Intensive Care Drug Manual

Intensive Care Drug Manual

As such all online versions of specific drug monographs have been removed until it has been completed.Please select the drug by its first letter from the menu above, or type the name into the light blue search bar. The book is split into two sections: an A-Z guide to the drugs available, and concise notes on the key topics and situations faced on a daily basis. The A-Z section provides succinct information on each drug including uses, limitations, administration directions and adverse effects. The second section details practice guidelines such as insulin therapy, Parkinson's disease therapy when nil-by-mouth, and drug dosing in renal failure. This revised edition includes seventeen new drug monographs and covers several new topics, including blood glucose management. A colour chart showing drug compatibility for intravenous administration is included at the back of the book. Presented in a concise, compact format, this book is an invaluable resource for doctors, nurses, pharmacists and other healthcare professionals caring for critically ill patients. Provides the latest information on drug therapy in the intensive care unitThe Pharmaceutical Journal 'Overall this book certainly accomplishes the goal of providing a practical reference for medication administration.Rob Shulman, University College London Rob Shulman is the lead pharmacist in critical care at University College London Hospitals, London. Create an account now. If you are having problems accessing these resources please emailYour eBook purchase and download will be. Get started with a FREE account. OSCE Handbook 2 Mb - Wellington Intensive Care.Study Notes (2012) 13.9 Mb - Wellington Intensive Car.Intensive Care and Emergency Medicine. A.P.I.C.E.Get books you want. To add our e-mail address ( ), visit the Personal Document Settings under Preferences tab on Amazon.

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Essential coverage of 48 of the most common and complex IV drugs, including drip rate calculation charts, drug calculation formulae, and much more help you safely and efficiently administer IV drugs. Current drug dosing charts for 48 of the most common, and most difficult to administer, intravenous infusion critical care drugs ensure that the information you need is readily available. Quick reference drug compatibility charts provide instant access to this crucial information. Drip Rates and Dosing information are arranged in tabular manner for each drug referenced in the text, allowing you to quickly prepare drugs in critical situations. A Drug Calculation Formulae section includes a list of the formulae most useful in determining IV drug concentration, doses, and infusion rates, helping you to eliminate memorization errors when calculating these important parameters. Calculation factors based on patient weight enable you to quickly change a patient’s infusion dose and titrate the drug to reduce the chance of medication errors. Nursing Considerations in each drug monograph offer practical information on administration and monitoring. Trade and generic drug name indexes help you find information quickly no matter what name is used. A handy reference to ACLS guidelines allows you to quickly see how infusion therapy fits into the ACLS protocol. Dobutamine (Dobutrex) 13. Dopamine (Intropin) 14. Drotrecogin Alfa (Xigris) 15. Epinephrine (Adrenalin) Injection 16. Eptifibatide (Integrilin) 17. Esmolol (Brevibloc) 18. Fenoldopam (Corlopam) 19. Haloperidol (Haldol) 20. Heparin 21. Ibutilide (Corvert) 22. Immune Globulin Intravenous (Gamimune, Gammargard, Gammar-P, Sandoglobulin) 23. Inamrinone (Inocor) 24. Infliximab (Remicade) 25. Insulin Drip 26. Isoproterenol (Isuprel) 27. Labetalol (Trandate) 28. Lepirudin (Refludan) 29. Lidocaine (Xylocaine) 30. Lorazepam (Ativan) 31. Magnesium Sulfate NEW! 32. Midazolam (Versed) 33. Milrinone (Primacor) 34. Nesiritide (Natrecor) 35.

