Essay on Ketamine

Mrs A's digoxin dose must be adjusted to her clinical condition and her serum levels monitored. Digoxin should be taken with meals to decrease the effects of gastric irritation that can accompany treatment. Frusemide and digoxin can both cause hypokalemia; this can be controlled by encouraging Mrs A to eat potassium-rich foods, instructing her about dosage regimen,

Trauma patients often present paramedics with difficult situations to handle. These patients most likely have multiple injuries that the paramedic must treat including internal and external injuries. The main concern in treating trauma patients is controlling the pain that the patient may be experiencing while not compromising the patients hemodynamic and respiratory state. The most common drugs used in pain management in the pre-hospital setting often cause undesirable side effects, such as respiratory depression, hypotension, apnea, and bradycardia. All of these side effects combined with a trauma patient who is already compromised can lead to a much bigger issue. What if there was a drug that could treat the pain, calm the patient, and not cause the nasty side effects of traditional pain management? Ketamine provides us the answer to this question.

• the dose to give and how often it may be repeated before referring to the resident’s doctor

After getting accommodated with the drug, 20 mcg may be increased. However, raising the dosage should be gradually done after keenly monitoring the body reactions.

The therapy ordered by the doctor for the patient includes 1000 mL of Dextrose 5% in 0.90% sodium chloride (normal saline), or D5NS, with 30 mEq of potassium chloride, KCl, at 125 ml/hr, which is a hypertonic tonicity. The D5NS restores fluid balance in the body due to fluid loss caused by hypernatremia or the elevation of sodium levels in the body. The potassium chloride will be used to manage hypokalemia. The dilution of the drug must be checked and rechecked due to the high concentration. The nurse should assess the patient hourly for symptoms of excessive losses of fluid, sodium, or potassium as well asks the patient if there is any burning or pain at the IV site. The order of 100 mL of albumin 25% draws fluid from the interstitial

In this experiment, we used atropine sulfate 0.05 mg/kg (Atropine, Mitsubishi Tanabe Pharmaceutical), midazolam 0.1 mg/kg (Dolmicam, Astellas Pharma Inc.) and butorphanol 0.1 mg/kg (Bettlefare, Meiji Seika Pharma) as premedicated intravenously administration. Ampicillin sodium 20 mg/kg (Vicillin, Meiji Seika Pharma) was administered intravenously at induction. General anesthesia was induced with intravenous propofol 6 mg/kg (Animal propofol, Mylan Pharmaceutical).

The total challenge dose is calculated as 0.15 to 0.3 g protein/kg body weight, not to exceed 3 g protein or 10 g whole food. In patients with a previous history of severe reactions, a lower starting dose of 0.06 g protein/ kg body weight is recommended. If the patient remains asymptomatic for 4 hours, a second dose is given, generally an appropriate single-serving amount followed by 2 to 3 hours of

The usual recommended dosage is 50 mg taken once a day, depending on how you respond to the medication;

In future practice, other means of sedation should be considered, however if time is an issue then droperidal has the potential to be life saving.

General measures include drinking clear liquids and eating small quantities of dry food, such as soda crackers. If individuals lose the ability to eat or drink and become dehydrated due to repetitive vomiting they may develop metabolic alkalosis and hypokalemia. Intravenous fluids such as half normal saline with 20 mEq potassium chloride may be given to maintain hydration. With persistent vomiting, a nasogastric tube may decompress the stomach and improve overall comfort.

As Mrs DCK has a history of high blood pressure and assuming her systolic blood pressure is above 90 mmHg, it is recommended to give 1000mL of NaCl 0.9% IV over the course of 60 minutes. For the continuous use of IV she should be given 1000mL NaCl 0.9% over the next 2 hours, then another 1000mL of NaCl 0.9% over the following 2 hours and finally 1000mL of NaCl 0.9% over the next 4 hours. Nrs DCK must be monitored carefully while giving her IV as she has decrease renal function (Endocrinology Expert Group, 2014). If she has hypernatremia at any stage, the fluid therapy may be switched to NaCl 0.45% solution.

Nitroglycerin is well absorbed through the oral, buccal and sublingual mucosa. Nitroglycerin administered orally is rapidly metabolized leading to decrease bioavailability. Nitroglycerin is metabolized rapidly through the liver as well as enzymes in the bloodstream, and has a half-life of 1-4 minutes. For acute angina, 0.4 mg is administered sublingual. In the event the initial dose does not decrease the pain, a second dose can be administered sublingually after 5 minutes up to a third dose. If the pain persists after administering the third dose, the patient is instructed to call 911. Topical doses can be administered 0.5-2 inches from the site of administration

Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist. It is thought that Ketamine helps to improve analgesia in those with pain refractory to high dose opiates as studied by Yang et al (1996) Mercadante et al (2009) explain that this could be due to a possible reversal of opioid tolerance. Normal doses can vary and Ketamine can be given in tablet form, as a subcutaneous “burst” or intravenously. The normal dose can range from 40-3200mg daily. Mercadante et al (2009) also outline that there may be a possibility that single dose ketamine may reduce hyperalgesia but more studies need to be done to confirm this.

magnesium sulfate to be given over 30 minutes set at 300 mL/hr to give the 6g in 30 min. She also has a maintenance dose of 2g per hour after the bolus which will be set at 50 mL/hr. (7) In this moment seizure control, pain management, environment management, fetal monitoring, potential Foley catheter from uterine relaxing from the magnesium sulfate and decreased urine output from preeclampsia, as well as left lateral position to help promote fetal circulation.

b.ii. The dosage will depend on the age, weight, and other health issues of the person.