Medical
   Quick Reference 		Your Logo Here


4) Quick 'Drug' Reference/ IVF/ Electrolytes...

BE SURE TO INCLUDE IN YOUR PHYSICAL EXAMINATION/MEDICAL QUESTIONAIRRE FORM THE FOLLOWING INFORMATION :

Include any medications, prescription or non-prescription, alcohol, or drugs that you are now taking or plan to take during your treatment.

Note if you are pregnant, or if you are planning to become pregnant while you are taking the medication.

Note if you are breast-feeding an infant.

http://pdr.net/login/Login.aspx

http://www.prescribingreference.com/ixbin/hixclient?_IXDB_=empr&search-form=login/login2.htm&_IXSESSION_=&submit-button=search (MPR)********

JCCC DRUG FORMULARY 2006 REVISED 12/05**********************************

http://www.drugs.com/    http://www.drugstore.com/   http://www.pqri.org/

http://www.ahrq.gov/qual/pillcard/pillcard.htm ( Pill card)

http://www.fpnotebook.com/PHA.htm ( System-wise)

http://medicine.iupui.edu/flockhart/table.htm ( Cytochrome P450 Enzymes and their Inhibitors/ Inducers)

http://members.aol.com/pocketpeds/pages/online.htm ( Peds- Drug Guide)

http://www.usask.ca/pediatrics/services/pain/policies/PEDIATRIC_ANALGESIC_DRUG_DOSAGE_GUIDELINES.pdf ( Ped Analgesic Drug Chart)

http://www.healthsquare.com/aindex/aa-af.htm ( A-Z)

https://online.epocrates.com/public/portkey/?monograph=formularies&src=PK ( Formulary Look-up)*****

http://209.85.165.104/search?q=cache:_GhPSW_I5scJ:www.macdill.af.mil/shared/media/document/AFD-060808-013.doc+amoxil+250/5&hl=en&ct=clnk&cd=44&gl=us ****

https://www.pfizerpro.com/content/home.jsp (Patient Assistance Programs)

https://online.epocrates.com/noFrame/ **************************DRUGS

http://dictionary.infoplease.com/sig ( sig.)

http://www.medscape.com/viewarticle/575036 ( Nephrotoxicity)

http://www.hiv-druginteractions.org/

http://www.pharmacist.com/am/template.cfm?Section=Home2

MEDICATIONS USED IN ADULT CODE BLUE EMERGENCIES 

Pharmacist Online Resources - Parenteral Therapy **** 

Intravenous Medication Administration Guidelines    Adult critical care medications for continuous IV infusion      Intravenous Dilution Standards - GlobalRPh 

Restricted Administration Drug Tables     Critical Care Drug Monographs     ICU Meds Intravenous Drip Rate Calculator      http://www.globalrph.com/drip.htm ( IV Drip-Rate Calculator)

Massachusetts General Hospital Intravenous Medication Reference      Intravenous Phenytoin / Fosphenytoin Administration Guideline       BCCA Cancer Drug Manual

http://www.methodistmd.org/pdf/osets/404-QM-(12-20-06).pdf ( NSTEMI/ Unstable Angina)

 

http://www.arthritis.org/drug-chart.php (Drug Chart/ Pain Meds)

http://members.aol.com/pocketpeds/pages/drugs/pp31.htm ( Peds/ Pain, Fever, Arthritis)

http://ww2.arthritis.org/arthritistoday/DrugGuide/chart_brms.asp ( Biologics)

http://www.arthritis.org/matching-conditions-to-meds.php ( Matching conditions to Meds)***

http://www.merck.com/mmhe/sec09/ch121/ch121c.html ( Peptic Ulcer/ Drugs)

Rx Wizard      http://www.rxlist.com/script/main/hp.asp

http://www.medindia.net/doctors/drug_information/home.asp ( A-Z)

http://www.medindia.net/drugs/drug_toxicity/home.asp ( Drug Toxicity)

http://www.nabp.net/ ( NABP)

http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/13WaysToSaveOnPrescriptions.aspx***

http://www.rxaminer.com/consult/consult_mydrugs.asp ( Generic/ Brand Drugs)

http://www.freemedicinefoundation.com/contact_us.html?gclid=COCbu-20rJICFQv_sgodDCncRg ***

http://www.prescribingreference.com/        ***

http://www.barksdale.af.mil/library/factsheets/factsheet.asp?id=5012

http://www.moodyservices.com/pdfs/Formulary.pdf

http://members.aol.com/pocketpeds/pages/omcc.htm ( Peds)

http://www.pdr.net/login/Login.aspx?engine=adwords!8815&keyword=PDR&match_type=&gclid=CP6IsOLzwo8CFQwsOAodpSAXcw ***