Nicardipine (Cardene) NEW! 36. Nitroglycerin 37. Nitroprusside (Nipride) 38. Norepinephrine (Levophed) 39. Octreotide (Sandostatin) 40. Pantoprazole (Protonix) 41. Phenylephrine (Neo-Synephrine) 42. Potassium Chloride NEW! 43. Procainamide (Pronestyl) 44. Propofol (Diprivan) 45. Reteplase (Retavase) 46. Tenecteplase (TNKase) 47. Tirofiban HCL (Aggrastat) 48.If you wish to place a tax exempt orderCookie Settings Thanks in advance for your time. Staying current with the pharmacology used in critical care has become increasingly difficult because of the continued development of new drugs. This handbook was designed to be a readily available reference to provide the necessary information to select an appropriate drug and dosage for a specific situation. The book consists of 13 chapters (acute resuscitation; anesthesia; cardiovascular therapies; pulmonary therapies; renal, electrolyte, and acid-base disturbances; endocrine; gastroenterology; hematology; neurology and psychiatric therapeutics; infectious disease; allergy; poisonings; drug monitoring) and three appendices (intravenous medication administration guidelines; intravenous to oral conversions; oral drug doses). As can be seen by the chapter titles, the book discusses all areas of pharmacology relevant to critical care. Unfortunately, the book sometimes loses sight of its basic focus on drugs, so it lists tables that have little direct pharmacologic implications, such as tension pneumothorax, tamponade, tracheal intubation techniques, tumor lysis syndrome, nutrition, blood component therapy, and transfusion reactions. In addition, some of the tables appear to be relevant primarily to patients outside of the intensive care unit (ICU); the book may be particularly valuable for the new specialty of hospitalists. Because it is difficult to discuss drug therapy outside of the context of specific diseases, the complementary presentation of drugs in both types of tables is extremely useful.

For example, one Table lists the available antiarrhythmic agents and a second Table providesa listing of drugs according to the specific arrhythmia. The major issue in critical care pharmacology frequently involves deciding the best choice among multiple available drugs. Unfortunately, the authors do not always prioritize the available drugs and frequently do not state whether the list is actually a prioritized list.For example, comments on adenosine therapy include the decrease in required dose when administered via a central venous catheter and the increased and decreased effects in patients receiving dipyridamole and theophylline, respectively. The multiple drugs and comments result in crowded tables, and the authors have chosen a type font (approximately size 8) that preserves readability while allowing tables to fit within the width of a single 4.5-inch page. The index is excellent, allowing the reader to find all references to a specific drug. However, because many drugs have more than 20 citations, a notation as to which pages focus on that particular drug would be a helpful addition. By their nature, handbooks tend to have an institutional bias and this is particularly common when multiple possible therapeutic alternatives exist. However, the authors appear to have provided a balanced presentation throughout the book (or else we share the same biases). The book readily provided information for almost all drugs, and the list of drug doses and the adjustments for renal and hepatic dysfunction were valuable. The listing of drugs was comprehensive, with only some minor omissions (ethacrynic acid from the diuretic category; inclusion of tranexamic acid but not aprotinin for prevention or treatment of anticoagulation). For vancomycin-resistant Enterococcus the book not only listed approved drugs, but also provided the phone number to contact for the investigational drug Synercid (Rhone-Poulenc Rorer, Collegeville, PA).

However, the book did not clearly differentiate among the available fluoroquinolones, even though the different agents have specific indications. Atrial fibrillation is the most common dysrhythmia in the ICU. The book provides a list of antiarrhythmic drugs and a separate page with a prioritized list for initial treatment and prevention of recurrence. For the management of hypertension, a common problem in the ICU, one Table listed available drugs, one Table listed drugs of choice in different settings, and two appendices discussed oral drugs. However, I was not convinced that the physician who did not already have an approach to the treatment of perioperative hypertension would be able to choose an initial drug and then convert to oral therapy on a subsequent day. Similar to many other textbooks, the handbook provides the standard tables regarding vasoactive therapy. Other agents such as epinephrine, dobutamine, phenylephrine, and milrinone were not mentioned in this section, nor was there discussion regarding the need to maintain cardiac output. In general, the two editions discuss the identical topics and have many tables with no or only minor changes. The increased length of the second edition is a combination of the increased number of available drugs and the use of a larger type size and other formatting changes. A comparison of the two editions demonstrates the significant advances that have occurred in critical care pharmacology, and the second edition is extremely up-to-date. It is equally useful on the reference shelf and in one's pocket. By continuing to use our website, you are agreeing to our privacy policy. Would you like to change to the United States site? To download and read them, users must install the VitalSource Bookshelf Software. E-books have DRM protection on them, which means only the person who purchases and downloads the e-book can access it. E-books are non-returnable and non-refundable.This is a dummy description.

