Medical No Nos
Medical No Nos Medical No Nos
9/11/11Topical Steroids and Bacterial Keratitis DO NOT dose the steroid at a greater frequency thanthe topical antibiotic. DO NOT add the topical steroid until improvement isnoted in response to the antibiotic DO NOT add a topical steroid until topical antibioticshave been employed for a minimum of 48 – 72 hours.Topical Steroids and Corneal Thinning Topical steroids tend to further dehydrate the cornealstroma. Topical steroids can exacerbate stromal thinning. DO NOT use topical steroids without close monitoringif there is keratolysis (loss of stromal tissue) of greaterthan 75%.Sickle Cell Disease• Affects primarily people of African and Mediterraneandecent.• Results from mutations in the normal adulthemoglobin molecule (HgA), when valine issubstituted for glutamate at the 6 th position in thehemoglobin polypeptide chain.• Alters the dimensional structure of the molecule (HgS)and causes deformation of the RBC2
9/11/11Sickle Cell Disease Factors that affect sickling: Dehydration Vomiting Diarrhea Exercise without fluid replacement Decreased Oxygen tension Acidosis (Respiratory or metabolic)Sickle Cell Disease Lab Values: Hemoglobin and Hematocrit MCV: mean corpuscular volume MCHC: mean corpuscular hemoglobin concentration BUN: blood urea nitrogenSickle Cell Disease DO NOT administer diuretics (carbonic anhydraseinhibitors, (ie, Diamox)) to sickle cell patients(homozygous Hg SS). You can precipitate a sickle cellcrisis. DO NOT administer oral (ie, glycerin) or ivhyperosmotics (ie, mannitol) to sickle cell patients.You can precipitate a sickle cell crisis.3
9/11/11Sickle Cell Disease Factors that affect sickling: Dehydration Vomiting Diarrhea Exercise without fluid replacement Decreased Oxygen tension Acidosis (Respiratory or metabolic)Sickle Cell Disease Lab Values: Hemoglobin and Hematocrit MCV: mean corpuscular volume MCHC: mean corpuscular hemoglobin concentration BUN: blood urea nitrogenSickle Cell Disease DO NOT administer diuretics (carbonic anhydraseinhibitors, (ie, Diamox)) to sickle cell patients(homozygous Hg SS). You can precipitate a sickle cellcrisis. DO NOT administer oral (ie, glycerin) or ivhyperosmotics (ie, mannitol) to sickle cell patients.You can precipitate a sickle cell crisis.3
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