This document provides information on the emergency medicines ketamine and fentanyl. Ketamine can be used for induction and maintenance of anesthesia, procedural sedation and analgesia, and sedation during ventilation. Common side effects include increased blood pressure, muscle tone changes, nausea and vomiting. Emergence reactions may occur for up to 24 hours after use. Fentanyl is an opioid analgesic that can be used for severe acute or chronic pain and breakthrough cancer pain. It comes in various forms including sublingual tablets, lozenges, injections and patches. Proper administration techniques are described to maximize benefits and minimize risks.
Soma pain medication is here to give you reliefAustin Parker
Are you suffering from acute pain on a regular basis? Soma pain med is here to help you through the painful ordeal and give you pain relief for around 2-3 hours.
Soma pain medication is here to give you reliefAustin Parker
Are you suffering from acute pain on a regular basis? Soma pain med is here to help you through the painful ordeal and give you pain relief for around 2-3 hours.
Emergency drugs means those drugs critical for patient care and approved by the institution’s pharmacy and therapeutics committee or equivalent committee. Drugs critical for patient care include drugs requiring administration within minutes or within less time than the pharmacy can be practically expected to respond, such as the administration of naloxone for treatment of an opioid overdose.
Emergency drugs means those drugs critical for patient care and approved by the institution’s pharmacy and therapeutics committee or equivalent committee. Drugs critical for patient care include drugs requiring administration within minutes or within less time than the pharmacy can be practically expected to respond, such as the administration of naloxone for treatment of an opioid overdose.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. Ketamine (Ketalar 200mg/2ml)
Indications
Induction and maintenance of anaesthesia
Procedural sedation and analgesia
Sedation during ventilation
DOSE - When used as sole agent:
IV, up to 1–1.5 mg/kg slowly titrated to effect over 2–5 minutes; then give half dose
every 10 minutes if required.
IM, 3–4 mg/kg; give half dose after 10 minutes if required.
3. Administration advice
Dilute dose with an equal volume of water for
sodium chloride 0.9% or glucose 5% before IV injection.
Give IV slowly (over at least 1 minute); rapid
administration may result in respiratory depression and
enhanced hypertensive response.
Common Adverse effects (>1%)
Raised BP and pulse rate, increased muscle
tone (sometimes like seizures), hyper-
salivation, nausea and vomiting,
emergence reactions
After a single dose, analgesic effects last about
40 minutes and amnesia lasts 1–2 hours
4. Emergence reactions
May occur during recovery and for up to
24 hours. They include vivid (possibly
unpleasant) dreams, restlessness,
hallucinations and irrational behaviour.
Urinary tract symptoms
There are reports of urinary symptoms including dysuria,
frequency, suprapubic pain and haematuria associated with
chronic ketamine misuse, as well as rare reports in patients
prescribed regular ketamine for chronic pain. Symptoms may
be reversible if ketamine is stopped but continued use could
lead to severe, irreversible damage.
5. Illicit/recreational use of ketamine
occurs (known as ‘special K’ or
‘vitamin K’)
https://www.magneticmag.com/2015/10/what-if-drugs-
had-branding-slogans-special-k--ketamine/
6. Fentanyl
Opioid analgesic
Severe Pain – Acute and chronic pain
Breakthrough pain in patients stabilised on opioid analgesia for cancer pain
(lozenge, buccal and sublingual tablets)
Epidural analgesia
1) Abstral 100mcg – 800 mcg Sublingual tablets.
2) Actiq 200mcg – 1600 mcg Lozenges
3) Fentanyl Injection 100mcg/2ml
4) Patches (Durogescis 12mcg/hours – 100mcg/hour)
7. Dose: 1.5mcg/kg (Maximum 100 mcg intranasal)
Analgesic effect: 100–150 micrograms fentanyl SC is
approximately equivalent to 10 mg morphine IM/SC.
Dose for tablets and patches:
Start low and go slow
?Dose conversions
12 micrograms/hour patch is approximately equivalent
to 45 mg oral morphine daily.
8. Intranasal
Draw up required volume into a syringe (allow an extra 0.1 mL
with first dose for priming), then attach an atomiser. Sit child at
a 45 degree angle or with head to one side. Squirt dose in
approximately 0.2 mL aliquots (to maximise absorption and
minimise sneezing) alternating between nostrils. Allow a short
interval (<1 minute) between aliquots if using only one nostril.
9. Patch
Write the date and time of application on the patch with permanent marker,
then apply it to dry, hairless, non-irritated skin on the upper part of your
or upper arm. Do not apply straight after a hot bath or shower, wait until skin
is cool and dry. Do not use if patch is damaged or cut. Check the patch is still
attached on the days between patch changes.
Remove after 3 days (72 hours) and put a new patch on a different place.
sure you know how to dispose of patches safely.
When wearing the patch, do not allow it to come into contact with direct
sources of heat such as electric blankets, heat pads, heat lamps, saunas or
baths.
After removing a patch, avoid exposing that area of skin to the sun for 2 days
as it may be more sensitive.
10. Warning
Abstral®, Actiq® and Fentora® are not
interchangeable. When switching, begin new brand
with its starting dose and titrate to minimise serious
toxicity.
Sedation score
•0 – wide awake
•1 – easy to rouse
•2 – easy to rouse, but cannot stay awake
•3 – difficult to rouse.
Aim to keep the sedation score <2; a score of 2
represents early respiratory depression.
Reference: Australian Medicines Handbook (AMH
2021)