BUMC Basics.pdf - Anesthesia Home

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11. Heart Burn: AOC. Maalox 320 mg PO Q6 hoursor TUMS
1000 mg PO Q6 hours and/or Pepcid 20 mg PO BID or
Protonix 40 mg PO Qday
12. Hyperkalemia: Check EKG; if peaked T waves or
prolonged QRS, give 1-2 amps Ca gluconate IV; then
consider one or more of the following: 10 Units IV insulin
with 1-2 amps D50, 1-2 amps HCO3; 10-20 mg inhaled
albuterol, 40 mg IV Lasix, or hemodialysis if decreased
GFR. If K is trending up and acute tx is not needed, give
kayexalate 30-90 g PO
13. Hypertension: Clonidine 0.1-0.2 mg PO or SL followed by
0.1 mg Q1hour up to a max dose of 0.6 mg; can also try
increasing the oral medication they are on or giving an
extra dose. If IV needed, try labetalol 5 mg IVP every 5
minutes if HR ok with max dose of 20 mg or Hydralazine 5
mg IVP every 15 minutes, max dose 20 mg
14. Insomnia: Ambien 5-10 mg PO Qhs
15. Nausea/Vomiting: Phenergan 12.5-25 mg IV Q4 hours or
Zofran 4-8 mg IV Q8 hours
16. Nasal congestion: Ocean spray nasal one spray in each
nostril Q8 hours, Oxymetazoline 0.05% 2 sprays in each
nostril Q12 hours
17. Pain: Norco 5/325 one to two tabs PO Q6 hours PRN pain
or Morphine 1-2 mg IV Q4 hours; Careful when Rx
Dilaudid. 1.5 mg Dilaudid is equal to 10 mg of IV
Morphine. We tend to under dose morphine and overdose
dilaudid. If adding narcotics, add a bowel regimen. If pain
persists, can also try 25-50 micrograms Fentanyl every 5-
10 minutes prn not to exceed 100 mcg.
18. Positive Blood Culture: If not on antibiotics, start the
following:
Gram positive: Vanc 1 gram IV, then Rx to dose
Gram negative: Zosyn or Merrem
19. Pruritis: Benadryl 25 mg PO Q4 hours
Drips that can be used on the floor
(telemetry) as of 4/2009:
• Diltiazem
• Amiodarone
• Dobutamine
• Dopamine
• Flolan (Epoprostenol)
• Aggrastat (Tirofiban)
• Integrillin (Eptifibatide)
• Reopro (Abciximab)