Taz Drug Case Studies

When there is a complication of the regional anesthesia which might include anaphylaxis, overdose, incorrect delivery technique and systemic absorption, the nurse will monitor for systemic toxic reaction which comprises of monitoring the central nervous system (CNS) stimulation along with CNS and cardiac depression. The nurse will also assess the patient for incoherent speech, restlessness, blurred vision, excitement, headache, nausea, vomiting, metallic taste, seizures, tremors, increase blood pressure, respiration and pulse. The patient may become apnea, hypotensive, unconscious, and have a cardiac arrest which may lead to death if the toxic reaction is not treated. Nursing intervention for the complication of regional anesthesia include establishing an open airway, administering oxygen, and notifying the surgeon. Treatment usually comprise of a fast acting barbiturate with epinephrine being administered for cardiac arrest. Edema and inflammation is an early sign of local complication with abscess formation, tissue necrosis and /or gangrene occurring later (Ignatavicius & Workman, 2013). Since general anesthesia was administer in addition to the regional anesthesia, the nurse and anesthesiologist will have to also monitor for complication of general anesthesia which range from a minor sore throat to death. Certain drugs used for general anesthesia may cause an acute, life threatening complication know as malignant hyperthermia (MH). The exposure of these agent to the skeletal muscle causes an increases in serum calcium and potassium level, metabolic rate leading to increased body temperature, acidosis and cardiac dysrhythmias. MH might occur immediately after the administration of the anesthesia, or several hours into the

2. What is the rationale for treating KH with an ACE inhibitor? What is the mechanism of action? What part of the blood pressure formula do they affect? The prescribed of medications are also ethnicity needs to take because some of the medications works better some of the groups ethnicity than other people. It is an angiotensin II of vasoconstrictor that elevates of B/P angiotensin II are also formed of angiotensin 1in the bloods enzyme and enzyme can cover ACE and interfere activity of enzyme of ACE because it decreases the angiotensin II. Most of all if he has vasodilation and blood pressure is reduces.

ACE inhibitors are important and useful in the medication and treatment for KH due to their effectiveness in treating hypertension. ACE inhibitors will help treat KH by slowing the angiotensin converting enzyme (ACE). Angiotensin II is produced by the body that can cause vasoconstriction of the blood vessels. Angiotensin II is made from Angiotensin I by the ACE. If the production of Angiotensin II is slowed by the ACE inhibitor, the blood vessels will be able to dilate, and blood pressure is able to be lowered (Copstead and Banasik). Thus, it is important for KH to stay on the ACE inhibitors due to his blood pressure readings. KH’s blood pressure is 135/96. His systolic blood pressure is in the pre-hypertensive range, however, his diastolic blood pressure is in the hypertensive range and therefore, his blood pressure is hypertensive. Since his blood pressure is high, it is important for KH to remain taking the

Patients can become hypertensive during induction, positioning, or tumor resection (12). Chronic catecholamine excess causes volume contraction and patients can become severely hypotensive, as in this case, if adequate volume resuscitation is not performed (12). It is prudent to evaluate for adverse events following hypertensive and hypotensive episodes. Serial neurological evaluations, CT brain, electrocardiograms, or serial cardiac enzymes may be warranted. Complications of surgery are primarily due to severe preoperative hypertension, high secretion tumors, or repeat intervention for recurrence (13). In one study, adverse perioperative events occurred in 32 percent of cases (14). The most common adverse event was sustained hypertension in 25 percent of the patients. There were no perioperative deaths, myocardial infarctions, or cerebrovascular events. Despite premedication of most patients with phenoxybenzamine and a beta-blocker, varying degrees of intraoperative hemodynamic lability occurred

The total mg of drugs sold in the first quarter for all of the six classes of drugs specified by the Nova Scotia College of Pharmacists is 494,625.

In evaluating M.T.’s medication regimen it is noted she is currently taking metoprolol 50mg twice daily and it is proven to be ineffective in managing her blood pressure which is currently noted as 174/94 with a pulse of 90. The metoprolol is a beta blocker and is not a first choice for a monotherapy to treat hypertension. The regimen is twice daily and creates complications for the M.T. to remember to take the medication. In addition, there is no documented history of heart failure or MI in M.T.’s medical history but there is

This paper discusses the medication Trazodone Hydrochloride. Information on the history and primary uses for the medication are included. Full description of the medication will be provided with information gathered from cited sources and personal experiences. Interaction of the medication on the human brain will also be discussed, as well as side-effects and medication dependency. Cross-medication between human medicine and animal medicine are illustrated by the use of human medications for the treatment of certain medical conditions observed in veterinary medicine. Finally, societal impacts and strategies to reduce these impacts will be discussed and alternative medications will be offered for consideration.

