ACUTE CORONARY SYNDROME BAIAE

Labs: ECG, CXR, CBC c PC, UA, BUN, Crea Labs: CXR (PA)
Rx: Aspirin 80 mg/tab #4 Rx: Hydrocortisone 200 mg/vial TIV heplock
Clopidogrel 75 mg/tab #1 Salbutamol + Ipatropium neb #3
Enoxaparin 0.5 cc #1 Budesonide 2 mL/neb #3
(or unfractionated heparin or fondparinaux) Neb kit #1
Carvedilol 6.25 or 25 mg/tab #1 Nasal cannula (adult) #1
ISDN 5 mg/tab #1 (NO LINE can cause congestion )
ISMN 30 mg/tab #1 HM: Salbutamol + ipratropium neb q6
Atorvastatin 40 or 80 mg/tab #1 Salmeterol + fluticasone inhaler 25/250mg 2puffs BID
Omeprazole 40 mg/tab ODHS Montelukast 10mg OD
HYPERTENSIVE URGENCY/EMERGENCY CAP-LR, COPD not in exacerbation
(Initial BP management) Labs: CXR, ECG, Sputum AFB
Labs (as OPD basis): CBC, UA, ECG, CXR, BUN, Crea, SGPT, Rx: Clarithromycin 500 mg/tab BID x 7 days
SGOT, FBS, Na, K, Lipid Profile Cefotaxime 500 mg/tab BID x 7 days
Rx: If BP < 180 Doxofylline 400 mg/tab
Amlodipine 5 mg/tab #1 Azithromycin 500mg tab OD 3-5day
Clonidine 75 mg/tab sublingual #3 Cefpodoxime 100/200mg cap BID 10 days
If BP > 180 Erdostine 300mg/cap TID 5 days
Nicardipine drip 2mg/2mL #1 CAP-HR
PNSS 1L #1 Labs: CXR, ECG, Sputum AFB, Sputum GS/CS
Soluset #1 Rx: Pip-Taz 4.5 g TIV initial, 2.25 g TIV q8 after
HM: Irbesartan 150mg OD Levofloxacin 300 mg TIV q24
Amlodipine 10mg ODHS N-acetylcysteine 600 mg tab in ½ glass H2O ODHS
Losartan 50/100mg ODAM Omeprazole 40 mg TIV
HASCVD, CVD bleed (CT confirmed) PTB
Labs: Plain cranial CT scan, ECG, CXR, CBC c PC, UA, BUN, Labs: CXR, ECG, Sputum AFB, Sputum GS/CS, Gene Xpert
Crea, Na, K, UA, SGPT, SGOT, Lipid profile, FBS Rx: Hook to O2
RX: If CBG <80, D50-50 1L Salbutamol + ipratropium TID
If CBG > 80, PNSS 1L Levopront 120ml 5ml TID 5 days
Mannitol 150 cc TIV q4 Omeprazole 40mg tab 30mins before
Atorvastatin 40 mg/tab OD Tranexamic acid 500mg cap TID for hematemesis
May give Furosemide 40 mg TIV q12 Metoclopromide 10mg tab TID for vomiting
Omeprazole Drip 50 mg + 100cc PNSS (soluset) For TB DOTS referral as OPD
DM – uncontrolled DYSPEPSIA (uninvestigated),
Labs: CBG CBC c PC, BUN, Crea, SGPT, SGOT, Na, K AGE, ABDOMINAL PAIN
Rx: Insulin Drip 6 u or 10 u Labs: CBC c PC, UA, FA, BUN, Crea, Na, K, CBG
Or Humulin R or Regular Insulin PT for women, ECG if >40 y/o
Metformin 500 mg/tab OD Rx: Omeprazole 40 mg/vial
Gliclazide 80 mg/tab HNBB 10 mg/mL amp
PULMONARY CONGESTION Metoclopramide 10mg/2 mL amp
(initial management, then labs) Ranitidine 2 mL/amp
Labs: CXR, ECG, CBC, UA, Na, K, BUN, Crea AGE: ORS or PNSS 1L
Rx: Furosemide 10 mg/mL/amp #8 HM: Omeprazole 40mg 30 ODAC x 14 days
OR 20mg/2mL/amp #4 HNBB 10mg tid x 3days
PNSS 1L #1 (add for AGE): Metronidazole 500mg BID x 7days