This is a dummy description.This is a dummy description.This is a dummy description.Offering a thorough update to this classic reference, the new edition provides new chapters on orthopedic injuries and wound management, significant revisions to the treatment protocols, and expanded toxicology information, as well as new references and drug information. The book retains its logical division into two parts, the first covering initial stabilization and the second offering a systems approach to specific conditions. As in the previous edition, chapters are extensively indexed and cross-referenced to facilitate ease of use in emergency situations. With many formulas, tables, drug dosages, and illustrations, Manual of Small Animal Emergency and Critical Care Medicine is an indispensable, convenient resource for busy emergency clinicians, whether they are new graduates or seasoned professionals. Even those in general practice will find it very useful when that unexpected emergency patient shows up in the lobby (at 4:45 pm on a Friday, naturally)!” ( VSPN.org, 9 August 2013) “Regardless, the second edition remains an accessible, well-written, and user-friendly text to guide practitioners in managing common small animal emergencies in any setting.” ( Vet Med Today, 15 December 2013) “ Overall, the 2nd edition of SAECCM is a very practical emergency and critical care manual. A revised and updated edition was necessary to reflect new medications and treatments.” ( Doody’s, 19 October 2012) “The second updated edition of Manual of Small Animal Emergency and Critical Care Medicine provides key details on common emergencies in small animals and offers a new edition with completely new chapter on orthopedic injuries, wound management, and expanded toxicology information and treatment protocols. Chapters are packed with indexing and cross-references, offer a fine outline format for emergency reference, and includes tables, drug dosages, formulas and illustrations throughout.

The result is a fine pick for any veterinary or animal medical reference library.” ( Midwest Book Reviews, 1 October 2012). By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Find out more Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice ). To learn more about the use of cookies, please read our Privacy Policy.She obtained her PhD in 2011 at Paris 6 University. Her special interests and research projects include management and follow-up of children with perinatal asphyxia. She also works on the improvement of the quality and safety of neonatal care, particularly on drug prescription and intravenous administration. Search for other articles: degruyter.com Google Scholar, Laurent Storme Clinique de Medecine Neonatale, Hopital Jeanne de Flandre, CHU Lille, Lille, France Email Further information Laurent STORME, MD, PhD, is professor of Pediatrics at the University Lille 2 France, and Director of the federative project “1000 days 4 Health”. He is Coordinator of the National Center for Rare Disease “Congenital Diaphragmatic Hernia”. He heads the Neonatal Intensive Care Unit at the University Hospital of Lille. Search for other articles: degruyter.

com Google Scholar, Aurelie Maiguy-Foinard Service de Pharmacie, Centre Hospitalier de Wallonie Picarde, Tournai, Belgique Email Further information Aurelie Maiguy-Foinard is a clinical pharmacist at the Wallonie Picarde Hospital in Belgium since November 2016. She was a hospital pharmacist at the Pharmacy Institute of the University Hospital of Lille for two years. She obtained her PharmD in 2013 and her PhD in 2014 at Lille II University. Her special interests and research projects included prevention of adverse drug effects associated with intravenous infusion in anaesthesia and intensive care unit, especially in neonatology. She worked specifically on the assessment of the impact of innovative infusion devices. Search for other articles: degruyter.com Google Scholar, Maxime Perez Faculte of Pharmacie, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associees (GRITA), Universite Lille Nord de France, Lille, France Institut de Pharmacie, CHU Lille, Lille, France Email Further information Maxime Perez is a hospital and university pharmacist at the Pharmacy Institute of the University Hospital of Lille since November 2015 with special interest in clinical pharmacy. He obtained his PharmD and his PhD in 2015 at Lille II University. His research projects include optimization of medical devices used for the injectable administration of incompatible drugs and the evaluation of particles generated during drugs infusion, especially in pediatric and neonatal cares. He teaches clinical pharmacy at the school of pharmacy of Lille. Search for other articles: degruyter.com Google Scholar, Bertrand Decaudin Faculte of Pharmacie, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associees (GRITA), Universite Lille Nord de France, Lille, France Institut de Pharmacie, CHU Lille, Lille, France Email Further information Bertrand Decaudin obtained his PharmD in 2003 and his PhD in 2006 at Lille University.

