Ortho Oracle - orthopaedic operative atlas

Warfarin Interactions and Resistance

– Contraindications same as Heparin:  – ASA (Bleeding)  – w/ hemorrhagic tendencies  – pregnancy  – severe hepatic or renal disease  – severe hypertension  – blood dyscrasis  – Agents which Increase Prothrombin Time:  – Acetaminophren;  – Allopurinol  – ASA – Steroids  – Cimetidine – Indomethacin  – Flaggyl  – Hypoglycemics  – Phenothiazines – Phenylbutazone  – Propylthiouracil  – … Read more

Vitamin A

– Discussion:  – it is also required in appropriate amounts for membrane stability;  – excess or defeciency may lead to rupture of lysosomal membranes;  – Vit A participates in the biology of epithelium, and in excess it causes proliferation of basal cells and hyperkeratinization;  – Toxicity:  – causes increased intracranial pressure, vomiting, and lethargy Effect … Read more


– See:  – Class IV Agents  – Discussion:  – Ca channel blocker, prolongs AV conduction, slows sinus rate, & exerts Negative Inotropic effect;  – Useful for converting narrow complex SVT to sinus rhythm in stable patients if carotid sinus massage unsuccesful;  – Useful for Unstable Angina, HTN, A.fib & A. Flutter (except when A.fib/flutter is … Read more


– Discussion:      – for penicillin resistant to staph – MSSA / MRSA – and w/ enterococci endocarditis (in combination with aminoglycosides);     – it is ineffective against gm neg bacterial (its large molecular weight keeps it from penetrating the outer cell membrane of            gram-negative bacilli);     – basic science:            – blocks glycopeptide polymerization in … Read more

Vancomycin Properties in Cement

– Discussion: (see vancomycin and addition of antibiotics to cement,  vanc in ca sulfate and local delivery of antibiotics to infected joints): – dosing:              – as much as 4 gm of vancomycin (as well as 4.6 gm of tobramycin) can be used per batch of cement; – note that the cost for a 1 … Read more

Troglitazone / Rezulin

– Discussion:     – has been taken of of the maket due to liver toxicity;     – a type of PPAR gamma activator which blocks insulin resistance, and allows lower dosages of            insulin without loss of efficacy;            – may also be given with … Read more


– for pruritis associatted with allergic and nonallergic conditions;  – acts as antihistamine of phenothiazine type;  – Adult: 2.5mg PO qid PRN or 5mg PO q12hr sustained realease;  – Note that extrapyrimidal effects may occur in the elderly


– See: After-Loading Agents:  – Discussion:  – for production of controlled hypotension during surgery;  – treatment of HTN Crises, HTN, pulmonary hypertension;  – note additive effect w/ other Antihypertensive agents;  – Adults: 0.5-1mg/min IV infusion titrated to effect


– for control of NAUSEA and VOMITING; acts on trigger zone in medulla oblongata, determine etiology of vomiting before using Antiemetics; – Dosage: 250mg PO tid to qid; Injection:200mg IM tid/qid


– Discussion:     – for UTI, otitis media, acut exacerbation of chronic bronchitis, pneumocystis carini;     – has an excellent spectrum of activity against beta lactamase-producing staph, and can be effective as an antistaphylococcal agent;     – septra not effective vs. group A strep;     – adult dose:       … Read more