 

If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), 
your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately.
 
http://www.merck.com/mmpe/sec21/ch326/ch326c.html ( Rumack-Mathew Normogram for Acetaminophen...)

http://www.fpnotebook.com/PHA.htm ***************************Miscellaneous

http://www.medscape.com/viewarticle/546258 ( ADE)

http://www.emedicine.com/quickref.shtml   (TOOLS)

http://www.needymeds.com/ ****

http://www.webmd.com/drugs/

http://www.medscape.com/viewprogram/5533 ****************

http://knowledge.emedicine.com/splash/shared/etools/index.htm  ************

http://www.manuelsweb.com/nursing.htm  Emergency meds infusion Dosage***********
 
https://www.pparx.org/Intro.php          http://www.phrma.org/  ( Prescription Assistance)
http://rxassist.org/           http://rxhope.com/    
http://caqh.org/  ( Verifying Pt eligibility & benefits).
 
http://www.nida.nih.gov/  ( Drugs of Abuse)
http://www.nlm.nih.gov/medlineplus/druginformation.html **********************************************************
 
Orange Book Query http://www.fda.gov/cder/ob/default.htm

Orange Book Current Cumulative Supplement
http://www.fda.gov/cder/orange/obcs.pdf  PDF
http://www.fda.gov/graphics/pdf.gif

Orange Book - Information and Data Files
http://www.fda.gov/cder/orange/obreadme.htm

Orange Book Monthly Additions and Deletions
http://www.fda.gov/cder/rxotcdpl/pdplarchive.htm

Paragraph IV Patent Certifications http://www.fda.gov/cder/ogd/ppiv.htm

(updated)
 
http://www.fda.gov/cder/drug/DrugSafety/DrugIndex.htm ( Patient Information Sheets) *************************
http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm  ( FDA approved  DRUG products).***************

http://www.intmed.mcw.edu/AntibioticGuide.html

http://www.pdrhealth.com/drugs/rx/rx-a-z.aspx

http://www.pdrhealth.com/drugs/otc/otc-a-z.aspx

 
 
 
http://www.insulindevice.com/ (Insulin Delivery Systems)
http://www.depo-medrol.com/depomedrol/depomedrol.portal (Depo-Medrol/ Methyl prednisolone IM & IA injection indications).
http://www.rxoutreach.com/en/ (Medicine Coverage for needy patients)
http://www.fpnotebook.com/REN104.htm (Phosphorus Replcement)
http://www.fpnotebook.com/REN98.htm (Calcium Replacement).
http://www.fpnotebook.com/REN105.htm (Potassium Replacement).
http://www.fpnotebook.com/REN106.htm  (Tx of Magnesium Deficiency).
 
http://barttersite.com/ (port-a -cath, Mg, K)
http://www.emedicine.com/ (electrolytes, other topics)
info@nephropharmacy.com (for Renal dosing of drugs book)
 
http://www.rxkinetics.com/heparin.html (Heparin Dosing Protocol/ More so with DVT, than ACS/ TIA);  
http://www.fpnotebook.com/HEM178.htm (Heparin Protocol);   http://www.fpnotebook.com/HEM180.htm (LMW Heparin Protocol)
http://www.fpnotebook.com/HEM180.htm ( Coumadin Protocol);  http://www.fpnotebook.com/HEM226.htm  ( Peri-Operative Anticoagulation)
 
http://www.fpnotebook.com/END154.htm (Insulin Sliding Scale).
 
http://jnnp.bmjjournals.com/cgi/content/full/65/3/362 (Pulsed Methyl Prednisone Dosage & tapering with oral Prednisolone in MS)
Spine Fractures desscriptions and information - www.cirugiadelacolumna ... (Dose of Methyl Prednisone for spinal cord decompression...
(Initial doses: 30/mg/kg during 15 minutes. Relax 45 minutes.
Infusion doses: 5.4/mg/Kg/hour during 23 or 43 remaining hours).
http://cmejama-archives.ama-assn.org/cgi/content/full/jama;295/21/2525/JXR60005F3  (Methyl Prednisone for Temp Arteritis + Vision Loss)
http://www.medscape.com/qna/AddResponses (Methyl Prednisolone in Acute severe asthma)
http://www.medscape.com/viewarticle/551396#question ( MethylPrednisolone --IM inj--for Hand Pain) ***
_____________________________________________________________________________________________________________
 
