pulmonary edema,dka,HTN , metoprolol , noradrenaline,dopamine

 

pulmonary edema : IHD , bilateral basal lung crepitation , sob 

if bp >160/90 

o2 

diuretics = lasix iv 2-3 amp 

angesid

foley catheter 

capoten tab 25mg 

*GTN 1amp in 200cc (7-10 drop per min)

*dopamine-dobutamine 2amp in 500ml (15 drop per min) to increase blood pressure 

dka 

two lines 

first line :

1L N/S in 30min , then

1L NS in 1 hour , then 1L in 2hr , the 1L NS in 4hour

second line : 

if there infusion pump , 0.15unit/kg iv direct , then 50 unit +50N/S (6 unit each hr)

*when RBG 250-270 = 3unit per hour 

(if there no infusion pump , 50unit insulin in 500N/S each 10cc 1unit /kg ex: 70kg , 70unit per hour , 70*15drop=1650/60min = 7drop per min 

*when RBG 200-250mg/dl = dextrose 50% or glucose water , if still dehydrated add 500L N/S 

if NA low , give Glucose/Saline 0.45% 

KCL : 1amp 10cc =20mg 

5cc in 500N/S after pass urine , ECG to monitor T wave if flat or inverted 

chart 

time , RBS , insulin given , S.K , s.KSL , uop , condition 

*plus , paracetamol if fever , plasil if vomiting , AB if infection 

metoprolol , how to give 

amp =5mg =5cc 

bolus 1cc every 1min (drugs of choice in chronic af )

dopamine 

2amp in 500cc N/S  or G/S

septic shock = 15-20drop/min 

cardiac dose = 10drop/min 

renal dose=5-7drop/min

noradrenaline 

1amp in 500cc N/S 

bolus 4cc iv bolus 

maintenance 7drop/min/24hr

HTN 

1-capoten 50mg 

2-labetalol 20cc/100mg 

1cc=5mg ,max dose 300mg 

3doses iv bolus 

first dose 20mg/4cc , after 20min , 40mg=8cc, after 20cc , 40-80mg =8-16cc

3-hydralazine (apresoline) amp

diluted in G/S 

amp/20mg=1cc+9cc N/S bolus iv 

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