…to myocardial excitability. This is done by repeatedly stimulating with gradually decreasing amounts of energy until the stimulus no longer yields an activation. The pacemaker…

…morphine Morphine has an active renally excreted metabolite that causes late sedation and respiratory depression Marked liver failure A reduced dose of all of them…

…swelling. A vein suspected of thrombosis or previously thrombophlebitic. Intraosseous access (absolute, for the bone in question): A fracture of the bone to be punctured…

…major haemorrhage protocol early. Protocols improve above all the logistics, the communication and the simultaneous delivery of red cells, plasma and platelets. Observational data from…

…compression. The reason compression nevertheless so often fails is that it is done wrongly: the patient pinches the nasal bone instead of the soft part…

…measure and document the visual acuity before anything else is done. The second most important is to look for signs of perforation — Seidel's sign…

…through changes in DNA acetylation. Lipid lowering efficacy Bempedoic acid is available as a single daily dose of 180 mg. The LDL C response varies…

…A reduction of at least 50% from baseline . The treatment sequence is generally: High intensity statin therapy at the highest tolerated dose. Addition of ezetimibe…

…infection or gastroenteritis at home Double or triple the oral daily dose during the days of illness (the patient's sick day rules) Vomiting or…

…the initial dose should be reduced. Dosage and Dose Escalation To terminate tachycardia, adenosine is rapidly injected intravenously at initial doses of 6 to 12…

Cardiology Clinical medicine Definition and scope Alcohol has dose , pattern , duration , sex , and genetically influenced effects on the cardiovascular system. Acute exposure produces transient haemodynamic…

…edoxaban Prothrombin complex concentrate, consider within 15 hours of the last dose. Andexanet alfa where available Low molecular weight heparin Protamine has only a partial…

Procedurer Injection technique is treated as self evident and is therefore often done wrongly. The two commonest errors are that an intramuscular injection in fact…

Procedurer What determines the outcome of an emergency intubation is rarely the laryngoscopy itself but what was done before it: how well the patient was…

…longer interval for all opioids Obesity Dose according to effect, not according to total body weight Concomitant benzodiazepine A markedly increased risk of respiratory depression…

…repeated dose , titrated against clinical effect. 2. Parenteral thiamine early , preferably before or at the same time as carbohydrate administration. 3. Rapid identification of seizures…

…not in the choice of dose. Paediatric doses are calculated on actual body weight unless otherwise stated. When the weight of a child aged 1…

…Prescribe basal insulin, mealtime insulin and the correction dose as three separate entries on the drug chart. Glucose targets on the ward Situation Target plasma…

…or refrain. Bacteraemia without suspicion of joint infection (relative; aspiration can seed a sterile joint). Marked coagulopathy or an anticoagulant at a therapeutic dose (relative;…

…empirical antibiotics [1]. A practical target: give the first dose of broad spectrum antibiotics within 60 minutes of triage or arrival. This is supported by…

…life of several days and more than a hundred clinically relevant interactions. What determines whether the treatment is safe is not the starting dose but…

…Time to onset of action 50 to 10 minutes Duration of action 30 to 60 minutes Delivery IV Dose Initial infusion dose: 0.1 μ…

…Time to onset of action 20 minutes Duration of action 5 to 8 hours Delivery IV Dose 1.25 to 5 mg IV followed by…

…Time to onset of action 1 to 2 minutes Duration of action 10 to 30 minutes Delivery IV Dose Bolus injection : 5 to 15 mg…

…are rarely useful, as myocardial concentration—which correlates best with total cumulative dose—may be a better predictor of long term tolerability. Hemodynamic Effects Amiodarone…

…By inhibiting the intracellular portion of its transmembrane pore, ivabradine reduces the slope of diastolic depolarisation and produces a dose dependent reduction in sinus rate…

…vessels. The estimation of pressure gradients is done using the Bernoulli principle . The Bernoulli principle is based on the law of conservation of energy , which…

…simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase 3 trials, tenecteplase was…

…the correct dose is given intramuscularly [2,3]. When should anaphylaxis be suspected? Anaphylaxis is a clinical diagnosis. Treat as anaphylaxis in any of the…

…Standard dose in atrial fibrillation Criteria for dose reduction according to FASS : : : Apixaban 5 mg × 2 2.5 mg × 2 if at least two of…