1. Useful strategies for identifying patients who are noncompliant with medications include all of the following except:
Answer: Measuring the concentrations of drugs that the patient has been prescribed
The following are important compliance improvement strategies to consider in patients: First, providers must identify poor medication compliance by recognizing patients who miss appointments, those who are not responding to therapy, and those who are not making medication refills. Second, providers should elicit their patients' feelings about taking medications and whether they feel that they can follow the regimen the provider is recommending. Asking patients nonconfrontationally about compliance barriers can uncover important clues as to why they may be missing medications and can allow healthcare providers the opportunity to troubleshoot ways to improve medication taking. Finally, patients should be encouraged to develop their own medication-taking system that works for them. Measuring drug concentrations can be misleading because it reflects only the last 1 or 2 doses that the patient may (or may not) have taken.
2. In the elderly, all of the following factors contribute to the occurrence of adverse drug reactions (ADRs) except:
Answer: Increased rate of elimination
Elderly and pediatric patients are particularly vulnerable to ADRs because drugs are less likely to be studied extensively in these extremes of age, and drug absorption and metabolism are more variable and less predictable in both of these groups. Ghose showed higher numbers of ADRs per patient in both the pediatric age group and in the elderly compared with the middle-age range, with the highest rates of ADRs occurring in octogenarians at a rate of 60 ADRs/10,000 people. Elderly patients with multiple medical problems who are taking multiple medications, those who have a history of ADRs, and those with a reduced capacity to eliminate medications are at high risk for ADRs.
3. Common reasons for ADRs include all of the following except:
Answer: Medication reconciliation
A large cohort study of Medicare enrollees, with over 30,000 patient-years of observation, revealed that 28% of ADRs were potentially avoidable. Most of the errors occurred at the stages of prescribing (58%) and monitoring (61%), with 21% of ADRs occurring as a result of poor medication compliance. (These percentages add up to more than 100% because, for a single adverse drug event, it is possible to identify errors at more than one stage of pharmaceutical care.) The medication reconciliation process for maintaining an accurate and portable record of a patient's medications can be useful in preventing medication errors and potentially reducing ADRs.
4. Useful compliance improvement strategies include all of the following except:
Answer: Avoiding inquiry on how patients are taking their medications
The most useful interventions for long-term medication compliance improvement have included complex combinations of more convenient care, information, counseling, reminders, self-monitoring, reinforcement, family therapy, and other forms of additional supervision or attention. Asking patients nonconfrontationally about compliance barriers can uncover important clues as to why they may be missing medications, and can allow healthcare providers the opportunity to troubleshoot ways to improve medication-taking. Providers should ask patients at every visit about how they are taking their medications and encourage them to use a selected time, location, and/or activity cue that fits their daily routine.
5. Which of the following statements is false?
Answer: Compliance varies directly with dosing frequency
Regimen simplification and frequent reinforcing clinic visits or telephone calls can help improve compliance. However, studies reveal that the simplest regimen still leaves 10% to 40% of subjects deviating from perfect dosing. The difference in compliance between once- and twice-daily dosing tends to be small in most studies, while compliance declines more significantly as the prescribed dosing frequency exceeds twice a day. Electronic monitoring has confirmed that the compliance varies inversely with the dosing frequency. In a study of 198 Canadian hypertensive patients randomized to diltiazem twice daily vs amlodipine once daily, those on a once-daily regimen displayed less dosing inconsistency than with twice-daily dosing. In another study of diabetic patients taking oral agents, compliance rates fell from 79% with once-daily medication to 38% with thrice-daily dosing.
6. In Classen's "trigger tool method," which of the following orders is not an example of a "trigger" event leading to the suspicion that an ADR had occurred?
Answer:
A practical approach to measuring medication-related harm utilizes Classen's sentinel signal or "trigger tool method," employing a software program linked to an integrated hospital information system, which also could potentially be used in an integrated outpatient system. Using this method, the software identifies triggers or sentinel events indicating a possible ADR, which then initiates a more detailed and concurrent chart audit. For example, with the ordering of certain drugs, antidotes, laboratory tests, and abrupt stop orders, a notification is sent indicating a need for a chart audit.
7. Medication noncompliance should be suspected in which of the following situations?
Answer:
The following are important compliance improvement strategies to consider in patients: Providers must identify poor medication compliance by recognizing patients who miss appointments, those who are not responding to therapy, and those who are not making medication refills. If a patient feels that the risk, cost, quality of life, or inconvenience outweighs the benefits of the therapy, he or she will need careful explanation and discussion of the benefits of the treatment.


