I never noticed this.
I never noticed this.
A nurse is looking for a vein on the hand of a premature baby.
Please support the American Heart Association with a donation. Follow this link to my personal page where you can make a secure, tax-deductible online donation. http://s.heartwalk.org/1lavlJ6
Different kind of fractures
*chugs a gallon of water*
ANTIBIOTICS CHEAT SHEET :)
* Sulfonamides compete for albumin with:
- Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies
- Warfarin: increases toxicity: bleeding
* Beta-lactamase (penicinillase) Suceptible:
- Natural Penicillins (G, V, F, K)
- Aminopenicillins (Amoxicillin, Ampicillin)
- Antipseudomonal Penicillins (Ticarcillin, Piperacillin)
* Beta-lactamase (penicinillase) Resistant:
- Oxacillin, Nafcillin, Dicloxacillin
- 3°G, 4°G Cephalosporins
- Beta-lactamase inhibitors
* Penicillins enhanced with:
- Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)
- Aminoglycosides (against enterococcus and psedomonas)
* Aminoglycosides enhanced with Aztreonam
* Penicillins: renal clearance EXCEPT Oxacillin & Nafcillin (bile)
* Cephalosporines: renal clearance EXCEPT Cefoperazone & Cefrtriaxone (bile)
* Both inhibited by Probenecid during tubular secretion.
* 2°G Cephalosporines: none cross BBB except Cefuroxime
* 3°G Cephalosporines: all cross BBB except Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.
* Cephalosporines are ”LAME" bc they do not cover this organisms
- L isteria monocytogenes
- A typicals (Mycoplasma, Chlamydia)
- M RSA (except Ceftaroline, 5°G)
- E nterococci
* Disulfiram-like effect: Cefotetan & Cefoperazone (mnemonic)
* Cefoperanzone: all the exceptions!!!
- All 3°G cephalosporins cross the BBB except Cefoperazone.
- All cephalosporins are renal cleared, except Cefoperazone.
- Disulfiram-like effect
* Against Pseudomonas:
- 3°G Cef taz idime (taz taz taz taz)
- 4°G Cefepime, Cefpirome (not available in the USA)
- Antipseudomonal penicillins
- Aminoglycosides (synergy with beta-lactams)
* Covers MRSA: Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.
* Covers VRSA: Linezolid, Danupristin/Quinupristin
* Aminoglycosides: decrease release of ACh in synapse and act as a Neuromuscular blocker, this is why it enhances effects of muscle relaxants.
* DEMECLOCYCLINE: tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)
* Phototoxicity: Q ue S T ion?
- Q uinolones
- T etracyclines
* p450 inhibitors: Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides
* Macrolides SE: Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis
* Bactericidal: beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.
* Baceriostatic: tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.
* Pseudomembranous colitis: Ampicillin, Amoxicillin, Clindamycin, Lincomycin.
* QT prolongation: macrolides, sometimes fluoroquinolones
Retail jobs summed up
I’d Like to introduce you to Kennedy, She and her family are why I walk.
When I was a kid my best friend Garey and I were inseparable. We played Football, Soccer and baseball together. We were Fire Explorers together hell we even chased the same girls in high school (he usually got the girl). 4 years ago his daughter Kennedy was born. That little girl changed his and my life forever.
Seeing Garey at Children’s Hospital doing everything he could to hold it together. To keep up the strong persona after being told something no one ever wants to hear about their child.
His little girl hooked up to 10 different machines to help her breath and keep her heart beating.
Kennedy had been born with a congenital heart defect, there was a hole in her heart about the size of a dime. This hole would only get bigger as she grew.
A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely. Signs and symptoms of severe defects in newborns include
•Cyanosis - a bluish tint to the skin, lips, and fingernails
•Poor blood circulation
Many congenital heart defects cause few or no signs and symptoms. They are often not diagnosed until children are older.
This wasn’t the case for Kennedy.
Treatment can include medicines, catheter procedures, surgery, and heart transplants.
Lastly: The Legacy of Life Endowment has been created for Congenital Heart Defect Research. One hundred percent (100%) of all funds will be placed in the endowment.
Funds can be raised separately or through any of the American Heart Association’s heart walks.
Anyone can request that the money they raise for an AHA Heart Walk be sent to the Legacy of Life.
I’m walking in the American Heart Association’s 2014 Puget Sound Heart Walk on Oct 11, 2014 and I’ve set a goal of $500 to raise funds to decrease heart disease and stroke in our community. They are the leading causes of death and disability in the US.
Please support me with a donation. Follow this link to my personal page where you can make a secure, tax-deductible online donation. http://s.heartwalk.org/1lavlJ6
When it’s 0300 and a pt is talking to you