves behavioral modifications, drug therapy using anticholinergic medications, neuromodulation techniques for refractory cases, and surgery for severe cases not responding to other options. The document provides detailed information on the definition, causes, evaluation, and management strategies for overactive bladder.
This document discusses cardiopulmonary cerebral resuscitation (CPCR) in dogs and cats. It defines key terms like respiratory arrest and cardiopulmonary arrest. It outlines that overall survival to discharge is around 6-7% for dogs and 3% for cats. The document then discusses the goals and steps of basic life support (BLS) including circulation, airway, and breathing. It also covers advanced life support (ALS) techniques like drug administration, electrical defibrillation, fluid therapy, and monitoring such as ECG and end-tidal CO2. Finally, it summarizes the RECOVER initiative which aimed to establish evidence-based guidelines for small animal CPR.
Copy Of Investigation Of Endocrine Diseaseguest633bcb
Endocrinology involves understanding hormone levels and stimulating or suppressing hormones that are too high or too low. The pituitary gland regulates other endocrine glands and has anterior and posterior divisions. Diagnosis of endocrine diseases involves hormone stimulation tests, hormone level measurements, and imaging tests. The thyroid, parathyroid, adrenal and other glands are involved in various metabolic processes and their functions and diseases are described.
The document provides an overview of gastrointestinal system anatomy and physiology, including the structures and functions of the mouth, esophagus, stomach, small intestine, large intestine, and accessory organs such as the liver, gallbladder and pancreas. It also discusses diagnostic tests and treatments for gastrointestinal disorders, including endoscopy, barium studies, enemas, nasogastric intubation and total parenteral nutrition. Specific conditions like hiatal hernia are described.
1. The document discusses the etiologies, management, and complications of ascites. The most common cause is cirrhosis which accounts for 75% of cases.
2. Physical exam findings for ascites include bulging flanks, flank dullness, shifting dullness, and fluid wave. Paracentesis is the gold standard for diagnosis and involves removing fluid from the abdominal cavity.
3. Treatment depends on the grade or severity of ascites. Mild ascites may only require diet modification while severe ascites is treated with paracentesis and diuretics like spironolactone and furosemide. Refractory ascites can be managed with repeated paracentesis, TIPS
Management of acute pancreatitis involves initially assessing the patient based on history, physical exam, and laboratory/imaging tests to confirm the diagnosis. Key factors include serum amylase and lipase levels over 3 times normal, abdominal pain, and imaging showing pancreatic inflammation. The condition is caused by premature activation of digestive enzymes within the pancreas due to various genetic and environmental factors. Treatment focuses on pain management, monitoring for complications, and treating any underlying causes like gallstones. Prognosis can be assessed using scoring systems like Ranson's criteria or CT severity index which evaluate markers of severity in the first 48 hours.
1. Gastrointestinal bleeding is a common presenting problem in the emergency room, with upper GI bleeding having an annual incidence of approximately 47 per 100,000 people.
2. The main causes of upper GI bleeding include peptic ulcers, esophageal varices, gastritis, and esophagitis.
3. The initial priorities in management are resuscitation through fluid resuscitation and blood transfusion if needed, followed by endoscopy to determine the source of bleeding and provide endoscopic therapy if active bleeding is detected.
This document provides tips for using a PowerPoint presentation on acute pancreatitis. It recommends:
1. Freely editing and modifying the slides to add your own name.
2. Not worrying about the number of slides, as many are blank except for the title to facilitate active learning sessions.
3. Showing blank slides first to elicit what students already know, then showing the content slide.
4. Repeating this process of blank slide then content slide at the end for review.
5. This format allows for active learning through three revisions of content.
Deodenal ulcer due to H pylori infectionAlexXander53
This document contains information about a patient presenting with epigastric pain, black stool, and occasional vomiting. The patient is a 62-year-old male taxi driver with a history of knee pain. On physical examination, he was found to have a high respiratory rate and blood pressure. He was diagnosed with a duodenal ulcer and Helicobacter pylori infection. The document then provides summaries from various student groups on relevant topics including the patient's medical history, common gastrointestinal issues in males age 60s, examples of gastrointestinal structures, and the physical examination of the abdomen.
