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Solu-Medrol (methylPREDNISolone)
- Class: Theraputic, anti-inflammatories immunosuppressant
- Action: Suppresses inflammation and the normal immune response
- Uses: Used systemically and locally in a wide variety of chronic diseases including: inflammatory, allergic, hematologic, neoplastic, autoimmune disorder
- Recommended Dose: Asthma exacerbation 120-180 mg/day in divided doses 3-4 times/day for 48hr then 60-80mg/day divided twice daily.
- Adverse Effects: PEPTIC ULCERATION, THROMBOEMBOLISM. Hypertension, nausea, anorexia, decreased wound healing, increased blood sugar
- Drug/Food Interaction: Additive hypokalemia with use of Loop Diuretics, hypokalemia increase risk of digoxin toxicity.
- NI: Reconstitute with provided solution, Concentration: Maximum of 125mg/mL. Direct IV push over 3-15min.
- Monitor I & O ratios and daily weights. Observe patient for peripheral edema, steady weight gain, rales/crackles, or dyspnea.
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Lasix (furosemide)
- Class: Loop Diurectic
- Action: Inhibits the re-absorption of sodium and chloride from the loop of Henle. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Decreases blood pressure.
- Uses: Edema due to heart failure, hepatic impairment or renal disease. Hypertension.
- Recommended Dose: 20- 40 mg, may repeat in 1-2 hr and increase by 20mg q1-2 hrs until response is obtained.
- Routes: PO, IM, IV
- AE/ SE: APLASTIC ANEMIA, AGRANULOCYTOSIS, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis
- Drug/Food Interactions: hypotension with antihypertensives, risk of hypokalemia with other diuretics and cort
icosteroids. - NI: Administer undiluted, Concentration: 10mg/mL. Assess patient for tinnitus and hearing loss. Give last dose no later than 5pm to minimize disruption of sleep cycle.
- Monitor blood pressure and pulse before and during admin.
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Dilaudid (hydromorphone)
- Class: Opiate Analgesic
- Action: Inhibits ascending pain pathways in the CNS, increases pain threshold, alters pain perception.
- Uses: Moderate to severe pain
- Recommended Dose: PO: 2-4mg, SQ/IV: 1-2mg (can be increased)
- Routes: PO, SQ, IV, Rectally
- AE/SE: Respiratory depression, nausea, hypotension, drowsiness, rash, itching.
- Drug/Food Interactions: MAOIs, muscle relaxants, other opiates, kava, St. John's wort (increases effects)
- NI: IV: Dilute with 5mL sterile water or NS and give 2mg or less/ 3-5min.
- Assess for pain using pain scale prior to and after admin; monitor respiratory rate and notidy if <10/min. Assess for CNS changes or allergic reactions. Check BP as needed.
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