Labs/ Procedures...

 
 
Clinical Monitoring of Direct Thrombin Inhibitors Using the Ecarin Clotting Time
http://www.utmb.edu/lsg/CollectionBlue.htm ( Coagulation Collection)
Heparin Monitoring
Coumadin (Warfarin Sodium)      Learning Ctr : Coumadin
http://en.wikipedia.org/wiki/Coagulation
http://en.wikipedia.org/wiki/International_normalized_ratio
http://en.wikipedia.org/wiki/Partial_thromboplastin_time
http://en.wikipedia.org/wiki/Von_Willebrand_factor
http://en.wikipedia.org/wiki/Thrombotic_thrombocytopenic_purpura
http://en.wikipedia.org/wiki/Hemolytic_uremic_syndrome
http://en.wikipedia.org/wiki/Plasmapheresis
 
 
http://www.emedicine.com/med/topic408.htm ( Cold Agglutinin Disease)
Cryoglobulinemia Home Page
 
Rho(D) Immune Globulin (Rho(D) Ig) (Injectable) - Drug Information -
Hemolytic disease of the newborn    
FETAL Maternal hemorrhage SCREEN    Fetal Screen - ARUP Lab Tests
Coombs test - Wikipedia, the free encyclopedia
http://www.medscape.com/viewarticle/565321 ( RBG, GTT)
 

HIV/AIDS/STD Branch - Tennessee Rapid Testing Guidelines

Tennessee Department of Health     Laboratory Services

 

12/1/93 - How long does it take your heart to circulate the total ...

Cardiovascular System Diagram    http://www.clt.astate.edu/jhuggins/ex__40.htm

http://mywebpages.comcast.net/wnor/lesson4veinsofarm.htm

 

Nervous | Examination *************    Motor > Normal************

http://www.drtouraj.com/nervechart.html

 

http://cim.ucdavis.edu/Eyes/eyeText.htm

Compact Phlebotomy Tray w/ Drawer from MarketLab 

http://www.marketlabinc.com/products/print/594

 

Hazard symbol - Wikipedia, the free encyclopedia

 

Vascular Access—Your lifeline to hemodialysis - DaVita

Venous Access - Specific types, advantages and disadvantages

 

http://www.lymphedemapeople.com/thesite/arm_lymphedema.htm

 
http://www.hcahealthcare.com/             
 
http://www.fpnotebook.com/LABCh3.htm ( Lab/ General-Index) ****all kinds of Tests/ Chapters
http://www.fpnotebook.com/LAB.htm ***********all tests/ Chapters 
http://www.fpnotebook.com/LAB5.htm ( Lab/ Lab-Index)***********************************
http://www.fpnotebook.com/LABCh4.htm ( Lab/ Pediatics/ Ped-Index)*** 
http://www.fpnotebook.com/HEM84.htm ( Ped Labs...for Hgb) *** 

ht 

 
http://www.labtestsonline.org/ ( TESTS/ DISEASES) ****************************
http://www.pathology.med.umich.edu/handbook/ ( TESTS)***********************
 
 

http://aepo-xdv-www.epo.cdc.gov/wonder/prevguid/p0000419/p0000419.asp ( Isolation Precautions in Hospital)

 

http://www.csun.edu/science/ref/laboratory/safety/ChemicalStorage.html

 

http://www.transfusionguidelines.org.uk/index.asp?Publication=HTM

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=9850&nbr=5274

http://www.uihealthcare.com/depts/med/pediatrics/iowaneonatologyhandbook/hematology/transfusion.html 

http://www.utmb.edu/lsg/LabSurvivalGuide/sample_procurement.htm ( Sample Collection Guide)

http://www.legacyhealth.org/body.cfm?id=810 (Specimen collection guidelines)

