HOSPITAL NOTES MAY 21,2011MINOR INTERSHIP

CHARGE SLIP C charged for 24 hours P paid at cashier PH philhealth member

PRESCRIPTION COMPLIANT complete NON-COMPLIANT incomplete UNFILLED with X marks

SEPARATE CHARGED SLIP P100 CEFALEXIN PNSS PLRS

OB PACK 30 PCS FERROUS SULFATE 21 PCS MEFENAMIC ACID 9 PCS METHERGIN

DRUGS NOT COVERED BY PHILHEALTH PARACETAMOL PIPERACILLIN + TAZOBACTAM CEFEPIME MEROPENEM

OTHER NAMES OF:EPINEPHRINE ADRENALINEVITAMIN K PHYTOMENADIONEPARACETAMOL ACETAMINOPHENLEVOPHED NORADRENALINEMETHERGIN METHYLERGOMETHRINEVACOSET MACROSETMICROSET MICRODRIPSAFETY FILTER FILTER SETVASOCAN/INSIGHT/IV CATH

G18 GREENG20 PINKG22 BLUEG24 YELLOW

D5 LRS PINKPNSS GREENPLRS DARK PINKD5 0.9% DARK ORANGED5 H2O ORANGE/REDMANNITOL GREENGELOFUSINE YELLOWIMB VIOLETD10 H2O DARK GREEND5 O.3% CLEAR PACKD5 NR YELLOW GREEND5 NM ORANGE

LECTURESTYPES OF DIURETICS

use to increase urine output Loop Diuretics – adverse effect is

hypokalemia Furosemide – tx for pulmonary

edema Osmotic Diuretics

Mannitol Thiazide Diuretics – HCTZ- Drug of choice in the tx of primary

hypertension Potassium Sparing

Spirinolactone Carbonic Anhydrase

GENERAL ANAESTHETICS Volatile Agents/Inhalants- According to minimum alveolar

concentration. Isoflurane Sevoflurane Halothane Enflurane

IV Agents Ketamine–dissociative anesthetic Thiopental-ultra short acting

barbiturate Anti-Cholnergic

-use to decrease secretion of fluids Atropine SO4 – used before

operation-antidote for organophosphate poisoning

Sympathomimetics Ephedrine-prolong effect of

anesthesiaROCEL ANNE QUIZON-DANGANAN

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HOSPITAL INTERNSHIP

Anxiolytics/NeurolepticsBenzodiazepines

Diazepam-drug of choice for status epilepticus

Lorazepam Midazolam Clorazepam

LOCAL ANAESTHETICS Ester (one “i”)

Cocaine Procaine Benzocaine Chlorprocaine

Amide (two “i”) Bupivacaine Heavy-8% dextrose Bupivacaine Isobaric-no dextrose Mepivacaine Prilocaine Lidocaine –tx for cardiac

arrhythmia

ANTICONVULSANT Magnesium sulfate- Epsom Salt

-tx for pre-eclampsia ”convulsion of pregnant women due to HBP”-tx for hypomagnesia

Phenobarbital-drug of choice for infant epilepsy (for babies)

Phenytoin

NEUROMUSCULAR BLOCKERDepolarizing-stimulates release of acethylcholine

FOUR CLASSES OF PENICILLIN causes anaphylactic shock

I. Natural Penicillin Pen G Benzathine 1.2M iu vial

-tx for rheumatic heart failure(Penadur)

Pen V Phenoxymethyl Penicillin-oral capsule

II. Amino Penicillin Amoxicillin (Moks) Ampicillin (Ampitrex) Co-amoxiclav (Qualiclav)

III. Penicillinase Resistant Penicillin Oxacillin (Wydox) Floxacillin (Cabain)

IV. Extended Spectrum Penicillin Piperacillin + Tazobactam

(Piracil) Ampicillin + Tazobactam

TWO MECHANISM OF ACTION1. Bacterocidal – completely destroy the

bacteria on the body that may cause death.

