Handbook of Drugs in Intensive Care. An A Z Guide by Henry G. W. Paw

By Henry G. W. Paw

A completely up to date version of this well-established advisor to medicinal drugs and prescribing for extensive care. The publication is divided into sections: an A-Z consultant to the medicine on hand, and concise notes at the key subject matters and occasions confronted each day. The A-Z part presents succinct details on every one drug together with makes use of, barriers, management instructions and antagonistic results. the second one part information issues which may come up in sufferers with specific stipulations akin to diabetes, epilepsy and renal failure, and different components which can have an effect on drug prescribing. there's additionally a bit of key info, exhibiting weight conversions, physique mass index and corresponding dosage calculations. This variation contains a color fold-out chart exhibiting drug compatibility for intravenous management. offered in a concise, compact layout, this e-book is a useful source for medical professionals, nurses and different doctors taking good care of seriously unwell sufferers.

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5 55 120 6 12 18 24 30 36 42 48 54 60 • Elderly • Congestive • Usual adult maintenance Heart Failure • Children • Young adult smokers • Liver disease How not to use aminophylline Rapid IV administration (hypotension, arrhythmias) Adverse effects Tachycardia Arrhythmias Convulsions Cautions Subject to enzyme inducers and inhibitors (p. 191) Concurrent use of erythromycin and ciprofloxacin: reduce dose Organ failure Cardiac: prolonged half-life (reduce dose) Hepatic: prolonged half-life (reduce dose) 18 HANDBOOK OF DRUGS IN INTENSIVE CARE AMIODARONE Amiodarone has a broad-spectrum of activity on the heart.

Unlike oral amiodarone, IV administration usually acts relatively rapidly (20–30 min). A Uses Good results with both ventricular and supraventricular arrhythmias, including those associated with WPW syndrome. When given at night it will help to promote sleep. It may take up to 2 weeks before any beneficial effect is seen unless a large loading dose is used. A Uses Depression in patients requiring long-term ICU stay, particularly where sedation is required Difficulty with sleep Contraindications Recent myocardial infarction Arrhythmia Heart block Severe liver disease How not to use amitriptyline During the daytime (disturbs the normal sleep pattern) AMITRIPTYLINE Administration • Oral: 25–75 mg nocte • IM/IV bolus: 10–20 mg nocte Adverse effects Antimuscarinic effects (dry mouth, blurred vision, urinary retention) Arrhythmias Postural hypotension Confusion Hyponatraemia Cautions Cardiac disease (risk of arrhythmias) Hepatic failure Acute angle glaucoma Concurrent use of MAOI Additive CNS depression with other sedative agents May potentiate direct-acting sympathomimetic drugs Prostatic hypertrophy – urinary retention (unless patient’s bladder catheterized) Organ failure CNS: sedative effects increased Hepatic: sedative effects increased 21 HANDBOOK OF DRUGS IN INTENSIVE CARE A AMPHOTERICIN (Fungizone) Amphotericin is active against most fungi and yeasts.

N Eng J Med 2001; 345: 494–502). NICE and the European Society of Cardiology both endorse the use of clopidogrel in combination with aspirin in non-ST-elevation acute coronary syndrome patients. The ␤-lactamase inhibitory action of clavulinic acid extends the spectrum of antibacterial activity of amoxycillin. 6 24 How not to use co-amoxiclav Do not mix with aminoglycoside in same syringe (will inactivate aminoglycoside) Adverse effects Hypersensitivity Cholestatic jaundice (usually self-limiting) Bleeding and prothrombin time may be prolonged Organ failure Renal: reduce dose Renal replacement therapy Removed by HD/HF/PD but significant only for high clearance techniques.

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