Portal hypertension, liver cirrhosis and liver transplantAnshu Yadav
Portal hypertension occurs when blood pressure within the portal venous system increases. It is commonly caused by liver cirrhosis and affects 5-10% of patients in developed countries. Cirrhosis results from chronic liver damage and scarring of the liver tissue. It can be caused by alcoholism, viral hepatitis, NASH, or genetic diseases. Common signs include fatigue, abdominal pain, and jaundice. Treatment focuses on managing complications through medications, procedures like TIPS or banding of varices, and potentially liver transplantation.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Common drugs and antidotes
1. Commonly Asked Emergency Drugs
Emergency Drug Initial Dose Indications
Adenosine 6 mg
Atropine sulfate 0.5 – 1 mg.q 3-5 min Bradycardia
Epinephrine 1 mg.q 3-5 min Cardiac arrest
Lasix 0.5-1 mg/kg Pulmonary edema
Lidocaine 1-1.5 mg/kg Ventricular fibrillation, Ventricular tachycardia
Magnesium sulfate 1-2 g Ventricular tachycardia r/t hypomagnesemia
Morphine Sulfate 1-3 mg Chest pain, pulmonary edema
Narcan 0.02-2mg Narcotic – respiratory depression
Nitroglycerine 0.4 mg SL Chest pain, pulmonary edema
Vasopressin 40 units Cardiac arrest
Antidotes
Agents Antidotes
Acetaminophen Acetylcysteine (Mucomyst)
Anticholinesterase Atropine So4
Anticholinergics Physostigmine
Benzodiazepines Flumazenil
Coumadine Vitamin K
Cyanide Sodium nitrate
Digoxin Digoxin immune fab (Digibind)
Dopamine Phentolamine
Heparin Protamine sulfate
Iron Deferoxamine
Lead Dimercaprol, edentate disodium and succimer
Magnesium Sulfate Calcium gluconate
Narcotics Naloxone
Drug Name Endings: What they can suggest you!!!
Endings class
*cain Local anesthetics
*cillin Antibiotics
*dine Antiulcer agent
*done Opiod analgesics
*ide Oral hypoglycemics
*lam/
*pam Antianxiety
*micin/
*mycin Antibiotics
*mine/
*zide Diuretics
*olol Beta blockers
*pril ACE inhibitors
*sone Steroids
2. FREQUENTLY ASKED MEDICATIONS
Drugs Trade /(generics) Classification Desired Effects Best Time to be Taken Other Considerations
1 Aminophylline (theophylline) Bronchodilator To case breathing AM / empty stomach • No smoking
• No caffeine
• Check heart rate
2 Amphogel (aluminum hydroxide) Antacid phosphate level Between meals and HS • Give with glass of w
• Report melena
3 Antabuse (disulfiram) Antialcoholic agent Avoidance of alcohol After 12 hrs. stoppage from alcohol • No alcohol in any m
4 Aspirin (ASA) Anti-inflammatory
Anti-pyretic
Analgesic
temperature
pain and inflammation
Full stomach • Check for bleeding
• Syrup of inpecae in
5 Atropine SO4 Anticholinergic and Vagolytic heart rate and decrease
secretion s
30 PC • Observe facial flus
• Avoid hot environm
6 Bacterium (cotrimoxazole) Antibiotic (-) infection PC • Reddish urine
• Rashes
• Assess for signs of
7 Benadryl (diphenhydramine hcl) Antihistamine
Anti – EPS
(-) allergy
(-) movement syndrome
Best taken with food • Avoid alcohol
8 Celestone (betamethazone) Steroids respiratory distress in
newborn
Best taken with food • Monitor weight
9 Cytoxan (cyclophosphamide) Antineoplastic size of tumor AM • Increase fluids
• Monitor CBC
10 Diabinase (chlorpropaminde) Antidiabetic agent Normal glucose range AM • Monitor for hypog
11 Diamox
(acetazolamide)
Antiglaucoma antidiuretics urine output
vertigo
AM with meals • Photosensitivity
12 Digoxin (lanoxin) Cardiac glycoside Normal heart rate AM • Assess pulse rate
• Monitor serum K
13 Dilantin (phenytoin) Anti-convulsant (-) seizure Best taken with food • Taper dosage