2. Bacteriostatic - prevents the growth of bacteria on the body.

BETALACTAM ANTIBIOTICS

PENICILLIN CEPHALOSPORINS

SIDE EFFECTS OF AMINOGLYCOSIDES Ototoxicity (ears) Neprotoxicity (kidney) Neuromuscular depression

Chloramphenicol (Medichlor) –drug of choice for typhoid feverAdverse Effects:

Bone marrow depressionAplastic anemiaGray baby syndrome

MACROLIDES Erythromycin Azithomycin

Adverse effects: GI disturbance

Tetracycline (Doxycycline) - antiretroviralAdverse effects:

Discoloration of teeth (yellow)OPIOIDS

Long lasting effect Used during operation For cancer patients

Meperidin – less potent than morphine Opioid Analgesic – does not cross the

placental barrier Fentanyl – 80x more potent than morphine

-limit: 20 amps. Celecoxib – (COX2 inhibitor) selective anti-

inflammatory Parecoxib- used for post surgery(40mg/ml

vial) Opium poppy – Papaver somniferum Tramadol – no need for yellow Rx

Nubain – January 28,2011-included under Dangerous Durgs-1 Yellow Rx per amp

Morphine-20 amps limit-3000mg (100tab) limit

Thiopental-3 vials limitROCEL ANNE QUIZON-DANGANAN

BS PHARMACYJBLMRH

HOSPITAL INTERNSHIP

LEAST TO GREATEST POTENCY Meperidin Morphine (adverse effect: constipation) Fentanyl

Naloxone-drug of choice for narcotic overdose-antagonist

Naltrexone-antagonist

Methyldopa (Dopamet/Aldomet)-safest antihypertensive drug for pregnant women.

CORTICOSTEROID Dexamethasone-tx for allergy Hydrocortisone Salbutamol-bronchodilator Cholesterol-most abundant steroid

DRUG OF CHOICE FOR HELICOBACTER PYLORI Lanzoprazole Amoxicillin Clarithromycin Metronidazole

3RD Generation Cephalosporins-tx for meningitis-can enter the blood brain barrier

Quinolones – for UTI Streptomycin- 1st line tx for TB BETALACTAM ANTIBIOTIC-contains

betalactam hormone

AUTONOMIC NERVOUS SYSTEM-responsible for maintaining the internal environment of the body (state of homeostasis)

Parasympathetic Sympathetic

AnabolismRest and Digest

CatabolismFight and Flight

ReceptorsB1 HeartA1 Vascular smooth muscleB2 Lungs

Inotropic Agents-increase the contraction of the heart

Adrenergic Agents-release adrenalineKidneyMedullaAdrenalAdrenal MedullaAdrenal GlandAdrenaline

Dobutamine-drug of choice for cardiogenic shock

Epinephrine-drug of choice for anaphylactic shock

Main adverse effect of penicillin Highest form of allergy

DIRECT ACTING AGONIST Epinephrine Norepinephrine

ANTI-ANGINAchest pain

Nitrates-drug of choice for angina ISDN (Isoket,Isordil) ISMN

*choice of nitrates depemds on the ECG and situation of the patient.

B-Blockers “prolols”Treatment for:

Hyperthyroidism Cardiac Arrythmia Hypertension Migraine Anxiety Angina Glaucoma(diabetic retinopathy) Increase intraocular eye pressure

B1 Cardioselective B2 Non-cardioselectiveMetoprolol

EsmololBetaxolol-glaucoma

Atenolol-cardiac arrhythmia/angina(Tenermin)

PropanololCartenolol

LevobunololNadolol

PenbutololPindolol-hypertension

Timolol-glaucoma

Calcium Channel Blockers “dipines”-inhibit the entrance of calcium in the cells

Hydropinidines Non-HydropinidinesAmlodopineFelodipineNicardipineNifedipine

VerapamilDiltiazem

DRUGS FOR ACUTE CORONARY SYNDROME NGT Patch- drug of choice for relieving

acute coronary spasm-most commonly used anti-anginal agent

ANTICOAGULANT

ROCEL ANNE QUIZON-DANGANANBS PHARMACY

JBLMRHHOSPITAL INTERNSHIP

-prevents blood clotting which may lead to hypertension, stroke or coma

Heparin-for dialysis Heplocks-insertion for IV fluids

ANTITHROMBOTICAdverse effect : GI Bleeding

Aspirin Clopidogrel

ACE inhibitors “prils”-blocks the synthesis of angiotensin IIAdverse effect: Cough

Captopril Enalapril

Potassium-most abundant intracellularly Sodium-most abundant extracellularly

CEPHALOSPORINS1st 2nd 3rd 4th

CephalexinCephadrineCephalotinCephapirinCefadroxilCefazolin

CefaclorCefprozil

CefamandoleCefonicid

CeforanideCefoxitinCefotetan

CefmetazoleCefuroxime

CefpodoximeLoracarbef

CefiximeCefoperazone

CefotaximeCeftizoximeCeftriaxoneCeftazidimeCeftibuten

CefdinirCefditoren

CefepimeCefpirome

*Ceftriaxone-drug of choice for meningitis PTU-Prophylthiouracil

-safest antithyroid drug for pregnant women Formalin-formaldehyde Magnesium Hydroxide-Milk of Magnesia