HYPERSENSITIVITY REACTION ORS
Labs: CBC c PC Racecadotril 100mg
Rx: Diphenhydramine 50 mg/amp #1 (add for APD): AlOH MgOH (Maalox) TID after meals x 5 days
Hydrocortisone 100 mg/vial #1 UTI/AUC
HM: Hydrocortisone 10 mg/tab ODHS x 7 days OR Labs: CBC c PC, UA, PT in women
Diphenhydramine 50 mg/tab ODHS x 7 days Rx: Ciprofloxacin 500 mg/tab BID x 7 days OR
BANIAE (DOB) Ofloxacin 200mg bid x 7 days
(initial management, then labs) Nitrofurantoin 100mg/tab tab q6 x 7 days
Labs: CXR (PA) Acute pyelonephritis: (+) RBC in urine
Rx: Salbutamol + Ipatropium neb #3 Prepare KUB UTZ request
Budesonide 2 mL/neb #3 Follow up in OPD once with result
 BPPV/vertigo IVF regulation (for 1000 mL)
Rx: Cinnarizine 25 mg/tab or 75 mg/tab # of Cc/hr Macroset Microset
Betahistine 8 mg/tab or 24 mg/tab hours (gtts/hr) (gtts/hr)
Metoclopramide 10 mg/tab 4 250 62 250
ANTI-TACHYCARDIC 6 160 40-41 160
Labs: Hypertensive workup + TSH, FT3, FT4 8 125 30-31 125
Rx: Metoprolol 100 mg/tab OD in AM OR 10 100 25 100
Propanolol 10 mg/tab OD
12 80 20 80
HYPOKALEMIC PERIODIC PARALYSIS
14 70 17-18 70
CC: Generalized body weakness, unable to move
16 60 15 60
Labs: CBC, UA, Na, K, KUB UTZ
20 50 12 50
Rx: (PO) Klyte 600 mg/tab, 1 tab TID x 2 days OR
Kalium durule, 750 mg/tab 2 tabs q1, max 8 tabs 24 40 10 40
(IV) KCl 40 meqs/amp in PNSS 1L via soluset 28 20 5 20
Potassium deficit = [(3.5* – actual K+)/0.27] ×100
*4.0 in cardiac patients GLASGOW COMA SCALE
DENGUE Eye Opening
Labs: CBC c PC, Dengue NS1/IgM/IgG, BUN, Crea, Na, K, 4 Spontaneous
PT, PTT 3 To speech
Rx: Hydrate (ORS or IVF) 2 To pain
Vitadex or alamin - TGP 1 None
Paracetamol 300/600 Verbal response
Tranexamic acid 100mg/3ml 3 amp Not intubated Intubated
LEPTOSPIROSIS 5 Oriented Seems able to talk
Sx: fever, wading in floodwaters, anuria, calf pain 4 Disoriented ---
Labs: Cbc pc, bun, crea, na, k, pt, ptt, ua 3 Inappropriate Questionable ability
Rx: Foley cath insertion! 2 Incomprehensible ---
PNSS, PLR, fast drip 1 None None
Leptomat (send out to PGH) Motor Activity
Ceftriaxone 1g vial 2 doses 6 Follows commands/spontaneous
For admission!!!!! 5 Localizes pain
PAIN RELIVER MEDICATIONS 4 Withdraws to pain
Celecoxib 100/200/400 mg cap 3 Decorticate (flexion)
Diclofenac 20mg/mL, 2 mg/tap, 20mg/tab 4 Decerebrate (extension)
Ketorolac 100 mg/amp 5 None
Tramadol + Paracetamol 500 mg/tab
OTHER MEDICATIONS Admission
Vitadex 1L Admit to (where) under the service of (physician)
Nutrilon 1 vial/PNSS 500 mL or 2 vials/PNSS 1000 mL Diet
Vitamin B complex, 1 tab OD x 30 days NPO, liquid/soft, or DAT. Indicate specific restrictions
Fluids
IV Meds: Main lines, side drips. Indicate preparations and rates.