14 Diuril (chlorothiazide) Diuretics urine output Best taken with food • Report weakness i
• Increase K in the d
15 Epinephrine Bronchodilator heart rate AM • Don’t operate mac
• Assess for increase
16 Flagyl (metronidazole) Antihelmintic (-) helminth Best taken with food • Avoid alcohol
• Not to give with an
• Tetratogenic
17 Haldol (haloperidol) Antipsychotic (+) symptoms of psychosis AC • Assess BP
• Photosensitivity
18 Kayexalate Promote excretions of K serum K • May cause constip
• Monitor serum po
19 Lasix (furosemide) Diuretic urine output AM • Increase intake of
20 Lithane (LiCO3) Antimanic hyperactivity PC • Monitor lithium to
• Decrease activity
21 Lovenox (mevacor) Antithrombotic (-) thrombosis • Soft bristle toothb
• No razor
• Keep protamine SO
22 Magnesium SO4 Anticonvulsant (-) convulsion • Assess DTR and PR
• Antidote is Calcium
23 Mastinon (pyridostigmine) Cholinesterase inhibitor muscle strength PC • Monitor for muscl
• Antidote is atropin
24 Mathergine (methylergonovine
maleate)
Oxytocic for post partum
atony
Firmly contracted uterus • Monitor BP
• Report dyspnea
25 Monoamine oxidase inhibitor Antidepressant Improved sleeping pattern PC • No tyramine rich f
• Assess for hyperte
• Monitor BP
26 Nitroglycerin Antiangina (-) chest pain Best taken before any strenuous
activity
• Taken SL; don’t ch
• Keep tablets in dar
27 Pancrease (pancreatin) Pancreatic enzyme (-) fat in the stool Between meal and snacks • Preparation is ente
• Observe for diarrh
28 Phenergan (promethazine
hyrochloride)
Antihistamine (-) allergy Empty stomach • Antidote is epinep
29 Reserpine (serpasil) Antihypertensive BP Best taken with meals • No sudden change
• Monitor BP and PR
30 Ritalin (methylphenidate) Stimulant hyperactivity AM / PC • Monitor growth an
31 Robaxin (methocarbamol) Skeletal muscle relaxant (-) muscle spasm AM • No alcohol
• Antidote : Epineph
32 Synthroid (levothyroxine sodium) Thyroid hormone supplement Normal T4 level AM • Monitor BP and PR
33 Tagamet (cimetidine) Antiacidity (-) heartburn Best taken with food • Avoid smoking
34 Thorazine (chlorpromazine hcl) Antipsychotic (-) positive signs of psychosis PC • Photosensitivity
• Monitor BP
3. 35 Valium (diazepam) Antianxiety (-) anxiety AC • No alcohol, caffein
36 Xylocaine (lidocaine) Antiarrythmic Normal heart rate • Monitor for toxicit
• S / E : tinnitus
37 Zyloprim (allopurinol) Antigout uric acid Best taken with food • Increase fluid intak
4. Common Tubes
Table or Apparatus Purpose Examples of Use Key points
Miller-Abbott tube Longer than Levin tube; has
mercury of air in bags so tube can
be used to decompress the lower
intestinal tract
1. Small-bowel obstructions
2. Intussusception
3. Volvulus
1. Care similar to that Levin NG tube irrigated.
2. connected to suction, not sterile technique
3. orders will be written on how to advance the tube
gently pushing tube a few inches each hour, patient
position may affect advancement of tube
4. X-rays determine the desired location of tube
Cantor Tube To drain bile from the common
bile duct until edema has
subscribed
Cholecystectomy when a common
duct exploration (CDE) or
choledochostomy was also done
1. Bile drainage is influenced by position of the
drainage bag.
2. Clamp tubes as ordered to see if bile will flow into
duodenum, normally.
T-tube A type of closed-wound drainage
connected to suction-used to
drain, a large amount of
serosa`nguineous drainage from
under an incision
1. Mastectomy
2. Total hip procedure
3. Total knee procedure
1. May compress unit, and have portable vacuum or
connect to wall suction.