He began his career as hospital pharmacist in Dunkerque General Hospital in November 2003 and moved to the Lille University Hospital in January 2009 with special interest in evaluation of medical devices and clinical pharmacy. Since September 2007, he teaches clinical pharmacy at the school of pharmacy of Lille. He manages research projects on drug infusion in anaesthesia and critical care medicine. Search for other articles: degruyter.com Google Scholar, Morgane Masse Faculte of Pharmacie, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associees (GRITA), Universite Lille Nord de France, Lille, France Institut de Pharmacie, CHU Lille, Lille, France Email Further information Morgane Masse is a hospital and university resident at the Pharmacy Institute of the University Hospital of Lille since November 2012. She obtained her PharmD in 2016 at Lille 2 University. Her research projects focus on interactions between content and container, especially with medical devices containing polyvinylchloride. Search for other articles: degruyter.com Google Scholar, Stephanie Genay Faculte of Pharmacie, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associees (GRITA), Universite Lille Nord de France, Lille, France Institut de Pharmacie, CHU Lille, Lille, France Email Further information Stephanie Genay is a hospital and university pharmacist at the Pharmacy Institute of the University Hospital of Lille since September 2013 with special interest in clinical pharmacy. She obtained her PharmD in 2013 and her PhD in 2014 at Lille University. Her research projects include optimization of medical devices used for the injectable administration of incompatible drugs, caracterization of interaction container-content, optimization of infusion in anesthesiology. She teaches clinical pharmacy at the school of pharmacy of Lille. Search for other articles: degruyter.

com Google Scholar and Pascal Odou Faculte of Pharmacie, EA 7365, Groupe de Recherche sur les formes Injectables et les Technologies Associees (GRITA), Universite Lille Nord de France, Lille, France Institut de Pharmacie, CHU Lille, Lille, France Email Further information Pascal Odou obtained his PharmD in 1997 and his PhD in 1998 at Lille University. He began his career as hospital pharmacist in the Psychiatric hospital of Armentieres in November 1997, moved a first time, to Dunkerque hospital in 1999, and a second time to the University Hospital in January 2009 with special interest in biopharmacy and sterile compounding. Since September 1998, he teaches biopharmacy, drug compounding and hospital pharmacy at the school of pharmacy of Lille. He manages the research unit on drug infusion named GRITA (Group of Research in drug Infusion and Technology associated) and he also manages the Pharmaceutical Department of the University Hospital of Lille. Search for other articles: degruyter.com Google Scholar A large number of factors are involved in this administration, directly related to the installation of the infusion line. Moreover, the therapeutics used are often limited, and excluding classic “Marketing Authorization”. Some of these products may prove to be incompatible and thus lose their effectiveness, or even generate particles that are likely to be administered to the patient. We must be aware of these risks in order to optimize the prescription and administration of these intravenous products, especially as we treat fragile and immature patients. The aim of this work is to review the literature on the subject for the prescribers of neonatology units. In addition to the medicines to be administered (antibiotics, sedatives, amines, etc.), these patients very often require parenteral (binary or ternary) nutrition (PN), and most of this is done via a single mono-lumen central venous catheter.