Epinephrine Omeprazole Monitoring
Dobutamine HNBB
VS, neuro VS, intake and output; indicate frequency
Nicardipine Metoclopramide
Diagnostics
Furosemide Ketorolac
Blood tests, imaging, special procedures
Diphenhydramine Paracetamol
Hydrocortisone Tranexamic acid Therapeutics
Medications, dosage, frequency, duration, watch out for
Nebs: Transfusions
Salbutamol + Ipatropium Budosenide Type of product, # of units, rate, interval
Premeds, side effects, anticipatory measures if any
Oral meds: Oxygen support
Amlodipine Metformin Mask/cannula at (# of LPM), specify target SpO2
Clonidine Omeprazole If on mech vent, indicate settings
Losartan HNBB Others
Tramadol + Paracetamol Cinnarizine Referrals to other specialties (indicate reason)
Special nursing care instructions
BASIC DRIPS
*When in doubt with computations, consult IM Plat or
refer to your friendly and pretty IM RODs! <3
NICARDIPINE
Indication: first line in management of hypertensive
urgency/emergency (SBP >180)
Prep: 10 mg/10 mL ampule, 1 amp in 90 cc PNSS
(100 cc in soluset)
Rate: Initially at 5 mg/hr
Titrate every 15 mins until target BP reached
Maximum 15 mg/hr
DOPAMINE
Indication: increase BP/HR in cardiogenic shock, symptomatic
bradycardia (i.e. AV blocks)
Prep: 200 mg/ampule, 1 amp in 250 cc D5W
(2 amps in px with limited fluid intake)
Rate: Initially at 2-5 mcg/kg/min
Titrate upward every 2-5 mins
Maximum 20-50 mcg/kg/min
DOBUTAMINE
Indication: increase BP/HR in myocardial dysfunction, but add
vasopressor (i.e. NE) if SBP < 70 mmHg
Prep: 250 mg/ampule, 1 amp in 250 cc D5W
(2 amps in px with limited fluid intake)
Rate: Initially at 10 mcg/kg/min
Titrate upward every 2-5 mins
NOREPINEPHRINE
Indication: initial vasopressor therapy
Prep: 2 mg/ampule, 1 amp in 250 cc D5W
(2 amps in px with limited fluid intake)
Rate: Initially at 2-4 mcg/kg/min
Titrate upward every 2-5 mins
If BP cannot be maintained >90 at 15/mcg,
benefit not likely
NITROGLYCERIN
Indication: hypertensive control in pulmonary edema sec. to
LV dysfunction; acute MI
Prep: 10 mg/10 mL ampule, 1 amp in 90 cc D5W
(100 cc in soluset)
Rate: Initially at 5 mcg/min
Titrate upward by 5 mcg/min every 5 mins until
starget BP achieved or pain controlled
UNFRACTIONATED HEPARIN (UFH)
Indication: acute thrombosis (MI, DVT, PE)
Prep: 10,000 units UFH In 100 mL IVF (PNSS)
(100 units/cc in soluset or infusion pump)
Rate: Initial IV bolus loading dose (__ units/kg),
then IV drip after (___units/kg/hr)
MI: 60 loading, 12 initial drip
DVT/PE: 80 loading, 18 initial drip
PTT obtained after 6 hours, to adjust
Target PTT: 1.5-2.3x control value (or 46-70 s)
(may also use Raschke’s protocol)