2. Small drainage tube may get clogged physician may
irrigate these at times
Hemovac A method of closed wound
suction drainage indicate when
tissue displacement and tissue
trauma may occur with rigid drain
tubes (e.g Hemovac)
1. Neurosurgery
2. Neck surgery
3. Mastectomy
4. Total knee and hip
replacement
5. Abdominal surgery
6. Urological procedure
Empty reservoir when full, to prevent loss of wound
drainage and back contamination
Jackson-Pratt See Hemovac See Hemovac See Hemovac
Three-way Foley To provide avenues for constant
irrigation and constant drainage
of urinary bladder
1. Transurethral resection (TUR)
2. Bladder infection
Watch for blocking by clots causes bladder spasms
Irrigant solution often has antibiotic added to normal salin
or sterile water
Sterile water rather than normal saline may be used for
lysis of clots
Suprapubic catheter To drain bladder via an opening
through the abdominal wall
above the pubic bone
Suprapubic prostatectomy May have orders to irrigate prn or continuously
Ureteral catheter To drain urine feom the pelvis of
one kidney, or for splinting ureter
1. Cystoscopy for diagnostic
workups
2. Ureteral surgery
3. Pyelotomy
Never clamp the tube-pelvis of kidney only holds 4-8 mL
Use only 5 mL sterile normal saline if ordered to irrigate
Common Diagnostics Procedures
Noninvasive Diagnostic Procedures
Characteristics:
1. it provides an indirect assessment of organ size, shape, and / or function
2. it is safe
3. it is easily reproducible
4. it requires less complex equipment for recording
5. it does not require the written consent of patient or guardian
General Nursing Tasks:
1. Decrease patients anxieties and offer support by
a. Explain purpose and procedure of test
b. Acknowledge questions regarding safety of the procedure
c. Remain with the patient while the procedure is going on
2. Use procedure in the collection of specimens that avoids contamination
A. Graphic studies of Heart and brain
1. Electrocardiogram (ECG) – graphic record of electrical activity generated by the heart during depolarization and repolarazation.
- diagnose abnormal cardiac rhythms and coronary heart disease
2. Echocardiography (ultrasound cadiography) – graphic record of motions produced by cardiac structure as high-frequency sound vibrations are echoed
though chest wall into the heart.
- used to demonstrate valvular or other structural deformities, detect pericardial effudion, diagnose tumors and cardiomegaly, evaluate
prosthetic valve function.
3. Electroencephalogram (ECG) – graphic record of the electrical potentials generated by the physiological activity of the brain
- used to detect surface lesions or tumors of the brain and presence of epilepsy.
4. Echoencephalogram – beam of ultrasound is passed though the head, and returning echoes are graphically recorded.
5. - used to detect subdural hematomas, intracerebral hemorrhage, or tumors.
B. Roentgenological studies (X-ray)
1. Chest – used to determine size, contour of the heart; size, location, and nature of pulmonary lesions: pleural thickening and effusions: pulmonary
vasculature: disorder of thoracic ones and soft tissues.
- used lead shield to protect pregnant woman
2. Kidney, Ureter, and Bladder (KUB) – used to determine size, shape, and position of kidney, ureter and bladder
- No special consideration
3. Breast (Mammography) – examination of the breast with or without the injection of the radiopaque substance into the duct of mammary gland.
- used to determined the presence of tumor or cyst (best done a week after menstruation)
- no deodorant, perfume, powder, or ointment in underarm area on the day of X-ray (contains Calcium oxalate)
- May be uncomfortable due to the pressure on the breast. (uses two x-ray plates)
C. Roentgenological studies (FLUOROSCOPY) – requires the ingestion or injection of a contrast medium to visualize the target organ.
Additional Nursing Task:
a. Administration of enemies or cathartics before the procedure and laxative after.
