Le métronidazole (Flagyl) reste la référence dans le traitement des infections anaérobies et des parasitoses comme la giardiase ou l’amibiase. Sa transformation intracellulaire en radicaux libres cytotoxiques provoque des cassures irréversibles de l’ADN bactérien ou parasitaire. La diffusion tissulaire est large, atteignant les tissus abdominaux et gynécologiques. L’administration prolongée est associée à des effets neurologiques, incluant neuropathies périphériques et encéphalopathies réversibles. L’association avec l’alcool déclenche une réaction de type antabuse. Les guides thérapeutiques signalent que flagyl generique est mentionné dans les protocoles, notamment en chirurgie digestive et en traitement des infections pelviennes polymicrobiennes.
Heart failure - diastolic
Physician Orders Adult Pneumonia, Community Acquired Admission Height:_________ Admission Weight:_________
Amission Status
Admit to inpatient to Dr. _______________________service.
IV Fluids
Assign to observation status to Dr. ________________ service
Dextrose 5% with 0.9% NaCl @ __________mL/hr
Admit Location
Dextrose 5% with 0.45% NaCl @ _________mL/hr
□ Medical floor □ Telemetry monitor □ ICU
Sodium Chloride 0.9% @ ____________mL/hr
Allergies
Additives _________________________________ Saline lock flush per protocol
______________________________________________
Medications Code Status Antibiotics Beta-Lactam (3rd-Generation Cephalosporin,
Partial Code (□ Intubation □ Defibril ation □ ACLS Meds
Penicillin) + Macrolide Cephalosporins, 3rd-Generation
Do Not Resuscitate (allow natural death)
cefTRIAXone / ROCEPHIN 1 gram intravenously every
Nursing Orders Vital Signs Macrolides
azithromycin / ZITHROMAX 500 milligrams intravenously
every 24 hours times 2 days, then 500 milligrams orally
Activity/Positioning
azithromycin / ZITHROMAX 500 milligrams intravenously
Ambulate with Assistance TID with O2 walker Bed rest □ BRP □ BSC
azithromycin / ZITHROMAX 500 milligrams orally daily
clarithromycin / BIAXIN 500 milligrams orally two times daily
Assessments Quinolones
levofloxacin / LEVAQUIN 750 milligrams orally every 24 hours
Glucose: finger stick q___________________________
levofloxacin / LEVAQUIN 750 milligrams intravenously
Assess smoking status & provide smoking education
Contingency
Notify physician for Temp >101 F, HR < 60 or > 120,
Antipyretics
RR < 8 or >30, SBP < 90 or >180,
acetaminophen / TYLENOL 650 milligrams orally
Urine Output < 120 ml for 4 hrs, Pulse Ox <90%
□ every 4 hours □ every 6 hours as needed for fever >100.4
Interventions: GI/ GU
acetaminophen / TYLENOL 650 milligrams rectally
□ every 4 hours □ every 6 hours as needed for fever >100.4
Analgesics Respiratory Mild Pain (1- 3) Oxygen and Oximetry
ace minophen / TYLENOL 650 milligrams orally
Oxygen via _______________________ at _____________
□ every 4 hours □ every 6 hours as needed for pain
maintain O2 sat at______% via pulse Oximetry or per O2 protocol
ace minophen / TYLENOL 650 milligrams rectally
□ every 4 hours □ every 6 hours as needed for pain
ibuprofen / MOTRIN 400 milligrams orally
Blood Gases
Arterial Blood Gas _______________________
Moderate Pain (4- 6)
□ 5/500 □ 7.5/500 □ 10/500 tablet orally
□ every 4 hours □ every 6 hours as needed for pain
Cardiac _____________________________
□ 5/325 □ 7.5/325 □ 10/325 tablet orally
Diabetic__________________________________
□ every 4 hours □ every 6 hours as needed for pain
Regular _________________________________
Other __________________________________
□ every 4 hours □ every 6 hours as needed for pain
Physician Orders Adult Pneumonia, Community Acquired Admission Height:_________ Admission Weight:_________ VTE: Prophylaxis– General Measures Severe Pain (7 - 10)
Ambulate – TID with assistance with O2 walker start today
Graded compression stockings -TED Hose
□ every 4 hours □ every 6 hours as needed for pain
□ knee high □ thigh high (call measurements to pharmacy)
HYDROmorphone / DILAUDID 1 milligram subcutaneously
□ every 4 hours □ every 6 hours as needed for pain
morphine _____ milligram intravenously
VTE: Unfractionated Heparin
heparin 5,000 units subcutaneously every 8 hours
Antidotes and Rescue Agents
heparin 5,000 units subcutaneously every 12 hours
naloxone / NARCAN _____ (0.2-2) mil igram
VTE: Low -Molecular-Weight Heparin
intravenously every ______min. (2-3) as needed for
for opiate reversal. May repeat times one. Give if decreased
enoxaparin / LOVENOX 40 milligrams subcutaneously daily
mentation and/or RR < 10 and notify physician STAT
enoxaparin / LOVENOX 30 milligrams subcutaneously daily
Sedatives
(dose for patients with CrCl < 30 mL/min)
LORazepam / ATIVAN 1 milligram intravenously
Laboratory
CBC now and every other day while on Heparin or Lovenox
LORazepam / ATIVAN 1 milligram orally 2 times a day
CBC with auto diff Now and _________________
zolpidem / AMBIEN 5 milligrams orally daily, at bedtime
Culture, blood now two separate sites
zolpidem /AMBIEN 10 milligrams orally daily, at bedtime
Bronchodilators
albuterol / PROVENTIL MDI ______puffs (use spacer)
every ______hours as needed for wheezing
Cardiology
albuterol 2.5 mg/0.5 mL neb solution /PROVENTIL via
Radiology/Imaging
nebulizer every _______hours as needed for wheezing
Levalbuterol / XOPENEX 0.63 mg neb solution via
Physician Consults
nebulizer every _____ hours as needed for wheezing
Reason _________________________________
Smoking Cessation Medications
nicotine 7 mg/24 hr transdermal film, extended
Reason__________ ____________________________
Other Consults
nicotine 14 mg/24 hr transdermal film, extended
nicotine 21 mg/24 hr transdermal film, extended
Laxatives
magnesium hydroxide / MILK OF MAGNESIA
30 milliliters orally daily as needed for constipation
Other Orders:
docusate sodium / COLACE 100 milligrams orally 2 times daily
bisacodyl / DULCOLAX 5 milligrams orally daily
bisacodyl / DULCOLAX 10 milligrams suppository
rectally daily as needed for constipation
□TO/VO Read Back & Verified________________________________________ Date/Time: _________________________
Physician _____________________________________________ Date/Time: _____________________ Version 11/11/2010
SECONDARY STROKE PREVENTION AND SMOKING Information for Patients and Families Authors: Sabrina Godbout; Jessica Goldberger; Genevieve Dupont; Sabrina Mansour; What is secondary stroke prevention? After a first stroke, the likelihood of experiencing a second stroke increases. There are certain changes an individual can make to his/her lifestyle, to reduce the possibility of
Physician Orders 
Physician Orders