Medication intravenous

Aggressive treatment requires administering an antimicrobial medication intravenously (IV). The antimicrobial medication is diluted in a neutral solution (pH 7.0 to 7.2), such as normal saline (NS), isotonic sodium chloride, or 5% dextrose and water (D5W). Antimicrobial medication can be administered as a piggyback infusion. 

Administer the diluted medication intravenously over 1-2 minutes. 

In moderate doses, the action of the benzodiazepines is remarkably like that of the barbiturates, but they are more selective because larger doses do not introduce the toxicity to the patient seen in barbiturate medication. Intravenous diazepam can be used in place of thiopental for the induction of general anaesthesia. It has been found that barbiturates act on the picrotoxin receptor in the GABA—receptor complex (Olsen, 1982) and, in this way, synergize the action of GABA. This effect is stereospecific for in pentobarbital it is confined to the (5)-isomer (Huang and Barker, 1980). It would seem that this type of activity plays only a minor part in medication with barbiturates which behave on the whole as structure-independent lipophiles (see p. 622). 

Medical appHcations of PFC emulsions for organ perfusion and intravenous uses have received much attention in recent years. The first commercial blood substitute (Fluosol DA 20%, trademark of the Green Cross Corp.) employed perfluorodecalin, and improved, second generation products based on this PFC, or perfluorooctylbromide, are now under development (20,21). The relatively high oxygen dissolving capabiHty of PFCs undedies these appHcations (see Blood, artificial). 

Elaborate precautions must be taken to prevent the entrance of Pu iato the worker s body by ingestion, inhalation, or entry through the skin, because all common Pu isotopes except for Pu ate a-emitters. Pu is a P-emitter, but it decays to Am, which emits both (X- and y-rays. Acute intake of Pu, from ingestion or a wound, thus mandates prompt and aggressive medical intervention to remove as much Pu as possible before it deposits in the body. Subcutaneous deposition of plutonium from a puncture wound has been effectively controlled by prompt surgical excision followed by prolonged intravenous chelation therapy with diethylenetriaminepentaacetate (Ca " —DTPA) (171). 

Notify a physician immediately. A suggested procedure for physicians or nurses is intravenous administration of 0.3 g (10 mL of a 3% solution) of sodium nitrite at the rate of 2.5 mL/min followed by 12.5 g (50 mL of a 25% solution) of sodium thiosulfate at the same rate. Watch the patient for 24 to 48 h, especially in cases of ingestion or skin absorption. If symptoms reappear, repeat the injections in half the original amounts. These solutions should be kept readily available. In some cases, first aid personnel have been trained to use the intravenous medication subject to government regulations. 

The final steps to a synthetic blood depend completely upon good chemistry tailored to meet the exact needs of the body Fluorocarbons, such as perfluorodecalin, recently have been found to induce hypennflated lungs when given either intravenously as an emulsion or mtratracheally as a neat liquid [18, 19] But this and other physiological side effects are now understood, and research is well advanced to prevent undesirable side effects in medical applications of fluorocarbon liquids... 

Intravenous medications are often administered in 5.0% glucose, C6H]206(aq), by mass. What is the osmotic pressure of such solutions at 37°C (body temperature) Assume that the density of the solution is 1.0 g-mL. ... 

The ultra-short-acting barbiturates include methohexital sodium (Brevi-tal) and thiopental sodium (Pentothal). These agents are used as anesthetics and are administered intravenously. Barbiturates with short-to-intermediate duration of action are used for their sedative-hypnotic effect in the treatment of anxiety. These medications include amobarbital (Amytal), butabarbital (Butisol), sodium pentobarbital (Nembutal), and secobarbital (Seconal). 

Other sedative-hypnotic medications, such as barbiturates, may play a useful role in severe withdrawal from this group of drugs. For example, in a case series of GBL withdrawal, use of intravenous pentobarbital in the range of 1-2 mg/kg/hour lowered the total requirement for intravenous lorazepam (Sivilotti et al. 2001). Antipsychotic medications are often used to reduce psychotic agitation. However, because antipsychotic medications lower the seizure threshold and may contribute to loss of central control of temperature leading to hyperthermia or neuroleptic malignant syndrome (NMS), they are not indicated as first-line medications for GHB withdrawal delirium (Dyer and Roth 2001 McDaniel and Miotto 2001 Sharma et al. 2001). If anti-... 

Amphotericin B is particularly effective against systemic infections caused by C. albicans and Cryptococcus neoformans. It is poorly absorbed from the gastrointestinal tract and is thus usually administered by intravenous injection under strict medical supervision. Amphotericin B methyl ester (Fig. 5.15C) is water-soluble, unlike amphotericin B itself, and can be administered intravenously as a solution. The two forms have equal antifungal activity but higher peak serum levels are obtained with the ester. Although the ester is claimed to be less toxic, neurological effects have been observed. An ascorbate salt has recently been described which is water-soluble, of similar activity and less toxic. 

These studies raise the possibility that, one day, imaging-based treatment protocols may allow for intravenous thrombolysis in patients well outside of the now-accepted 3-hour window, provided they demonstrate substantial diffusion-perfusion mismatch. Such protocols could allow for treatment of a vastly larger number of patients than are currently treated. It has been estimated that only 1-7% of acute stroke patients currently receive thrombolytic medication, and that, in up to 95% of cases, they are ineligible because they present outside of the 3-hour time window. As many as 80% of patients who present 6 hours after stroke onset may demonstrate a significant diffusion-perfusion mismatch. "... 

Propylene Glycol Content of Commonly Utilized Intravenous Medications 1 2 3 4 5... 

Monitor osmolar gap in patients receiving prolonged or high doses of above intravenous medications (e.g., lorazepam >10 mg/h infusion for >48 h). 

Administer all intravenous medications in saline where possible... 

Concentrate intravenous medications ° Evaluate maintenance fluids ° Concentrate parenteral nutrition 0 Use concentrated enteral nutrition products Avoid and/or discontinue nephrotoxins wherever possible... 

Dietary, intravenous fluids, medications (e.g., ticarcillin, metronidazole)... 

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