UW Laboratory Medicine - Specimen Collection Guide

http://www.labcorp.com/datasets/labcorp/html/frontm_group/frontm/section/speccol.htm ( Specimen Collection Guide)

http://www.aruplab.com/TestDirectory/SpecialSpecimenCollection/

 

http://www.msnusers.com/phlebotomy/orderofthedraw.msnw ( Order-of-Blood Draw)***

 
 
 
http://www.utmb.edu/lsg/LabSurvivalGuide/Viral.html *****( Table-Form)************************
http://www.webmd.com/hw/lab_tests/hw235580.asp ( Detection of Viral Infection) ***
 
How Much Blood is Too Much - DrGreene.com  ( Guidelines for Pediatric Blood-Draws)***
 

http://www.utmb.edu/lsg/LabSurvivalGuide/Throat.html ( Throat Cx)

 

http://www.utmb.edu/lsg/LabSurvivalGuide/CSF.html ( CSF)

http://www.healthofchildren.com/C/Cerebrospinal-Fluid-CSF-Analysis.html  ( CSF analysis )

 

http://www.aruplab.com/TestDirectory/SpecialSpecimenCollection/infectious_disease.jsp ( ID)

http://www.gomcl.com/ASP/asp1.htm ( Antimicrobial Susceptibility Profile Index)

http://www.utmb.edu/lsg/LabSurvivalGuide/Wounds.html ( Wound Sample Collection)

 

Guidelines for Specimen Collection | CDC ORST ( Stool...)

http://www.utmb.edu/lsg/LabSurvivalGuide/Fecal.html

http://www.revolutionhealth.com/conditions/cancer/colon-cancer/screening-diagnosis/stool-analysis (Stool Analysis)

 

http://www.utmb.edu/lsg/LabSurvivalGuide/Cyto.html ( Pap Smears/ Storage & Handling of Body Fluids)***

http://www.utmb.edu/lsg/LabSurvivalGuide/SpecimensAcceptanceRejection_cyto.html

 

http://www.utmb.edu/lsg/LabSurvivalGuide/Biopsy.html ( Biopsy Tissue)

 

http://www.utmb.edu/lsg/LabSurvivalGuide/Cytogenetics_collection.htm ( Cytogenetics Sample Collection)

 

http://www.covenantlab.com/specimen_processing.html ( Specimen Processing Guide)

 

 

Lab Test Interpretation    ( Interpretation of Test Results)

http://www.labtestsonline.org/understanding/index.html

http://stason.org/TULARC/health/lab-test-interpretation/index.html

http://www.rphworld.com/pharmacist/link-482.html

 

http://www.amazon.com/Interpretation-Diagnostic-Tests-Jacques-Wallach/dp/0781716594 ( Book)

http://www1.mooremedical.com/index.cfm ********Supplies*********http://floridaexcell.com/ --# 49 C Phlebotomy; 
http://nccls.org/ ---Book/ Guidelines & Stds.
 

 

http://veinviewer.com/main/content.aspx?mnu=veinviewer ***

http://www.rheniummedical.com/Veinlite/?gclid=CNmvgcWps48CFVB1OAodAQ7HNA

 

clcpages.clcillinois.edu/home/bio554/exam.html (PBT--ASCP)
 
 
Read about ---Lab Stds---CDC, EPA, NCCLS, NFPA, OSHA, CAP, NAACLS, JCAHO,

NCA, DOT, CCF, NIOSH, CLSI, NIDA

 

 

Medical Calculators

http://www.ovulation-calculator.com/            
http://www.mdcalc.com/uanstemitimiscore ( TIMI Score..)*******************
http://pda.ahrq.gov/clinic/psi/psicalc.asp (Pneumonia severity index)

Formulae

   http://www.ncemi.org/default.htm (Calculators);  http://athena.usask.ca/growthutility/phv_ui.cfm?type=2 (Prediction of Adult Height)

    http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter23/10-23.html (Formulae);    

    http://www.emedicine.com/splash/etools_xml.pl?file=apache_ii_score_for_adults&prog=edecision (Apache score)

    http://www.trauma.org/scores/gcs.html (Glasgow Coma Score)

    http://www.emedicine.com/quickref.shtml  (TOOLS)  ********

    http://knowledge.emedicine.com/splash/shared/etools/index.htm  (E-TOOLS)

    http://www.mdcalc.com/  *****************************

 