b. Keeping the patient NPO 6-12 hours before examination
c. Ascertain patient’s allergy and allergic reactions
d. Observing for allergic reactions to contrast medium
e. Providing fluid and food after procedure to prevent dehydration
f. Observe stool for color and consistency until barium passes
1. Upper GI (Barium swallow) – ingestion of barium sulfate or meglumine diatrizoate (Gastrografin [white and chalky substance], followed by fluoroscopic
and x-ray examination)
- used to determine patency and caliber of the esophagus and to detect esophageal varices, mobility of gastric wall, presence of ulcer, filling
defects due to tumor, patency of pyloric valve and presence of structural abnormalities
2. Lower GI (Barium Enema) – rectal instillation of barium sulfate followed by glouroscopic and x-ray examination
- used to determine contour and mobility of colon and presence of any space-occupying tumors. Perform before upper GI
Patients preparations:
- no food after evening meal the evening before the test
- stool softener laxatives and enema suppositories to cleanse the bowel before the test
- NPO after midnight before the test
After care:
- increased fluid intake, food and rest
- laxatives for at least two days or until stools are normal in color and consistency
3. Cholecystogram – ingestion of organic iodine contrast medium (Telepaque) followed in 12 hour by x-ray visualization
- gallbladder disease is indicated with poor or no visualization of the bladder
- accurate only if GI and liver function is intact
- perform before barium swallow and barium enema
Patients preparations:
- administer large amount of water with contrast capsule
- low-fat meal before evening before x-ray
- oral laxative of stool softener after meal
- no food allowed after contrast capsule
After care:
- increased fluid intake, food and rest
- observe for any untoward reactions
4. Intravenous Pyelography (IVP) – injection of a radiopaque contrast medium in the vein of the client to visualize ureter, bladder and kidney
Patients preparations:
- Laxative in the evening before the examination
- NPO for 12 hours
- Cleaning enema morning of the procedure
After care:
- increased fluid intake, food and rest;
- observe for any untoward reactions
6. D. Computed Tomography (CT) – an x-ray beam sweeps around the body, allowing measuring of various tissue densities. Provides clear radiographic deficition of
structures that are not visible by other techniques.
- initial scan may be followed by “contrast enhancement” using an injection of contrast agent iodine via vein, followed by a repeat scan.
Patients preparations:
- instructions for eating before test vary
- clear liquids up to 2 hours before the procedure are permitted
E. Magnetic resonance imaging (MRI) – noninvasive technique that produces cross sectional images by exposure to magnetic energy sources. It uses no contrast
medium; takes 30-0 minutes to complete. Patient may still for periods of 5-20 minutes at a time.
Patients preparations:
- patient can take food and medications except for low abdominal and pelvic studies (food and fluid withheld) 4-6 hr to decrease peristalsis)
- Restrictions
a. those who have metal implants
b. those with permanent pacemakers
c. those who are pregnant
F. Ultrasound (sonogram) – uses sound waves to diagnose disorders of the thyroid, kidney, liver, uterus, gallbladder, fetus and intracranial structures of the
neonate.
Patients preparations:
- advise client not to chew gum or smoke before the procedure
- no x-ray
- for gallbladder studies; NPO for 8 hours
- for lower abdomen and uterus ; 32 ounces of water PO 30 minutes before the procedure
G. Pulmonary function studies
• Ventilatory studies – use of incentive spirometer to determine how well the lung is ventilating.
1. Vital capacity (VC) – largest amount of air that can be expelled after maximal inspiration
Normal = 4000 – 5000 mL.
Decrease = indicate lung disease
Increase or decrease = indicate chronic obstructive lung disease
2. Forced expiratory volume (FEV) – percentage of vital capacity that can be forcibly expired in 1, 2, or 3 seconds.
Normal = 80 – 83% in 1 sec
90 – 94% in 2 sec
95 – 97% in 3 sec
decrease = indicate expiratory airway obstruction
H. Sputum Studies
1. Gross sputum evaluations – collection of sputum samples to ascertain quantity, consistency, color and odor
2. Sputum smear – sputum is smeared thinly on a slide so that it can be studied microscopically.
- used to determine cytological changes or presence of pathogenic microorganism
3. Sputum culture – sputum samples are implanted or inoculated into special media.
- used to diagnosed pulmonary infection
I. Examination of the gastric contents
1. Gastric analysis – aspiration of the contents of the fasting stomach analysis of free and total acid
Gastric acidity increase : duodenal ulcer
Gastric acidity decrease : pernicious anemia an cancer of the stomach
J. Doppler ultrasound – measures blood flow in the major veins and arteries. The transducer of the test instrument is placed on the skin, sending ultra-high-
frequency sound.
- sound varies with respiration and valsalva maneuver
- no discomfort to the patient.
