Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
shortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2rption, avoids first-pass metabolism and has a rapid onset of action. Its disadvantages include the increased risk of serious side-effects ami the possibility of phlebitis or tissue necrosis if extravasation occurs.Intramuscularrhe need for frequent, painful injections, rhe presence of a coagulopath Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2y (risk the development of a haematoma, which may become infected) and the lack of muscle hulk often seen in the critically ill means that this routeEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
is seldom used in the critically ill. Furthermore, variable absorption because of changes in cardiac output and blood flow to muscles, posture and sitshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2Absorption is variable and unreliable.OralIn rhe critically ill this route includes administrations via NG, NJ, PEG. PEJ or surgical jej unostomy feeding tubes. Medications given via these enteral feeding lubes should be liquid or finely crushed, dissolved in water. Rinsing should take place before Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2and after feed or medication has been administered, using 20 30 ml WEI. In the seriously ill patient this route is not commonly used to give drugs. NoEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
te than some liquid preparations contain sorbitol, which has a laxative effect ar daily doses >15 g. An example of this is baclofen, where the 1 ioresshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2 crush tablets than to administer liquid preparations, rhe effect of pain and its treatment with opioids, variations in splanchnic blood How and changes in intestinal transit times - as well as variability in hepatic function, make it an unpredictable and unreliable way of giving drugs.Buccal and su Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2blingualAvoids the problem of oral absorption and first-pass metabolism, and it has a rapid onset time. It has been used for GTN, buprenorphine and niEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
fedipine.SHORT NOTESROUTES OF ADMINISTRATION245HANDBOOK OF DRUGS IN INTENSIVE CARERectalAvoids the problems of oral absorption. Absorption may be varishortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2) are subject to hepatic metabolism: those from the anal canal enter the systemic circulation directly. Levothyroxine tablets can be used rectally (unlicensed) when the oral route is unavailable.TracheobronchialUseful for drugs acting directly on the lungs: [3 .-agonists, anticholinergics and cortic Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2osteroids. It otters the advantage of a rapid onset of action and a low risk of systemic side effects.SHORT NOTESROUTES OF ADMINISTRATION246HANDBOOK OEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
F 1 )RUGS IN INTENSIVE CARELOADING DOSEAn initial loading dose is given quickly to increase the plasma concentration of a drug to the desired steady-sshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2ady-slate if the usual doses are given ar the recommended interval. Thus, steady-state may not be reached for many days.There arc two points worth noting:•For IV bolus administration, rhe plasma concentration of a drug after a loading dose can be considerably higher than that desired, resulting in t Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2oxicity; albeit transiently. I llis is important for drugs with a low therapeutic index (digoxin, theophylline). Io prevent excessive drug concentratiEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
ons, slow IV administration of these drugs is recommended.•For drugs that are excreted by the kidneys unchanged (gentamicin, digoxin) reduction of theshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absor Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2fore, cannot be excreted unchanged in rhe urine or bile. Water-soluble drugs such as the aminoglycosides and digoxin arc excreted unchanged by the kidneys, rhe liver is rhe major site of drug metabolism. T he main purpose of drug metabolism is to make the drug more water-soluble so that it can be ex Ebook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2creted. Metabolism can be divided into two types:•Phase 1 reactions arc simple chemical reactions including oxidation, reduction, hydroxylation and acEbook Handbook of drugs in intensive care - An A-Z guide (5th edition): Part 2
etylation.•Phase 2 reactions are conjugations with glucuronide, sulphate or glycine. Many of the reactions arc catalysed by groups of enzyme systems.SshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absorshortNotesROUTES OF ADMINISTRATIONIntravenousThis is (he most common route employed in the critically ill. Il is reliable, having no problems of absorGọi ngay
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