1) Serum Osmolality: 2*Na + BUN/2.8 +  GLU/18 + ETOH/4.6  (N=285-295 mosm/kg)http://www.fpnotebook.com/REN78.htm

2) NaHco3 Replacement: Base Deficit(meq/l) *Wt(kgs) /4  (Give half the deficit over 8-12 hrs; In Cardiac arrest, give it immediately)

    http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=sodium_bicarbonate_replacement&BlankTop=1 

3)Na Correction in Hyperglycemia: True Na= Measured Na+ (Serum Glucose-100)/100 * 1.6

   http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=sodium_correction_in_hyperglycemia&BlankTop=1

4)Alveolar-arterial Gradient (http://www.fpnotebook.com/REN52.htm);

   http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=room_air_alveolar-arterial_gradient&BlankTop=1

 A-a (O2)= (FiO2%/100) * (Patm - 47 mmHg) - (PaCO2/0.8) - PaO2 (all units mmHg)

5)Anion Gap= Na-Cl+HCO3; (http://www.fpnotebook.com/REN56.htm)

 (Normal Anion Gap: 12 +/- 2 meq/L )

6)BMI: (Weight in kg)/((Height in meters)*(Height in meters))

     http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=body_mass_index&BlankTop=1

7) Est. Creatinine Clearance = [[140 - age(yr)]*weight(kg)]/[72*serum Cr(mg/dL)] (multiply by 0.85 for women)

    http://www.intmed.mcw.edu/clincalc/creatinine.html;  

   Timed Cr Clearance:  http://www-users.med.cornell.edu/~spon/picu/calc/crclcalc.htm

8) http://www-users.med.cornell.edu/~spon/picu/calc/fenacalc.htm
FENa =
UNa * PCr
  x 100
PNa * UCr

9) Free Water Deficit Tx in Hypernatremia:   0.6 * Weight * (Sodium/140 -1)

    http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=free_water_deficit&BlankTop=1

    http://www.bcchildrens.ca/NR/rdonlyres/F0674005-EF69-4DAE-9A42-76D7DE69E17D/13009/dkaprt.doc  ( DKA Protocol & Tx of Dehydration in Children).

    NEW PROTOCOL FOR DKA IN THE ED   ( Peds/ ED---PICU/ DKA)

    http://www.aau.edu.et/faculties/med/internalmed/Notes/DKA_protocol.htm  ( DKA Protocol in Adults)

    http://www.medcalc.com/pedifen.html  ( Fluids & Electrolytes/ Peds)*****************************************************************

 Anion gap (AG)
AG = [ Na+] - [ Cl- + HCO3-]
Corrected Sodium *
Corrected Na+ = [ Na + 1.6 x([ glucose in mg/dl] - 100)
Serum Osmolality
Plasma osm = 2 x Corrected Na + Glucose/18 + BUN/2.8
* Serum sodium should be corrected for hyperglycemia

http://www.patientcareonline.com/patcare/article/articleDetail.jsp?id=391516  ( Adult Maintenence Fluids; Tx of 'life -threatening' electrolyte abnormalities)***

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

http://www.patientcareonline.com/patcare/article/articleDetail.jsp?id=391516&sk=&date=&&pageID=6 ( Tx of Hyponatremia)----Serum Na correction




 

 

 

Na deficit = (Desired Na – serum Na) × 0.6 × body wt in kg

Once the deficit is calculated, the amount of 3% saline solution required to correct it can be determined by dividing the deficit by 513 mEq/L (the concentration of sodium in 3% saline).

http://en.wikipedia.org/wiki/Body_water ( Calculation of Total Body Water) ***

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Tx of Hypernatremia & Maintenance Fluid requirement in Adults:

The 24-hour maintenance fluid requirement can be calculated by using the patient's body weight (in kg) and the following correlations:

First 10 kg body wt = 100 mL/kg
Second 10 kg body wt = 40 mL/kg
Remainder of body wt = 10 mL/kg

So, for a 70-kg male with a serum sodium of 160 mEq/L, the 24-hour maintenance fluid requirement would be

100 mL/kg × 10 kg = 1000 mL
40 mL/kg × 10 kg = 400 mL
10 mL/kg × 50 kg = 50 mL
Total = 1450 mL/d