K. Glucose Testing – to detect disorder of glucose metabolism, such as diabetes.
1. Fasting blood sugar (FBS) – blood sample is drawn after a 12 fast (usually midnight). Water is allowed.
Normal blood glucose ; 60 – 120 mg/dL
Diabetic patient = 126 mg/dL
7. 2. 2 hr postprandial (PPBS) – blood is taken after meal
Patients preparations:
- offer a high-carbohydrate diet for 2-4 days before testing
- patient fast overnight
- eats a high-carbohydrate breakfast
- blood sample is drawn 2 hr interval
- no cigarette smoking and caffeine for these may increase glucose level
Common Diagnostics Procedures
Invasive Diagnostics Procedures
Characteristics:
1. it directly records the size, shape and function of an organ;
2. it requires the written consent of the patient or guardian;
3. it may result in morbidity and occasionally death.
General Nursing Task:
1. Before procedure:
a. have patient sing permit to procedure
b. ascertain and repot any patient history of allergy or allergic reaction
c. explain procedure briefly and accurately
d. explain that contrast medium might cause flushing or warm feeling
e. keep patient NPO 6-12 hour before procedure if anesthesia is to be used
f. allow patient to verbalize concerns
g. administer preprocedure sedatives, as ordered
h. if procedure done at bed side:
- remain with patient and offer reassurance
- assist with optimal positioning of patient
- observe for indication of complications – shock, pain and dyspnea
2. After procedure:
a. observe and record vital signs
b. check injection or biopsy sites for bleeding, infection, tenderness, or thrombosis
• report untoward reaction to the physician
• apply warm compress to ease discomfort, as ordered
c. if tropical anesthesia is used during procedure, do not give food or fluid until gag reflex returns
d. encourage relaxation by allowing patient to discuss experience and verbalize feelings.
A. Procedures to evaluate the cardiovascular system
1. Angiography – intravenous injection of radiopaque solution or contrast for the purpose of studying its circulation through the patient’s heart, lungs
and great vessels.
- Used to check the competency of the heart valves, diagnose congenital septal defects, study heart function and structure before cardiac
surgery, detect occlusions of coronary arteries.
2. Cardiac catheterization – insertion of a radiopaque catheter into a vein to study the heart great vessels.
- Used to confirm diagnosis of heart disease and determine extent of disease, measure pressures in the heart chamber and great vessels, obtain
estimate of cardiac output, and obtain blood samples to measure oxygen content.
a. Right heart catheterization – catheter is inserted through a cut-down in the antecubital vein into the superior vena cava, through
the right atrium and ventricle and into the pulmonary activity.
b. Left-heart catheterization- catheter maybe passed retrograde to the left ventricle through the brachial and femoral artery, it can
be passed through the left atrium after right-heart catherization by means of a special needle that punctures the septa; or it may
be passed directly into the left ventricle by means of a posterior puncture.
Specific nursing considerations:
1. Preprocedure patient teaching:
a. Fatigue is a common complaint due to lying still for 3 hr
b. Feeling of fluttery sensation while the catheter is passed back into the left ventricle
c. Flushed, warm feeling may occur when contrast medium is injected.
2. Postprocedure observations:
a. monitor ECG pattern for arrhythmias
b. check extremities for color and temperature, peripheral pulses for quality.
3. Angiography (Arteriography) – injection of a contrast medium in to the arteries to
study the vascular tree.
8. - Used to determine obstructions or narrowing of peripheral arteries.
B. Procedure to evaluate the respiratory system
1. Lung scan – injection of radioactive isotope into the body, followed by lung scintiscan, which produces a graphic record of gamma rays emitted by the
isotopes in the tissues.
- used to determine lung perfusion when pulmonary emboli and infarctions are suspected.
2. Pulmonary angioghraphy – x – ray visualization of the pulmonary vasculature after the injection of a radiopaque contrast medium.
- used to evaluate pulmonary disorders such as pulmonary embolism, lung tumor and aneurysms, and changes in the pulmonary vasculature due
to such conditions as emphysema.
