Mel

Dextrose in Water (50%)Other Names: D50WClassification:

Caloric Agent Action:

Rapidly increases blood glucose levels levels Transient Transient osmotic osmotic diure diuretic tic Indications: Documented hypoglycemia (¡Ü

4 mmol) Seizures of unknown etiology Cerebral/meningeal edema related to eclampsia Contraindications:

1. Rapid rates of administration administration predisposes the patient to pain and may cause phlebitis if aperipheral vein is used; to minimize this effect administer slowly 2. 2.Excessive IV administration may cause fluid overload, water intoxication, +/or CHF3 3. .D50W and Thiamine 100 mg IV (mini bag or IVP) should be given together whenalcoholism or malnutrition are suspected Dosages

No significant contraindications in the emergency setting

Preparation

Precautions

: 25 g/50 ml preload (D50W)

1. Extravasation of the tissue

Adult

2. Suspected intracranial hemorrhage, CVA3.Wernicke·s encephalopathy in the alcoholic patient due to probable thiamine deficiency

: 12.5 - 25 gm D50W slow IV, repeat PRN x 1

Adverse Reactions

Pediatric

: 0.5 gm/kg D25W slow IV to a maximum of  25 gm (dilute D50W 1:1 with NS), repeatPRN x 1

1. Pain, phlebitis at injection site Kinetics

2. Hyperglycemia and glycosuria 3. Fluid overload Interactions/Compatibility/Stability

Dextrose 50% has an acidic pH (3.5 - 5) and therefore specific compatibility compatibility information should beconsulted when Dextrose 50% is injected into an IV line containing another drug Special Considerations

Onset < 1 minutePeak Depends on degree of hypoglycemiaDuration Depends on degre e of hypoglycemia Side effects: CHF, pulmonary edema, venous irritation

Drug Study – Gentamicin Sulfate Posted by: Admin November 14, 2008 · Comments (3)

procedure, may repeat in 8 h Child: IV/IM < 27 kg , 2 mg/kg 30 min before procedure, may repeat in 8 h

Adverse Effects: Special Senses: Ototoxicity (vestibular  disturbances, impaired hearing), optic

Garamycin, Garamycin Ophthalmic,

neuritis. CNS: neuromuscular blockade:

Genoptic

skeletal muscle weakness, apnea,

Classifications: antiinfective;

respiratory paralysis (high doses);

aminoglycoside antibiotic

arachnoiditis (intrathecal use). CV:

Action:

hypotension or hypertension. GI: Nausea,

Broad-spectrum aminoglycoside antibiotic

vomiting, transient increase in AST, ALT,

derived from Micromonospora 

and serum LDH and bilirubin; hepatomegaly,

purpurea. Action is usually bacteriocidal.

splenomegaly. Hematologic: Increased or 

Indication:

decreased reticulocyte counts;

Parenteral use restricted to treatment of 

granulocytopenia, thrombocytopenia (fever,

serious infections of GI, respiratory, and

bleeding tendency), thrombocytopenic

urinary tracts, CNS, bone, skin, and soft

purpura, anemia. Body as a Whole:

tissue (including burns) when other less

Hypersensitivity (rash, pruritus, urticaria,

toxic antimicrobial agents are ineffective or 

exfoliative dermatitis, eosinophilia, burning

are contraindicated. Has been used in

sensation of skin, drug fever, joint pains,

combination with other antibiotics. Also used

laryngeal edema, anaphylaxis). Urogenital:

topically for primary and secondary skin

Nephrotoxicity: proteinuria, tubular necrosis,

infections and for superficial infections of 

cells or casts in urine, hematuria, rising

external eye and its adnexa.

BUN, nonprotein nitrogen, serum

Dosage and Route:

creatinine; decreased creatinine 

Moderate to Severe Infection

clearance. Other: Local irritation and pain

 Adult: IV/IM 1.5 –2 mg/kg loading dose

following IM use; thrombophlebitis, abscess,

followed by 3 –5 mg/kg/d in 2 –3 divided doses Intrathecal4 –8 mg preservative free q.d. Topical 1 –2 drops of solution in eye

superinfections, syndrome of hypocalcemia (tetany, weakness, hypokalemia, hypomagnesemia).

q4h up to 2 drops q1h or small amount of 

Contraindication:

ointment b.i.d. or t.i.d.

History of hypersensitivity to or toxic reaction

Child: IV/IM 6 –7.5 mg/kg/d in 3 –4 divided

with any aminoglycoside antibiotic. Safe use

doses Intrathecal >3 mo , 1 –2 mg

during pregnancy (category C) or lactation is

preservative free q.d.

not established

Neonate: IV/IM 2.5 mg/kg q12 –24h

Nursing Responsibility:

 Acute Pelvic Inflammator y Disease  Adult: IV/IM 2 mg/k g followed by 1.5 mg/kg

 Assessment & Drug Effects 

Lab tests: Perform C&S and renal

q8h

function prior to first dose and

Prophylaxis of Bacterial Endocarditis

periodically during therapy; therapy may

 Adult: IV/IM 1.5 m g/kg 30 min before

begin pending test results. Determine creatinine clearance and serum drug

concentrations at frequent intervals, particularly for patients with impaired renal function, infants (renal immaturity), older adults, patients receiving high doses or therapy beyond 10 d, patients with fever or extensive burns, edema, obesity. 

Repeat C&S if improvement does not occur in 3 –5 d; reevaluate therapy.



Note: Dosages are generally adjusted to maintain peak serum gentamicin concentrations of 4 – 10 g/mL, and trough concentrations of 1 –2 g/mL. Peak concentrations above 12 g/mL and trough concentrations above 2 g/mL are associated with toxicity.



Draw blood specimens for peak serum gentamicin concentration 30 min –1h after IM administration, and 30 min after  completion of a 30 –60 min IV infusion. Draw blood specimens for trough levels  just before the next IM or I V dose. Use nonheparinized tubes to collect blood.