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Posts Tagged ‘COPD’

ANALGESICS Short Acting Narcotics hydrocodone/APAP codeine/APAP oxycodone IR* morphine sulfate IR NSAIDS diclofenac ibuprofen meloxicam naproxen Other Analgesic tramadol ORAL ANTI-INFECTIVES Antifungals fluconazole nystatin terbinafine Cephalosporins and Related amoxicillin/clavulanate cephalexin cefdinir Macrolides Azithromycin Quinolones ciprofloxacin levofloxacin Tetracyclines doxycycline hyclate minocycline IR tetracycline Other clindamycin SMX/TMP metronidazole Antivirals acyclovir BEHAVIORAL HEALTH ADHD amphetamine salt combo dextroamphetamine […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 236 – PARENTERAL NUTRITION Alexander Wilmer   Greet Van den Berghe Malnutrition is a pathologic state resulting from unmet metabolic needs. It is associated with reduced body mass, reduced organ function, abnormalities in blood chemistries, and increased morbidity and mortality. Malnutrition is common in clinical practice, among […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SPECIFIC COMMON TREATMENT SCENARIOS Initiation of Mechanical Ventilation The initiation of mechanical ventilation involves several steps in clinical decision making ( Table 106-1 ). Despite the utility of such guidelines, each patient must be evaluated for specific factors that could modify the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier COMPLICATIONS Intubation Endotracheal intubation can be used to secure a patient’s airway, to act as a conduit to deliver gas from the ventilator to the patient, to prevent aspiration, and/or to help with pulmonary toilet when secretions are increased. However, intubation can […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Fan E, Needham DM, Stewart TE: Ventilatory management of acute lung injury and acute respiratory distress syndrome.  JAMA  2005; 294:2889-2896.Volume- and pressure-limited lung-protective ventilation is preferred for acute lung injury and acute respiratory distress syndrome Piantadosi CA, Schwartz DA: The acute respiratory distress syndrome.  Ann Intern Med  2004; 141:460-470.A […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier TYPES OF MECHANICAL VENTILATORS Negative Pressure Ventilators Delivery of gas to the lungs requires a pressure gradient across the airways and alveoli. During spontaneous breathing, this pressure gradient is generated by development of a negative pleural pressure as a result of contraction […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 105 – ACUTE RESPIRATORY FAILURE Leonard D. Hudson   Arthur S. Slutsky    ACUTE RESPIRATORY FAILURE Definition Acute respiratory failure occurs when dysfunction of the respira-tory system results in abnormal gas exchange that is potentially life-threatening. Each element of this definition is important to understand. The term […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier    REFERENCES 1. Dodek P, Keenan S, Cook DJ, et al: Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia.  Ann Intern Med  2004; 141:305-313. 2. Van den Berghe G, Wilmer A, Hermans G, et al: Intensive insulin therapy in the medical ICU.  N Engl J Med  2006; 354:449-461. 3. The SAFE Study […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier THORACOSCOPY AND VIDEO-ASSISTED THORACIC SURGERY Thoracoscopy was originally limited to pleural biopsies and the drainage of empyemas or pleural effusions ( Chapter 100 ). The recent improvement in light sources and video-optic instrumentation has led to integration of the thoracoscope into most […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 102 – SURGICAL APPROACH TO LUNG DISEASE John J. Reilly Jr.   Steven J. Mentzer The role of surgery in the diagnosis and treatment of lung disease has expanded greatly as lung transplantation has gained acceptance as a therapeutic option for selected patients with advanced lung disease. In […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 97 – OVERVIEW OF PNEUMONIA Andrew H. Limper It is a useful distinction to separate pneumonias, which are infections of the lung parenchyma and thus distinct from infections limited to the trachea or large bronchi ( Chapter 96 ), into those acquired in the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Bradley JM, Laserson T, Elborn S, et al: A systematic review of randomized controlled trials examining the short-term benefit of ambulatory oxygen in COPD.  Chest  2007; 131:278-295.A modest benefit is seen, but long-term benefits are less clear Calverley P, Anderson J, Cell B, et al: Salmeterol and fluticasone propionate and […]

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