Aminophylline and Theophylline secondline therapy

-Aminophylline load dose 5.6 mg kg total body weight in 100 mL D5W IV over 20min. Maintenance of 0.5-0.6 mg kg ideal body weight h (500 mg in 250 mL D5W) reduce if elderly, heart liver failure (0.2-0.4 mg kg hr). Reduce load 50-75 if taking theophylline (1 mg kg of aminophylline will raise levels 2 mcg mL) OR -Theophylline IV solution loading dose 4.5 mg kg total body weight, then 0.40.5 mg kg ideal body weight hr. -Theophylline (Theo-Dur) PO loading dose of 6 mg kg, then maintenance of 100-400...

Lower Urinary Tract Infection

Call physician if BP < 90 60 > 160 90 R > 30, < 10 P > 120, < 50 T > 38.5 C Lower Urinary Tract Infection (treat for 3-7 days) -Trimethoprim-sulfamethoxazole (Septra) 1 double strength tab (160 800 mg) PO bid. -Norfloxacin (Noroxin) 400 mg PO bid. -Ciprofloxacin (Cipro) 250 mg PO bid. -Ofloxacin (Floxin) 200 mg PO bid. -Lomefloxacin (Maxaquin) 400 mg PO qd. -Enoxacin (Penetrex) 200-400 mg PO q12h 1h before or 2h after meals. -Cefpodoxime (Vantin) 100 mg PO bid....

Myocardial Infarction and Unstable Angina

Diagnosis Rule out myocardial infarction 4. Vital signs q1h. Call physician if pulse > 90,< 60 BP > 150 90, < 90 60 R> 25, < 12 T > 38.5 C. 5. Activity Bed rest with bedside commode. 7. Nursing Guaiac stools. If patient has chest pain, obtain 12-lead ECG and call physician. 8. Diet Cardiac diet, 1-2 gm sodium, low fat, low cholesterol diet. No caffeine or temperature extremes. 10. Special Medications -Oxygen 2-4 L min by NC. -Aspirin 325 mg PO, chew...

Initial Diagnostic Evaluation of Hypertension

A. 15 Lead electrocardiography may document evidence of ischemic heart disease, rhythm and conduction disturbances, or left ventricular hypertrophy. B. Screening labs include a complete blood count, glucose, potassium, calcium, creatinine, BUN, uric acid, and fasting lipid panel. C. Urinalysis. Dipstick testing should include glucose, protein, and hemoglobin. D. Selected patients may require plasma renin activity, 24 hour urine catecholamines, or renal function testing (glomerular filtration...

Beta Agonists Acute Treatment

-Albuterol (Ventolin) 0.5 mg and ipratropium (Atrovent) 0.5 mg in 2.5 mL NS q1-2h until peak flow meter > 200-250 L min, then q4h OR -Albuterol (Ventolin) MDI 2-4 puffs q4-6h. -Albuterol Ipratropium (Combivent) 2-4 puffs qid. Corticosteroids and Anticholinergics -Methylprednisolone (Solu-Medrol) 60-125 mg IV q6h or 30-60 mg PO qd. Followed by -Prednisone 20-60 mg PO qd. -Triamcinolone (Azmacort) MDI 2 puffs qid or 4 puffs bid. -Beclomethasone (Beclovent) MDI 4-8 puffs bid with spacer,...

Acute Bronchitis

-Ampicillin sulbactam (Unasyn) 1.5 gm IV q6h OR -Ampicillin 0.5-1 gm IV q6h or 250-500 mg PO qid OR -Cefuroxime (Zinacef) 750 mg IV q8h OR -Cefuroxime axetil (Ceftin) 250-500 mg PO bid OR -Trimethoprim Sulfamethoxazole (Bactrim DS), 1 tab PO bid OR -Levofloxacin (Levaquin) 500 mg PO IV PO qd 250, 500 mg . 10. Symptomatic Medications -Docusate sodium (Colace) 100 mg PO qhs. -Ranitidine (Zantac) 50 mg IV q8h or 150 mg PO bid. 11. Extras Portable CXR, ECG, pulmonary function tests before and after...

Systemic Lupus Erythematosus

Diagnosis Systemic Lupus Erythematosus 6. Activity Up as tolerated with bathroom privileges 8. Diet No added salt, low psoralen diet. -Ibuprofen (Motrin) 400 mg PO qid (max 2.4 g d) OR -Indomethacin (Indocin) 25-50 mg tid-qid. -Hydroxychloroquine (Plaquenil) 200-600 mg d PO -Prednisone 60-100 mg PO qd, may increase to 200-300 mg d. Maintenance 10-20 mg PO qd or 20-40 mg PO qOD OR -Methylprednisolone (pulse therapy) 500 mg IV over 30 min q12h for 3-5d, then prednisone 50 mg PO qd. -Betamethasone...

Acute Gout Attack

Activity Bed rest with bedside commode 6. Nursing Keep foot elevated support sheets over foot guaiac stools. -Ibuprofen (Motrin) 800 mg, then 400-800 mg PO q4-6h OR -Diclofenac (Voltaren) 25-75 mg tid-qid with food OR -Indomethacin (Indocin) 25-50 mg PO q6h for 2d, then 50 mg tid for 2 days, then 25 mg PO tid OR -Ketorolac (Toradol) 30-60 mg IV IM, then 15-30 mg IV IM q6h or 10 mg PO tid-qid OR -Naproxen sodium (Anaprox, Anaprox-DS) 550 mg PO bid OR...

Diet NPO

IV Fluids D5 NS at 125 cc h -Activated charcoal 50 gm PO q4-6h, with sorbitol cathartic, until theophylline level < 20 mcg mL. Maintain head-of-bed at 30-45 degrees to prevent aspiration of charcoal. -Charcoal hemoperfusion is indicated if the serum level is > 60 mcg mL or if signs of neurotoxicity, seizure, coma are present. -Seizure Lorazepam 0.1 mg kg IV at 2 mg min may repeat x 1 if seizures continue. 11. Labs CBC, SMA 7& 12, theophylline level now and in q6-8h INR PTT, liver panel....