Managements

& PJS
⑰ ylactic sk:
Be
↓

Broncho constriction
- Bronchodilation
⑦Ba -

so we
give Adrenaline
wo m e n 19 ,
- BP
·
Route -> IM> Subcutaneous

Cnever given IV -
highly arrytamogenic)
· conc -> 0 5m1
.
of 1 : 1000 goen given IM

·
99 % patient improve in this Dose

if patient to not improve then Repeat the Dose within lomie

If still not
improve IV Adrenaline - 1 : 10000
we
give
·

⑬ Cardiac Awrest : -

CPR

if not worked
↓

Adrenaline
through IV 1 10000
=> :

if firt the veie

you can't
↓

Route is Intraossews ->

through special needle ⑰ inject in to tibia

if above can't happen

# ]
↓

endotracheal tube
we never use intracardial
Then we
give ⑰ by
⑥ Acute of Angina/MI
:

Attack -

① 3 Joses of OTN
m given 5mie apart , an opioit analgesic (morphines
me
given parenterally
② Low flow
O2therapy
③
e

saviefusion
of /
Dextrice : Maintainance of Blast vol

⑧ IV
NaHCOs infusion
:
Correction of Acitosis 6/t lactic acid
⑦ B-Blocker
m
should he use within 24hr if there is no contraindication

Arythmia , ④ mortality ⑰ Infract size ,

⑥ Furosemite

3
I NEV
mi
purp failure
↓ in case there is
L
⑪ cardiac preload venofialation
⑦ prevention of thrombus :

Aspirie given Antiplatlet

orally
:

weight hepasi I unfracted heparin

Low
min
molecular :
Anticoagulant -> Prevent Deep vein
thrombosis
⑧
Tharumbolysis & Reperfusion -

Fibrinolytic agent
e
plasminogen Activation - meeterecteplase
⑨ Prevention of MARBs
Remodeling & Subsequent CHE :
-

⑯
ension
* Normal
Age <55359
- >,
m Age 5555
non-Black Black of
any age
H ↓
Step 11 Cat channel Blocker Dicetic
ACE O /ARB
(CB)
I
step 2- ALEF/ARB + CCB & Dianetic

↓
Step 3 - ACEO/ ARB + (CB +
Diuretics
↓
step 4- ACEO/ ARB +

(CB + Diuretics

(Resistant HIN) I

Altosterone
Antagonist / higher Dose Thiazite

B Blocker/ :
Blocker

When # DBP> with evidence

emergency
: SBP3220 120mmig
* -

of Active
organ Damage
Target BP should not be morethan 25 % Over I for
Reduced period
:

tr
150
/mmonty over next 2-ohr
& to normal over next 98

Days
m
:
-

Nicadipine -> I . V infusion with Jig/her , 8 By 2 5 .

my/hr every smin

Latetalol
-> I .
v infusio to max
15cy/nw
Nat
> Iv infusion
Nitropressite
 He pregnancy
*
: -

uses
mAvritet Day
Labetull-C+B #,
ACE &
-> 4 Risk of Gretal Damage ·

orally
· Nife tipine -> 22B3 , stopped before
Diuretics-> ↓ Blad volm
labay
Selective Blocker-> placental size
Non B
Methyl Dopa
↓ ·

Neontal Beaty castin ·

Hysraluzine
Nat .
Nitroprussite ->C/I in
eclampsia

⑦ mefailure
Relief of low out put Symptom
Arrest/Reversal of Disease progress
Restoration of Cartial performance perlongation of Survival

O/ARBS
Day - Digoxin/Dobutamine/Dopamine
ACE
Fonotropic
· ·

Diureti -> Furosemite , thinzite

·

#
·
RAS F -> ACE O AARBS ·
Alfosterone
Antagonist
-

Spironolactone
·
vasutilations ->
Hydralazine ,
nitrates eplerenone
·
B# - Metoprolol , Bisoprolol casvetilol ,
,

nebivolol
⑰ enemie
If patient oral
is conscious
glucose frit juice
·

- is
given
unconscious (Lever) -> 50 me of 50 % glucose IV

⑳ Diabetes Refoacidosis : -

mir

Insulin Replacement Bolus

Regular insuline
in IV in fose
ving followed
·
: a o .
2-0 3
.

by 0 10/ry/hr.
IV

Monitoring of Blood
glucose level
patient insulin administeres
once in conscious
subcutaneously
·
Fluid Replacement :

Normal Saline Iv IL/hr , Rate

gradually decreases

kt -> us 10-20 MEg/ infused after shw of initiative of insulin the

rapy
·

S .

n+I ECI should be monitores

·
NaH183
·
phosphate
·

Antibiotics
⑰ Diabetes Mellitus
- mu

of Diabetes
New
patients
W
I
Type I
Type II
↓ ↓
Diet + Insulin Diet + Exercise +

Metformie
↓
controlled e

Controlled
-
uncontrolled

↓ -

uncomplicates , well nourishes/obese severe ,

unterweight ,

↓ complications present ,

infection
pregnancy >

truy [Sulfonylurea/Maglitinite/pioglitazone/
,

metformin +

One
Surgery
DPP-1 : /<-glucositale &] ↓
Insulin I Metformin
I -
controlled uncuntsollet
↓

(meetinel)
metformin
twosay
contrites
+

↑
t

(pioglitazone = < -glucosidase -)