3 ELECTROLYTES IN LACTATED RINGERS SOL. Sodium Potassium

CalciumCOMMON HERBAL MEDICINES

PLANT S.N. USELagundi Vitex negundo Antiasthma

Sambong Blumea balsamifera UrolithiasisVersa Buena Mhentha cordifolia Pain reliever

Ulasimang Bato Peperomia pellucid Decrease uric acid level on the blood

Niyug-niyugan Quisqualis indica For ascariasis

Liver - main organ for drug metabolism Kidney - main organ for drug excretion

H2 ANTAGONIST1st: Cimetidine2nd: Ranitidine3rd: Famotidine4th: Omeprazole (PPI)

Gliclazide(Zebet) 80mg oral hypoglycemic Glibenclamide (Euglodin)5mg oral

hypoglycemic

LOCAL DENTAL ANESTHESIA Lidocaine carpule Lidocaine spray

MUSCLE RELAXANTAdverse effect: euphoria

Propofol(incubate) Succinylcholine

ATS 1500iu amp – green-antitetanus-with in 24 hours only-adult use 3 amps-5 yrs old below with vaccine(no need for ATS)-after 24 hours toxoid only

Tetagam-tetanus immunoglobulin

-alternate to ATS

Verorab + Favirab-intramuscular-used when near head and spinal cord

Berirab-used when allergic to Favirab

Favirab-depends on BW-if allergic to it, use Verorab

Verorab-from chicken Rabifur-from duck

Modified Fluid Gelatin -plasma expander -synthetic

Voluven(Hydroxyethylstarch)-vegetable

PNSS- for IV and irrigation Plain 0.9%-for external irrigation only

Terbutaline-antiasthma/bronchodilator-pink ampule-tocolytic(relaxant) aka pampakapit

Potassium chloride (KCl)-last drug injected in little injection-10% KCl in the body-dilute to D5W 500cc-cannot be used as direct IVDRUG OF SHOIC FOR GONORRHEA/SYPHILIS

Pen G Ofloxacin Ceftriaxone

Meropenem- for sepsis Furosemide-decrease sodium Hyoscine-for stomach pain

ROCEL ANNE QUIZON-DANGANANBS PHARMACY

JBLMRHHOSPITAL INTERNSHIP

EXEMPT REGULATED DRUG Methergin Phenytoin Tramadol

100mg Caffeine content in 1 cup of coffee

Metformin-antidiabetic drug use to lose weight-needs yellow Rx

Macroset- 20drops/min Microset- 60drops/min

Mannitol-osmatic diuretic-usually used by patient with pressure in the brain

LEUKEMIA: Cyclophosphamide -can cause alopecia(hair

loss) Cisplatin -ototoxic, ear disturbances Metotrexate -stanatitis (singaw)

antidote:Leucovarin Calcium Doxuribicin -cardiotoxicity Bleomycin -pulmonary fibrosis

ARV-ANTIRETROVIRAL DRUGS Co-trimoxazole(Lamivadine) Zidovudine 150mg/300mg Efavirenz + Vitamin E

Carbapenems Meropenem trihydrateLincosamide ClindamycinNitroimidazoles MetronidazoleSulfonamides Co-trimoxazole

Spirinolactone-antialdosterone/rennin angiotensin modulator

Carvedilol-combined alpha and beta blocker

Tamoxifen-drug of choice for breast cancer patients after chemotherapy-continuously used for 5 years

Iodine 131-radiotherapy use to destroy hyperthyroidism (papayat)

H1-for allergies H2- for stomach

Oral Hypoglycemic AgentsBig Amides Sulfonyl UreaMetformin Gliclazide

Glibenclamide

Betaxolo-antiglaucoma Terramycin-prevents blindness Silver Sulfadiazine-drug of choice for burns

H1 antihistamines-acts on muscles1st gen 2nd gen

DiphenhydramineChlorphenamine

Loratidine

DRUGS THAT CAN CAUSE ULCER Mefenamic acid Aspirin

H2 Antagonist-acts on the stomach for gastric acid reactionFamotidineRanitidine

PROTON PUMP INHIBITOR Omeprazole Lanzoprazole

Drugs Acting on the UterusTocolytic-uterine relaxant Oxytocic-uterine stimulant

IsoxsuprineTerbutaline(bronchodilator/uterine

relaxant)

Metherginoxytocin

FOUR MOST POWERFUL ANTIDOTEActivated charcoal

GarlicVitamin CPlantane

ROCEL ANNE QUIZON-DANGANANBS PHARMACY

JBLMRHHOSPITAL INTERNSHIP