Vasopressor Brochure
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This document discusses vasopressors and inotropes used to treat various types of shock. It provides recommendations for specific clinical situations like septic shock, heart failure, cardiogenic shock, and others. For septic shock, first-line agents are norepinephrine and phenylephrine due to their vasoconstrictive effects. Dopamine and dobutamine are recommended for heart failure depending on dose. Norepinephrine and dobutamine are indicated for cardiogenic shock. The document also reviews the pharmacological properties and receptor activities of common vasopressors and inotropes like norepinephrine, epinephrine, dopamine, dobutamine, and isoproterenol.
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The document discusses pain assessment and management for patients. It states that all patients expressing signs of pain must receive an appropriate assessment and treatment. Pain is best determined by the patient as pain measurement is subjective. Patients should receive a comprehensive pain assessment upon arrival that examines onset, duration, location, quality, relief factors, aggravating factors, pain goal, and intensity using a standardized scale. Patients must be reassessed after any pain interventions like medications or other treatments to determine the effectiveness of the treatment.
Brilliant healthcare performance group inc -service excellence
Eva Francis is the president and CEO of Brilliant Healthcare Performance Group Inc, a healthcare consulting firm focused on improving patient experience. The company works to transform organizational culture and reshape the patient experience by focusing on providing excellent service and care for every patient at every contact. The ultimate goal is to have satisfied patients and families who are the company's biggest fans.
Care of care givers
This document discusses the challenges faced by caregivers who experience traumatic events like mass shootings or natural disasters. It outlines common symptoms of compassion fatigue like anxiety, withdrawal, and depression. It then provides strategies for coping with compassion fatigue, such as taking time for self-care, communicating with peers, practicing stress management techniques, and seeking counseling or support programs. The overall message is that caregivers need support to process their experiences and prevent burnout, and organizations should foster wellness initiatives to help renew caregivers' compassion.
Business - Team work
This document discusses the importance of teamwork. It defines teamwork as people working together to achieve more than what can be accomplished individually. Teamwork is needed for problem solving, communication, cohesion, and learning. It is important across organizations to produce better work, increase morale, and improve retention. Both team leaders and team players have important roles to play - leaders provide motivation and understand strengths/weaknesses while players communicate well, listen actively, cooperate and commit to the team. For organizations to succeed, they must set clear goals, define plans, engage employees and execute strategies to achieve increased and sustainable results.
Prescription
Clinical Pharmacology discusses the responsibilities of physicians in prescribing drugs safely and effectively. It addresses important considerations like deciding if a drug is necessary, assessing risks and benefits, monitoring adverse drug reactions, and improving patient compliance through education and partnership. Prescribing requires balancing multiple factors to contain costs while providing clear benefits to health.
Headache in ENT
Headaches have many causes and are classified into three main categories: primary, secondary, and cranial neuralgias. Primary headaches include tension, migraine, and cluster headaches. Secondary headaches can result from head/neck trauma, blood vessel disorders, non-vessel diseases, medications, environmental changes, and psychotic disorders. Sinusitis is a common cause of headaches, accounting for 20% of cases, with symptoms like nasal discharge and facial swelling. CT scans and physical exams are used to diagnose sinus headaches and check for sinus blockages.
Mpob syllabus
This document outlines the objectives, expected outcomes, modules, and evaluation criteria for a course on Management Process & Organizational Behavior. The objectives are to provide an understanding of management tasks and functions, familiarize students with individual and group behavioral patterns in organizations, and enhance students' ability to predict and control human behavior. The course covers fundamentals of management, planning, organizing, controlling, and organizational behavior at individual, group and organizational levels. Students will learn management principles, decision making, structure, and dynamics of interaction between individuals and organizations. Evaluation includes exams, quizzes, assignments, and attendance requirements.
24.antiplatelet drugs
Antiplatelet drugs work by interfering with platelet function and are classified as either thromboxane A2 synthesis inhibitors like aspirin, or other drugs such as dipyridamole and clopidogrel. Aspirin is commonly used at low doses of 75-150 mg daily and works by irreversibly inhibiting thromboxane synthase, reducing thromboxane A2 production and platelet aggregation. It is often used to treat myocardial infarction, prevent heart attacks in high-risk patients, and reduce the risk of stroke.
Headache; A Clinical Approach
This document provides guidance on evaluating and managing headaches. It emphasizes the importance of a thorough history and examination to properly analyze the headache and guide management. The history should follow the SOCRATES framework and look for red flags. Examination includes mental status, cranial nerves, and looking for triggers of migraine or tension headaches. Common headache types like migraine and tension headaches are described. Migraine prophylaxis includes beta-blockers, antiepileptics, and antidepressants. Tension headaches are often treated with aspirin, paracetamol, or amitriptyline. Cluster headaches respond to sumatriptan or verapamil. A structured approach is key to diagnosing the headache type and choosing appropriate treatment
Pharmacology drug chart
Drugs can have different effects and side effects depending on dosage. This chart provides information on common drugs including their uses, dosages, side effects and drug interactions to consider for patient safety. It aims to be a helpful reference for medical professionals in treating patients and avoiding adverse reactions.