3. Bronchoscopy – introduction of a fiberoptic scope into the trachea and bronchi
- used to inspect tracheobronchial tree for pathological changes, remove foreign bodies or mucous plugs causing airway obstruction, and apply
chemotherapeutic agents.
a. Prebronchoscopy interventions:
• oral hygiene
• postural drainage as indicated
b. Postbronchoscopy interventions:
• Instruct patient not to swallow oral secretions
• Save expectorated sputum for laboratory analysis
• NPO till gag reflex returns
• Observe for subcutaneous emphysema and dyspnea
• Apply ice collar to reduce throat discomfort
4. Thoracentesis – needle puncture through the chest wall and into the pleura
- used to remove fluid and occasionally air from the pleural space
- nursing considerations
a. position : high fowler’s position or sitting upon edge of the bed, with feet supported on the chair.
b. If the patient is unable to sit up – turn unto unaffected side
a. Position: high fowler’s position or sitting upon edge of the bed, with feet supported on the chair.
b. If the patient’ is unable to sit up-turn unto unaffected side
C. Procedures to evaluate the renal system
1. Renal angiogram – small catheter is inserted into the femoral artery and passed into the aorta or renal artery, radiopaque fluid is in stilled, and serial
films are taken.
- Used to diagnose renal hypertension and pheochromocytoma and differentiate renal cyst from tumors.
Postangiogram nursing actions:
1. Check pedal pulse for signs of decreased circulation.
2. Cystoscopy – Visualization of bladder, urethra, and prostatic urethra by insertion of a
tubular, lighted, telescopic lens (cystoscope) through the urinary meatus.
- Used to directly inspect the bladder; collect urine from the renal pelvis; obtain biopsy specimens from bladder and urethra; remove calculi; and treat
lesions in the bladder, urethra, and prostate.
Nursing actions following procedure:
• Observe for urinary retention
• Warm sitz baths to relieve discomfort
3. Renal biopsy – needle aspiration of tissue from the kidney for the purpose of
microscopic examination.
Procedures to evaluate the digestive system:
1. Esophagoscopy and gastroscopy – visualization of the esophagus, the stomach, and sometimes the duodenum by means of a lighted tube
inserted through the mouth.
2. Proctoscopy – visualization of rectum and colon by means of a lighted tube inserted through the anus.
3. Peritoneoscopy – direct visualization of the liver and peritoneum by means of a peritoneoscope inserted through an abdominal stab wound.
4. Liver biospsy – needle aspiration of tissue for the purpose of microscopic examination; used to determine tissue changes, facilitate diagnosis,
and provide information regarding a disease course.
9. Nursing action:
1. Place patient on right side and position pillow for pressure, to prevent bleeding.
5. Paracentesis – needle aspiration of fluid from the peritoneal cavity used to relieve excess fluid accumulation or for diagnostic studies.
a. Specific nursing actions before paracentesis:
a. Have patient void - to prevent possible injury to bladder during procedure
b. Position – sitting up on side of bed, with feet supported by chair.
c. Check vital signs and peripheral circulation frequently throughout procedure
d. Observe for signs of hypovolemic shock – may occur due to fluid shift from vascular compartment following
removal of protein – rich ascitic fluid.
b. Specific nursing actions following paracentesis:
a. Apply pressure to injection site and cover with sterile dressing.
b. Measure and record amount and color of ascitic fluid; send specimens to lab for diagnostic studies.
D. Procedures to evaluate the reproductive system in women
1. Culdoscopy – surgical procedure in which a culdoscope is inserted into the posterior vaginal cul-de-sac
- Used to visualize uterus, fallopian tube, and peritoneal contents.
2. Breast biopsy – needle aspiration or incisional removal of breast tissue for microscopic examination.
- used to differentiate among benign tumors, cysts, and malignant tumor in the breast.
3. Uterotubal insufflation (Rubin’s Test) – injection of carbon dioxide into the cervical canal.
- Used to determin fallopian tube patency
E. Procedure to evaluate the neuroendocrine system
1. Cerebral angiography – fluoroscopic visualization of the brain vasculature after injection of a contrast medium into the carotid or vertebral
arteries
- used to localize lesions (tumors, abscesses, and occlusions) that are large enough to distort cerebrovascular blood flow.
2. Myelogram – through a lumbar-puncture needle, a contrast medium is injected into the subarachnoid space of the spinal column to visualize
the spinal cord.
- Used to detect herniated or ruptured intervertebral disks, tumors and cysts that compress or distort spinal cord.
Nursing consideration:
• Elevate head of bed = with water soluble contrast
• Flat position – with oil contrast
• V/s every 4 hr for 24 hr.
3. Lumbar puncture – puncture of the lumbar subarachnoid space of the spinal cordwith a needle to withdraw samples of cerebrospinal fluid.