-- insulin I metformis
uncontrolles -

Csult wasi
controlled =
⑦ easis
·
Inj Hydrocortisone 200rg Ev
·
Iv normal saline with 5 % glucose
· Correct fluit &
electrolyte imbalance
③
Thelasis [Thyarit star) : Beside usual feature there is

hypeopyrexia ,
cartial
arrythmia , nauser ,

H " vomitting ,
Diazurhen & mental confusion
m

Hospitalization
↓

hydration & infective

supportine Cooling Blanket Antibiotic to tit
:

case ,

↓
Propranolol IV us Oral propranolol (#it (II then Diltiazem]
I

propylthiouracil via
nasogastric tate
↓
sofium ; potate sally ,
it & Release & peripheral conversion

*
In
hyforcortisone
:

O peripheral conversive

⑫ Selepticus
[ I
: Recurrent attack of tonic-clonic secuse with out
of episote last
Recovery consciousness in between . E single
longer than 30 min

maintain patients airway

↓
20-50m1 of 50 % Dextrose injected IV to correct hypoglycemin if it is

p ↓ Responsible for Seizure

-

Lorazepam i v
. .

for
E in
was watch
hypotension & Respiratry Depression
Diazepam

Fosphenytoin in in normal saline glucos

us monitor cardiac
rhythm I BP
Ephenytoin in infusion in ornal saline
↓
 if seieuse continues
↓

it infusion watch for

* phanotassitie my Respirati Depression

if seizure continues
↓

demeval anasthesia with IV midazolam

Steps -> Maintain airway I BP
-
- propofol

0
L Nepoisoning :
*

Ethyl
m
Alcohol -
*
ty Alcohol
circulative keep patient in quite , Dask room :
airway Breathing
maintain the

E
, ,

Fluid & ebestrtte Balance postect the

eye form light
Gastric
lavage if Necessary ↓
dastric
↓ lavage with Naltl's if patient
IV alucose to connect
hypoglycemia Brought within Chr of ingestive of methanol
↓ ↓
thiamine administered infusion IV NaHWs for Avicosis
Connecting
:

is as in

soft
↓
in
glucose ↓
k2 If there
hypokalemia
:

is
Hemotyalisis help hasten the
recovery
in
↓
Ethanol : Diver intragastric ,
competatively
⑭ a. inhibit . But now a
lay not uses

↓
*
nations/ As there FOMEPIZOLE : IV infusion

↓
Hydrocortisone hemisuccinate Iv stat followed Folate Calcium leucovaria
therapy
:

by IV infusion
↓
·
Nebulizes Salbutamol Foratropium Burmite
·

high flow humitities of inhalative

↓
salbutamol/terbutalize Im/S2 : to reach smaller Bronchi
↓
Antibiotic for
correct
Dehydration I
Intulation & mechanical breathing -> ->

chest infection
Acidosis with saline I
if neefet
NaHCO3
Sthna
*

Regular high Dose Inhalation al Corticosteris ⑦ Inhales log acting Ba afonist

↓ (Salmterol)
Leukotrine antagrinst/sustaines release oral theophylline/sustaines Release

↓ oral B2 agonist
Rescue # short inhales B2 agonist
with
acting
↓
If not controlled Oral ⑦ toy acting ⑦ ICS
then Start
therapy B2

inhalation
* Seasonal Asthma
mi

·
Regular low Jose ICS 3-4 week before anticipated Seasonal attack
and continue fill 3-4 ween after season is over

· children -> oral Montelukast/Intrilukast

inhales short Be aforist
· It asthma episode with
acting
⑪ peptic uncert
mu

->limpeding RentinMutial
induct
H pylon
=>
-

get
Y

S
clanithcomycin
Amoxycillin
Metronitzale/tinitazole
retracycline
⑧
PPIG (must effectivel

Sounotafter the
·

·
I Receptor Blocker
·

Antrauts
·
Sofium
alginate
Metoclopramite
~
parhicetic -
3 LES towe
⑧ Eary 10-20m of calcium gluconate Slowly
:

I V
Inject 10 % . .

⑧ poisoning

* To prevent further absuption of icon from gut

-> Induce vomitting/perform fastric lavage with Naltls - Make Iron insoluble

egg yolk I milk orally

wine >
->
complex ine

To
* find & Remove in
already absorbet
:

DESFERRIOXAMINE Im
chelating agent E IV
:

-> Inn ,

ar
-calcium ed etate

Balance
electrolyte
3 By
* Fluit &
Ev infusion
correct Acidosis

*
Diazepam in uses to control convulsions

OR Deep
min
veie thrombosis

Perphylaxis #
LMW hepasin/fontaperinux/
Fontaprinox/(mw heparin
Unfractiones heparin
unfractioned hepasis [in
Kitney Disease)
followes by
Followed
by
wasfaris a Rivaroxaban
wastar's

⑤ Organ transplantation by immuno supressant Regimen

I
*

Regimen Diven in preoperative period : Just before transplant to

:

about 2-12 week after it

cyclosporine/tacrolimue/Sirlims prednisolone OMMF/ Azathioprine

*
Mee
Reginen : -

Paologet period ,
life long
Cyclosporie/tacrolimus/Sicolinug ⑦ Prednisolone ⑦ MMF/ Azathioprine
Anee
*
acute
Reginen : to
supress Rejective

starit pulle therapy -> methylprednisolone 0 .

5-18 is
faily fur 3-5
tays

⑦ e Malaria

*
Uncomplicates
-
[Chloroquine Resistant]
⑦
Duration ->
says-> Slowly eliminated antimalaria
·

Artemisirir Derivative

↓
in north east states Artemeether & mefloquine/lumefantrive
:

Artesunate ⑦ Sulphatoxine
All over India except :
-

pyrimethamine
north east state

*
/sever
Parenteral Artemisinis Derivative [for at healt 24hr]
EsArtesunate
in
IV

↓
once patient able to take
orally switch to full course of a ALT
u

for stay