Generic dispensing
The document outlines the process for generic drug dispensing. A prescription is first evaluated to determine if it is correct, erroneous, or violative/impossible. If correct, the prescription is filled and filed. If erroneous, the prescription is filled but also reported. If violative or impossible, it is not filled but still reported. The customer is then informed of generic alternatives and prices before dispensing their selection.
Approach to headache
This document provides an overview of approaches to evaluating and diagnosing headaches. It outlines the various pain-sensitive structures in the head and skull that can cause headaches, as well as common causes like muscle spasms, inflammation, increased pressure, and diseases of nearby areas. The assessment involves taking a detailed history and performing focused exams of extracranial structures, neurological function, and "warning signs" that suggest serious underlying issues. Based on the findings, tests like CT/MRI and spinal taps may be needed. Common headache types discussed include tension headaches, migraines, cluster headaches, and others, along with their characteristic features and treatment approaches.
Review of Head and Neck Anatomy
The skull is divided into two parts - the cranium and facial skeleton, composed of 22 bones. The ophthalmic nerve gives off collateral branches before terminating in three branches, and innervates structures of the orbit. The external carotid artery branches into numerous arteries that supply the head and neck region. The maxillary artery further divides into ascending, lateral, descending, and deep branches that supply surrounding structures.
Antiplatelet drug comparison chart
This document compares four antiplatelet drugs: aspirin, clopidogrel, prasugrel, and ticagrelor. It outlines their indications, dosing, mechanisms of platelet inhibition, pharmacokinetics, and when to hold the dose prior to surgery. Aspirin is a nonsteroidal anti-inflammatory drug that irreversibly inhibits platelet aggregation. Clopidogrel, prasugrel, and ticagrelor are P2Y12 receptor inhibitors that irreversibly or reversibly prevent ADP-induced platelet activation. They have varying bioavailability, peak effects, half-lives of their active metabolites, and CYP enzyme metabolism pathways.
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Brilliant healthcare performance group inc -service excellence
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Vasopressor Brochure
- 1. Clinical Application Septic Shock Norepinephrine (Levophed)- Alpha 1 and vasoconstriction raise MAP causes reflex bradycardia but Beta 1 counteracts this and improves CO Phenylephrine (Neosynephrine)- pure vasoconstriction 2nd Line Agent: Vasopressin and Epinephrine- may require decreased need for other vasopressors Heart Failure Dopamine- dose dependent, Dobutamine 2nd Line Agent: Milrinone- phosphdiesterase inhibitor w/ similar effects as Dobutamine w/ lower incidence of dysrhythmias, cannot be used if pt. is hypotensive Cardiogenic Shock Norepinephrine (Levophed) Dobutamine added after establishing adequate perfusion to increase contractility, HR, and CO Anaphylactic Shock Epinephrine 2nd Line Agent: Vasopressin Neurogenic Shock Phenylephrine (Neosynephrine)- Hypotension Phenylephrine(Neosynephrine)- post anesthesia Epinephrine- post CABG References Williamson AP, Seifen E, Lindemann JP, Kennedy RH. WB4101- and CEC-sensitive positive inotropic actions of phenylephrine in rat cardiac muscle. Am J Physiol. 1994;266(6 Pt 2):H2462. UCI Internal Medicine Residency Mini- Lecture Series http://www.texasheart.org/HIC/Topics/Me ds/inotropic.cfm http://chicago.medicine.uic.edu/UserFiles/S ervers/Server_442934/Image/1.1/residentg uides/final/icuguidebook.pdf VASOPRESSORS AND INOTROPES VASOPRESSORS AND INOTROPES By: Megan Heffernan
- 2. Background Vasopressors Class of drugs that elevate Mean Arterial Pressure (MAP) by inducing vasoconstriction Indicated for decrease of >30 mmHg from baseline systolic blood pressure or MAP <60 mmHg when either condition results in end-organ dysfunction secondary to hypoperfusion Inotropes Increase cardiac contractility so that the heart can pump more blood with fewer heartbeats Many drugs have both vasopressor and inotropic effects Pharmacological Properties Alpha 1 Adrenergic Effects Vascular wall → Vasoconstriction Effects Heart → Increase duration of contraction w/o increased chronotropy Beta Adrenergic Beta 1 → Effects Heart → Increase inotropy and chronotropy Beta 2 → Effects b lood vessels → Vasodilation Dopaminergic Effects Renal, Mesenteric, Coronary, Cerebral → Vasodilation Subtype → Vasoconstriction (through norepinephrine release) Medication Receptor Activity & Clinical Effects Phenylephrine (Neo) Alpha 1 SVR increase, CO increase Minimal cardiac ino or chrono Norepinephrine (Levo) Alpha 1 and Beta 1 SVR increase, CO increase Epinephrine (Adrenalin) Potent Beta 1, moderate beta 2 and alpha 1 CO increase, SVR increase (low dose), SVR increase (high dose) Dopamine (Inotropin) Doses dependent (mcg/kg/min) .5-2 = beta 1 and dopaminergic, vasodilation 5-10 = beta 1, alpha 1, dopaminergic, increase CO & SVR >10 = alpha 1, beta 2, dopaminergic, increase SVR Dobutamine Beta 1 and 2 Increase CO and decrease SVR, reduce LV filling pressure Isoproterenol (Isuprel) Potent Beta 1 and 2 Increase CO, decrease SVR Indicated for hypotension from bradycardia