- Used to evaluate CSF for infections and determine presence of hemorrhage.
Note: not done if increased ICP is suspected
Position: Before : fetal position / knee chest position
After : flat or supine
Test Indication
Antigen skin Test to rule-out cancer of the lungs
Benedict’s test For glucose monitoring
Bentonite Flacculation Test Test for filariasis
Beutler’s test Test for galactosemia
Blanching test Determines the impairment in circulation
Bronsulpthalein test Liver angiography
Caloric test Test done by placing water in the ear canal causes nystagmus. A test for inner ear
CD4 determination Checking the immune status to AIDS patient
Cerebral perfusion test Test used to check the cerebral function
Coomb’s test Determines the production of the antibodies. RhoGAM is given (1st
72 hours)
CPK BB Test for brain muscles
CPK MB Test for cardiac muscles: for MI
CPK MM Test for muscle injury
Dark field illumination test and kalm test Determination for the presence of syphilis
Dick test Detect scarlet fever
Dull’s eye test Determines the presence of blindness. Done in 1st
ten days (+) normal (-) abnormal
10. ELISA test Determines presence of HIV
Gram staining and Culture of cervical and urethral
smear
Determination for the presence of gonorrhea
Gross hearing test Test used by whispering words or spoken voice test
Guthrie test Test for PKU
Heat and Acetic acid test For protein or albumin detection
Immunochromatographic test A rapid assessment method done for filariasis. The antigen test that can be done at daytime
Jones Criteria One way of diagnosing Rheumatic heart fever
Lepronin test A screening test for leprosy
Liver enzyme test For SGOT and SGPT
Liver profile test Determines Hepa-b surface antigen
Lumbar puncture Determines for the presence of meningitis and encephalitis. Position the patient in side lying
position
Malaria smear Test to confirm malaria; specimen is taken at the height or peak of fever
Mantoux test Determination for TB exposure
Meniere’s test Test for vestibular function
Methylene blue test For ketone detection
Moloney test Hypersensitivity test for Diphtheria
Oxytocin challege test Determines if the fetus can tolerate uterine contraction; (+) CS is necessary
Pandy’s test Determines the presence of protein in the CSF
Phenosulpthalein test Kidney angiogram
Queckkenstedt’s test Test that involve the compression of jugular veins
Rectal swab Done in patient with cholera, pinworm detection
Rinne Test Shifted between mastoid bone and two inches from the ear canal opening
Romberg’s test Assess gait and station such as ataxia
Schick test Susceptibility test for diphtheria (+) no immunity (-) with immunity
Schiller’s test Staining the cervix with an iodine solution. Healthy tissues will turn brown, while cancerous
tissue resist the stain
Schilling test Used to patient with severe chilling sensation; for confirmation of pernicious anemia
Schwabach test Differentiate between conductive and sensorineural deafness, mastoid of patient and
examiner
Shake test Determines the amount of surfactant in the lungs.
Skin test Purpose it to produce antigen reaction
Slit skin smear A confirmatory test for leprosy
Specific gravity test For diabetes mellitus and insipidus as well as for dehydration
Sperm count test For male infertility (low sperm count-oversex)
Sputum exam For defection and sensitivity of causative microorganism, for pneumonia and TB
Sulkowitch test Urine test detection for calcium deficiency and calcium in the urine
Sweat chloride test Used to diagnosed cystic fibrosis
Tensilon (Endophonium) test For rapid detection of myasthenia gravis
Tonometer Test used to measure ocular tension and helping in detecting early glaucoma N=12-20 mmHg
Torniquet test Done to determine presence of petechiae in Dengue Hemorrhagic fever
TZANK test Determination for the presence of herpes simplex
Weber test Evaluation of bone conduction. Tuning fork is placed on patient’s forehead or teeth
Wedal’s Test For typhoid fever determination
Western blot test A confirmatory for AIDS
Arterial Blood Gases
Type Causes Manifestations Management
Respiratory Acidosis
pH<7.35;
PaCO2>45
. COPD
. Respiratory
. Overdose
. Atelectasis
. Pulmonary edema
. Aspiration
. Weakness
. Tachycardia
. Decreased LOC
. Headache
. Assess VS
. Monitor
. ABG
. CPT
. TCDB