…plus 1.5 g for the first dose, then 1 g × 1 IV Clostridioides difficile, primary infection, low risk of recurrence vancomycin 125 mg × 4…

…not afterwards. Indications Medicinal charcoal is given after the ingestion of a potentially toxic dose of a substance that binds to charcoal, when it can…

…in the presence of hyperkalaemic ECG changes or arrhythmia. 4. Shift potassium into the cells with insulin and glucose. Add high dose salbutamol in marked…

…Overview of vasopressors and inotropes Vasoconstriction Vasodilatation Positive inotropy Phenylephrine Vasopressin Midodrine Noradrenaline Adrenaline, high dose Dopamine, high dose Adrenaline, low dose Dopamine, intermediate dose…

…unless there is an absolute contraindication. The agent and dose are according to the local protocol. Alternatives when there is a contraindication: catheter directed treatment…

…overlap. Document the time of the suspicion of sepsis, the first dose of antibiotic, the cultures, the fluid bolus and the start of the vasopressor…

…At 5 minutes A full, adequate dose of a benzodiazepine About 10 minutes Repeat the benzodiazepine once if the seizure persists, and prepare step 2…

…to the drug, the last dose, the renal function and the severity of the bleeding 7 Manage antiplatelet drugs according to their indication. Do not…

…2.5 mg/mL Slow Long When prolonged analgesia is wanted The maximum dose of lidocaine is given in the Swedish medicines compendium (FASS) and…

…Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial loading dose: 300–500 mg as soon as possible after…

…Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg), of which the maximum dose per 24 hours is…

…transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of normal saline and give by slow injection over 5…

…to onset of action 15 to 30 minutes. Peak effect Within hours. Duration of effect 8 to 24 hours Delivery IV Dose Initial dose: 1…

…Infusion start dose: 25–50 μg/kg/min. Maximum infusion dose: 300 μg/kg/min. Bolus doses of 300 μg/kg can…

…Time to onset of action 10 30 minutes. Duration of action <4 hours. Delivery IV or IM. Dose Injections • IV: 10–40 mg every 4…

…Common therapeutic dose: 4 6 mg/h. Clevidipine is administered in lipid emulsion (containing soy, egg), of which the maximum dose per 24 hours is…

…Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications Dose α1 effect β1 effect β2 effect…

…dose infusion. Bolus regime : • 20 mg IV bolus over 2 minutes, followed by 20 to 80 mg every 10 minutes to a total dose of…

…hospitalization (Class IIb recommendation). • On highest tolerated dose statin: • If LDL C < 1.4 mmol/L (55 mg/dL): No change. • If LDL C…

…Time to onset of action 5 to 15 minutes Duration of action 1.5 to 5 hours Delivery IV Dose 5–15 mg/hour IV…

…blood pressure. Maximum dose: 100 μg/min. Time to onset of action: 2 to 5 minutes Duration of action: 5 to 10 minutes. Adverse…

…dose (10 μg/kg/minute) should never be used for mor than 10 minutes. Administer sodium thiosulfate (cyanide into thiocyanate) and terminate infusion of…

…or active peptic ulcer). Patients weighing < 60 kg (maintenance dose of 5 mg recommended instead of 10 mg). Patients receiving medications that increase bleeding…

…Dosage: Acute Coronary Syndromes Treatment with Ticagrelor should start with a loading dose of 180 mg (two 90 mg tablets) followed by 90 mg twice…

…regardless of whether conversion to sinus rhythm occurs) unless contraindications occur. If hemodynamically stable atrial flutter occurs after the first dose, the second dose can…

…accumulation of these peptides irritates afferent neural pathways in the respiratory tract. This process is not dose dependent. Similarly, angioedema occurring in the setting of…

…increasing to the maximum tolerated dose. A rise in the serum creatinine up to 30% is considered acceptable. In the setting of acute heart failure…

…prevention trials involving individuals with an estimated 10 year cardiovascular risk of 10%. Approximately 12% reduction in non fatal myocardial infarction with low dose aspirin…

…coronary disease, many of whom have a previous acute coronary syndrome. The available evidence supports consideration of low dose colchicine as an adjunct to, rather…

…The standard post ACS regimen is DAPT for 12 months, generally consisting of low dose aspirin and a potent P2Y12 inhibitor, preferentially prasugrel or ticagrelor…