All of these therapies result in infusion volumes that can be significant, sometimes with “hidden” intakes such as sodium, and therefore need to be accounted for in total daily intakes. Continuous or discontinuous injectable drugs are administered at low volumes and flow rates on the same infusion line as parenteral nutrition (which also often has a low flow rate). This is likely to cause disturbances in administration, and in particular interactions during prolonged contact in the tubing. Moreover, light can create reactive oxygen species that can oxide other chemicals. Factors Several factors are involved in the administration of IV treatments, in particular in relation to the devices used. One consequence is the existence of significant variability in the volumes delivered to the patient. This is therefore problematic for certain drugs such as catecholamines, aminoglycosides or even insulin. When intravenous treatment is administered, there are 7 factors that can influence this administration: The height separating the end of the catheter from the syringe pump delivering the drug. A vertical movement of the syringe pump delivering the drug solution to the patient will result in a bolus (after an upward displacement), a sudden fluid retraction (after a downward movement) and a no-flow time (ranging from a few seconds to several minutes). These changes are affected by the height of the movement, the type and volume of the syringe, the type and length of the tubing, the pressure exerted or the programmed infusion rate. Characteristics of the syringe delivering the drug. The impact of this factor is amplified with the programming of low flows. Characteristics of the tubing delivering the drug. The impact of this factor is further enhanced in combination with high volume syringes (50 mL) and low flow programming. The use of non-return and anti-siphon valves.

Non-return valves and anti-siphon valves are unidirectional valves, that is, they allow the passage of the solution only in one direction, either to the patient. They are referred to as non-return valves because they prevent the fluid from rising to the other infusion lines. Anti-siphon valves are referred to as they prevent a free flow of the contents of the syringe by gravity, resulting from the presence of air in the syringe. The use of in-line filters. The in-line filters are inserted into the infusion sets to prevent deleterious administration of particles to the patient. Not all drugs are filterable, such as suspensions, micellar solutions, liposomes, having a high viscosity or a risk of adsorption on the filter membrane. The use of multi-access devices. As several medications (including PN and IV lipids) are administered simultaneously, the infusion line set comports multi-access devices. Thus, stopcocks or octopusses are often added to the infusion line. The catheter. There are several catheters available for NICU patients. The first vascular access usually used in NICU is the umbilical one, which is a short-term and emergency access. Umbilical venous catheters (UVCs) are commonly used in NICUs to provide intravenous fluids and nutrition, to provide intravenous medications, and for blood sampling. UVCs are used from birth to 5 days of life and are replaced by a Peripherally Inserted Central Catheter (PICC). A PICC is a venous silicon catheter used for a medium or long-term access. The ideal position for the tip of the PICC is in the inferior or superior vena cava. PICC allows drug administration, parenteral nutrition, fluid therapy and infusions. The choice of the catheter will depend on the chosen venous approach, the duration of the infusion, the desired flow rate, the type of drug administered, or the weight of the patient. These characteristics are amplified with the programming of low infusion rates.

Risks There are a number of risks associated with prescribing and administering IV treatments, especially in NICU. Errors may occur at every stage between the decision to administer a therapy to the patient and the actual delivery to the patient.The last risk, sometimes unknown, is that of Systemic Inflammatory Response Syndrome (SIRS). Drug interactions Incompatibility is an undesirable reaction that occurs between the drug and the solution, container or another drug. The two types of incompatibilities associated with IV administration are physical and chemical. A drug interaction describes the alteration of a drug effect due to the influence of another substance resulting in a solution that is no longer optimal for the patient after the substances are mixed. Physical reactions of drugs usually refer to either phase separation or precipitation due to a change of the relation between ionization and nonionization and solubility. The pH-value and the buffer capacity of the IV solutions and the drugs used are major factors responsible for physical interactions. Unfortunately, there is still missing datas for several drugs (Figure 1 ). Injection or infusion of drugs and fluids releases micro particles into the bloodstream. Various studies have demonstrated the contamination of infusion solutions with glass particles from opening glass ampoules, particles from rubber stoppers or conglomerates of the PN components. Particulate matter are “mobile undissolved particles, other than gas bubbles, unintentionally present in the solutions”. Injectable drug particulate matter are divided into two classes based on the source of the particulate matter: intrinsic particles, defined as those originally associated with the solution, and extrinsic particles, defined as those that enter the container or solution during manufacturing.

