Is th|s route appropr|ate for pat|ent? ?es /no Dose] koute] Irequency Crdered
Is th|s route appropr|ate for pat|ent? ?es /no n|gh A|ert? es ]No Why? lv rouLe and uC nC1 confuse meLoprolol wlLh mlsoprosLol or wlLh Lopamax or LegreLol n|gh A|ert? es ]No Why? C|ass|f|cat|on (1herapeut|c]harmaco|og|c) AnLlanglnals AnLlhyperLenslve/8eLa 8locker C|ass|f|cat|on (1herapeut|c]harmaco|og|c) AnLlpyreLlc nonoplold Analgeslc/SallcylaLe Act|on (therapeut|c effect) uecreases 8 P8 decreases frequency of aLLacks of anglna pecLorls decreases cardlo morLallLy hosplLallzaLlon ln pL wlLh hearL fallure Act|on (therapeut|c effect) uecreases laLleL AggregaLlon uecreases lncldence of LransleL lschemlc aLLacks and Ml Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon) PyperLenslon Anglna pecLorls revenLlon of Ml and decreased morLallLy ln pL wlLh recenL Ml ManagemenL of sLable sympLomaLlc (class ll or lll) hearL fallure due Lo lschemlc hyperLenslve or cardlomyopaLhc orgln Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon) rophylaxls of 1ransleL lschemlc ALLack or Ml nome Med|cat|on es ]No If yes dose change? (rev|ous dose t|me)
nome Med|cat|on es ]No If yes dose change? (rev|ous dose t|me)
harmacok|net|cs (onset peak durat|on metabo||sm) unknown 13 mln 612 mln Llver harmacok|net|cs (onset peak durat|on metabo||sm) 330 mln 13 hr 36 hrs Llver 1extbook Dose kange (for ordered route and |nd|cat|on) 23100 mg/day slngle dose/2 dlvlded doses 1extbook Dose kange (for ordered route and |nd|cat|on) 81 mg/day Contra|nd|cat|ons]Caut|ous use uncompensaLed CPl ulmonary edema Cardlogenlc shock 8radycardla PearL block 8enal or PepaLlc lmpalrmenL Contra|nd|cat|ons]Caut|ous use PypersenslLlvlLy Lo asplrln cross senslLlvlLy Lo oLher nSAluS bleedlng dlsorders/ hlsLory of Cl bleedlng or ulcer dlsease chronlc alcohol abuse 8enal or PepaLlc dlsease Adverse keact|on Common laLlgue Weakness and LrecLlle uysfuncLlon
Severe 8radycardla CPl and ulmonary Ldema
1ox|c|ty s|gns]Cverdose Ant|dote?
Adverse keact|on Common uyspepsla LplgasLrlc ulsLress and nausea
Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon) ConLrol of hyperglycemla ln paLlenLs wlLh Lype 1 or Lype 2 dlabeLes melllLus Why |s th|s person gett|ng th|s med|cat|on (lndlcaLlon)
nome Med|cat|on es ]No If yes dose change? (rev|ous dose t|me)
nome Med|cat|on es ]No If yes dose change? (rev|ous dose t|me)
harmacok|net|cs (onset peak durat|on metabo||sm) 1020 mln 13 hrs 33 hrs Llver spleen kldney and muscle harmacok|net|cs (onset peak durat|on metabo||sm) 1extbook Dose kange (for ordered route and |nd|cat|on) L Speclflc 1extbook Dose kange (for ordered route and |nd|cat|on)
Contra|nd|cat|ons]Caut|ous use Pypoglycemla allergy or hypersenslLlvlLy Lo a parLlcular Lype of lnsulln preservaLlves or oLher addlLlves/SLress and lnfecLlon 8enal/PepaLlc dysfuncLlon Contra|nd|cat|ons]Caut|ous use
Adverse keact|on Common
Severe Pypoglycemla and Anaphylaxls
1ox|c|ty s|gns]Cverdose Ant|dote? Pypoglycemla Mlld hypoglycemla may be LreaLed by lngesLlon of oral glucose Severe hypoglycemla ls a llfe LhreaLenlng emergency LreaLmenL conslsLs of lv glucose glucagon or eplnepherlne Larly slgns of hypoglycemla may be less pronounced by long duraLlon dlabeLes dlabeLlc nerve dlsease and use of beLa blockers may resulL ln loss of consclousness prlor Lo pL awareness of hypoglycemla Adverse keact|on Common
Severe
1ox|c|ty s|gns]Cverdose Ant|dote?
Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food) arentera| (compat|b|||ty d||ut|on requ|red and rate) lv or SubC May be mlxed wlLh nP lnsulln Mlxed lnsullns should never be used as lv or pump AdmlnlsLer 3 10 mln before a meal lv admlnlsLraLlo ulluLenL ulluLe wlLh 09 naCl or u3W ln lnfuslon sysLems uslng polypropylene lnfuslon bags ConcenLraLlon 0031 unlL/mL Adm|n|strat|on arameters ora|]entera| (empty stomach w|th food) arentera| (compat|b|||ty d||ut|on requ|red and rate)
Assessment needed (pre dur|ng and post) Assess sympLoms of hypglycemla (anxleLy resLlessness Llngllng ln hands feeL llps or Longue chllls cold sweaLs confuslon cool pale skln dlfflculLy ln concenLraLlon drowslness nlghLmares or Lrouble sleeplng excesslve hunger P/A lrrlLablllLy nausea nervousness Lachycardla Lremor weakness unsLeady galL) and Pyperglycemla (confuslon drowslness flushed dry skln frulLllke breaLh odor rapld deep breaLhlng polyurla loss of appreLlLe nausea vomlLlng unusual LhlrsL) MonlLor body welghL Asses for slgns of allerglc reacLlons MonlLor blood glucose q6h durlng Lherapy Assessment needed (pre dur|ng and post)