Overall, the knowledge and expertise an anesthesiologist acquired allows them conduct preoperative procedures and evaluations of patients before undergoing an operation to ensure the best possible operational safety for the patient. The evaluation of patients is important because of numerous factors that can could possibly lower the effectiveness of the anesthetics being used or severely endanger a patient. Before an operation an anesthesiologist must evaluate a healthy patient with a systems approach. This procedure usually evaluates the airway, pulmonary system, neurologic system, cardiovascular system, and endocrine system(Hata p.585-588). Each of the systems that need to be evaluated have different methods or procedures to ensure the best

Unlike my first day of internship, which ended in panic and mess, I could now comfortably sit in front of my computer to type medical history until a nurse called me out to check on an 80y/a patient of COPD & Cor Pulmonale. He was transferred to our department from a rural hospital a week before, with serious heart failing symptoms. Standard treatments promptly alleviated his pulmonary rale, but he still appeared to be somnolence with only shallow breathing, and PCO2 was 50mmHg. Attending suggested pulmonary encephalopathy and treated accordingly. The ABG reading I took that morning was showing progress. What was bothering me was his edema in lower extremities was not fading at all. When a senior resident and I approached him, we found the patient suddenly lapsed into coma. We immediately ordered Brain imaging, ECG, cardiac enzyme panel, but "unfortunately" they all turned out to be normal and the patient was not appearing to be in acute distress or potential shock. We were in a bit panic about this situation, but the savior of the day, our attending physician, walked by the ward and noticed our situation. He surfed over the patient's history quickly, and ordered thyroid function tests. It turned out eventually that this patient had hypothyroidism from the very beginning, yet none of us checked upon admission. After replacing his depleted

The MDT would also have to consider psychosocial factors. One major psychological factor would be anxiety. Anxiety can have an effect on the respiratory system and can contribute to hyperventilation (Kelly, 2014). Some things nursing staff could do to counteract this is to give the patient reassurance. A way they can do this is exploring the patient's ideas, concerns and expectations. It is important to make sure the patient is able to convey their fears. Another way to decrease anxiety is to summarise all stages of care and explain what’s happening e.g. taking a blood pressure or placing a cannula (Kular, 2014). One reason for an increase in anxiety might be because he cannot communicate because of his breathlessness. This is why it is recommended

Trazodone: This is an antidepressant classified as a serotonin reuptake inhibitor which is used mainly in the treatment of depression. Trazodone selectively hinders the reuptake of serotonin, causing the serotonin concentration in the brain’s synapses to increase (American Psychiatric Association, 2010). This increase in serotonin is thought to exert a penile erection however there is no clear evidence that supports this. It is used as a 50-200mg dose per night while the common side effects include dry mouth, fatigue and drowsiness. (Padush, n.d)

On a warm day in late spring, Dr. Doe stepped into his resident hospital ready to face the long hard day of administering anesthetics. His first patient, Mrs. Butterworth, is scheduled for surgery at 10:00 a.m. With the spare time, Dr. Doe decided to look over that days patient charts one more time to try to get to know his patients just a little better before administering potentially lethal drugs. Forming a connection with patients is risky business in this field, but is something that many anesthesiologists practice to make their duties more personal. Luckily for him, Mrs. Butterworth’s chart was exactly as he remembered- sixty-four years old, hypertension, nerve damage in her feet from Type II Diabetes.

Lisinopril and levofloxacin were prescribed for Mr. P. Lisinopril was prescribed to treat Mr. P’s new found hypertension. Lisinopril is considered an angiotensin converting enzyme inhibitor (ACE inhibitor). ACE inhibitors are designed to block the vasoconstrictive properties by angiotensin II (Gutierrez, 2008, p712). By blocking this action, and dilating the arteries, the increased workload of the heart is once again decreased, causing decreased blood pressures again (Gutierrez, 2008, p712). ACE inhibitors also help the kidneys excrete sodium and water, thus decreasing the blood volume and decreasing the workload of the heart (Gutierrez, 2008, p712). ACE inhibitors “are biotransformed in the liver” (Gutierrez, 2008, p713, para 5). Excretion occurs through the urine and stool (Gutierrez, 2008, p713).

Mr. Armstrong being 76-years-old likely plays a factor in his diagnosis, considering that acute renal failure is most common amongst the elderly (Singh, Levy, & Pusey 2013). Mr. Armstrong’s history of uncontrolled hypertension is likely due to primary hypertension, which is sustained increases in blood pressure due to genetics combined with environmental factors that increase vascular tone and blood volume (McCance, Huether, Brashers, & Rote, 2014). “Increased vascular volume is related to a decrease in renal excretion of salt, often referred to as a shift in the pressure-natriuresis

There are many different methods of dispersing and accumulating data from subject self-reports, but for the purpose of this research proposal we have elected to adopt a method used in relatively recent study published by the Journal of Drug Issues entitled: “Substance Use, Drug Treatment, and Crime: An Examination of Intra-Individual Variation in a Drug Court Population”.