 
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-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

 

    Insulin Drip Protocol   ( Adults)

Continuous Variable-Rate IV Insulin Drip

Continuous Variable-Rate IV Insulin Drip (cont'd)

Converting to SC Insulin

Correction Bolus (Supplement)

Correction Bolus Formula

Initiating SC Basal Bolus

 

10) MAP= (2/3 * Diastolic BP) + (1/3 * Systolic BP)

  http://www.ncemi.org/cgi-ncemi/edcalc.pl?TheCommand=Load&NewFile=mean_arterial_pressure&BlankTop=1;

  http://en.wikipedia.org/wiki/Mean_arterial_pressure

11)Predicted endotracheal tube size for age= 4 plus (age/4)

     http://www.ncemi.org/default.htm

12) Predicted PEF Calculator: http://www.ncemi.org/default.htm (Males)

                                         http://www.ncemi.org/default.htm (Females)

13) Blood alcohol concentration estimation 

        http://www.ncemi.org/default.htm

     (volume ingested in mL x the "proof" of the beverage x 1.463) / (patient weight in lbs)

14) http://medcalc3000.com/imode/QTIntervalCorrection.htm

    QTIntervalCorrection

15)Adjusted Calcium= Calcium+ 0.8*(4-Pt. Albumin)

16) http://www.ncemi.org/cgi-ncemi/edcalc.pl? TheCommand=Load&NewFile=ionized_calcium_estimation&BlankTop=1 (Ionized Calcium Estimation)

17)Burns: http://www.regionshospital.com/Regions/Menu/0,1640,11272,00.html

          http://www.regionshospital.com/Regions/Menu/0,,4822,00.html

                         http://josephmstillburncenter.com/cpm/minorburns.pdf

   The stable burn patient is then completely undressed, and the percentage of the body surface burned is calculated. Resuscitation begins with placement of large-bore venous catheters and infusion of lactated Ringer's solution according to the Parkland resuscitation formula (4 ml/ kg/% burn, half infused in the first eight hours and the remainder in the next 16 hours).29 A Foley catheter is used to monitor urine output. Patients with extensive burns or burns of critical areas are routinely stabilized and transferred to a burn center for definitive care, according to American Burn Association transfer criteria.24
18) Total Maintenance Fluids ( http://www.outlinemed.com/demo/nephrol/2453.htm)

  1. Adults: ~2 liters per day, or ~80mL/hr for 70kg person
  2. Children:
    1. The "4:2:1" rule is often used to calculate the rate (mL/hr) based on weight (wt)
    2. Rate = 4mL/kg/hr (up to 10kg) + 2mL/kg/hr (10-20kg) + 1mL/kg/hr (>20kg)
  3. In general, D5-1/2NS+20mEq/L KCl or Lactated Ringer's should be used for maintenance.

19)Pulse Pressure= SBP-DBP (N=40-60) 

   http://www.modern-psychiatry.com/pulse_pressure.htm 

20) Peri-Operative Fluid Management:

    http://www.medana.unibas.ch/eng/amnesix1/efmain.htm#periop

21) LDL = TC-HDL-(TG/5)

22) http://www.mededcenter.com/module_viewer.asp?module=100&page=1#hemoCardIndex 

   (Hemodynamic Monitoring).

http://www.mededcon.com/card02.htm (CVP).

http://www.lakesidepress.com/pulmonary/books/physiology/chap10b.htm (Mechanical Ventilation)

http://www.lakesidepress.com/pulmonary/papers/eq/eq1.html (Abbreviations in Ventilation).

http://members.nuvox.net/%7Eon.jwclymer/rq/index.html (Respiratory Quotient Calculator)

http://www.pgmeenotes.blogspot.com/ (Acid-Base Balance, Urinary Casts/ Tumor Markers/ Nails/ Pupils)******

http://www.the-abg-site.com/level1.htm (ABG Analysis)

23) Osmotic gap = 290 - [2 (stool Na + stool K)]

24) http://www.mdcalc.com/fena  (FENA)   http://www.fpnotebook.com/REN60.htm  ( FE of HCO3)

       http://www.fpnotebook.com/RENCh1.htm ( Acid- Base Disorders/ RTA/ Related Chapters)

25) http://www.mdcalc.com/stemitimiscore