Solutions Considering all these elements, it seems essential to design the infusion line set with the prescribing habits of the NICU and the needs of the patients. We also adapt the volume of the syringes according to the perfused flow rates. We designed our actual infusion line set with NICU nurses and hospital pharmacists. It was then tested in vitro with solutions of different colors, at the flows prescribed in NICU. This allowed us to highlight the importance of the use of non-return valves because in their absence there was a rise of colored product in the tubings.This software should soon integrate the known drug incompatibilities, and thus further limit the risk of error when prescribing. Conclusion The management of prescriptions in NICU patients is a daily and challenging issue. It requires taking into account the volumes, the devices used and the possible drug incompatibilities in these immature and low weight patients. The design of the infusion line seems essential and should be carried out in partnership with our pharmacist colleagues, or even tested it in vitro if possible, as we did in our department. Although this may appear complex, there are now technological solutions adapted to this particular population of NICUs, and new devices are also being developed and tested. There are still missing data on the various possible drug interactions, but the use of in-line filters may partially limit their consequences. The real complexity of these administrations in NICUs necessitates close collaboration between neonatologists and the pharmacists in order to optimize each infusion line. Conflict of interest statement: Authors state no conflict of interest. All authors have read the journal’s Publication ethics and publication malpractice statement available at the journal’s website and hereby confirm that they comply with all its parts applicable to the present scientific work.

Safety, dosing, and pharmaceutical quality for studies that evaluate medicinal products (including biological products) in neonates. Crossref PubMed Ward RM, Benjamin D, Barrett JS, Allegaert K, Portman R, Davis JM et al. Crossref Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Optimising the use of medicines to reduce acute kidney injury in children and babies. Crossref PubMed Oni L, Hawcutt DB, Turner MA, Beresford MW, McWilliam S, Barton C et al. Evaluation of the vancomycin dosage regimen based on serum creatinine used in the neonatal intensive care unit. Crossref PubMed Irikura M, Fujiyama A, Saita F, Fukushima S, Kitaoka H, Fukuda T et al. Crossref PubMed Zhao W, Lopez E, Biran V, Durrmeyer X, Fakhoury M, Jacqz-Aigrain E. Vancomycin continuous infusion in neonates: Dosing optimisation and therapeutic drug monitoring. Crossref PubMed Chessex P, Laborie S, Lavoie JC, Rouleau T. Photoprotection of solutions of parenteral nutrition decreases the infused load as well as the urinary excretion of peroxides in premature infants. Discrepancies between predicted and observed rates of intravenous gentamicin delivery for neonates. Crossref PubMed Sherwin CMT, McCaffrey F, Broadbent RS, Reith DM, Medlicott NJ. Hemodynamic response to intentionally altered flow continuity of dobutamine and dopamine by an infusion pump in infants. PubMed Stowe CD, Storgion SA, Lee KR, Phelps SJ. Crossref PubMed Cunningham S, Deere S, McIntosh N. Cyclical variation of blood pressure and heart rate in neonates. PubMed Donald AI, Chinthamuneedi MP, Spearritt D. Effect of changes in syringe driver height on flow: A small quantitative study. Crossref PubMed Neff TA, Fischer JE, Schulz G, Baenziger O, Weiss M. Infusion pump performance with vertical displacement: Effect of syringe pump and assembly type. The effect of syringe size on the performance of an infusion pump. Crossref Kim DW, Steward DJ.