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mannitol - DEC ICP (INC ICP causes NV, HA, fixed dilated pupils, papilledema)MOA - osmotic diuretic - draws water into renal tubule by osmosis, outside kidney it draws water fr tissue into blood Severe INC ICP causes Cushing's triad (HTN, bradycardia, irreg breathing)**SE: hyponatremia, pulm edema MOA - inhib topoisomerase II (prevent DNA repair), ability to intercalate (insert itself) bet DNA base pairs (blocking DNA syn), & ability to generate free radicals (cause cellular damage)MOST IMP SE: CARDIOTOXICITY -- dilated cardiomyopathy, CHF (elev JVP, DEC ejection fraction, pulm edema), severe alopecia deposits as Ca oxalate in various tissues1-3 hrs - confusion, ataxia, hallucination, sllurred speech, coma Next - cardiopulm sx, met acidosis - NV, hyperventilation, HTN, tachycardia, pulm edema, resp distress24-72 h - urinary ca oxalate crystals w/ oliguric/anuric renal failure Tx - Na bicarb, ethanol, hemodialysis, fomepizole Note: anion gap = serum Na - (HCO3 Cl), if SABA, others - terbutaline, metaproterenol, pirbuterol, levalbuterol, fenoterol MOA - stim B-2 adrenoceptors in airway, DEC intracell Ca, hyperpol smooth mm d/t INC K influx (can lead to hypokalemia), DEC myosin activity ==inhib hepatic syn of vit K dep clotting factors (II, VII, IX, X) - block extrinsic pathway, also protein C, S, ZTx - prophylaxis/Tx of thrombosis & thromboembolism (esp afib, cardiac valve rep, DVT, PE, prev MI)Monitor PT and INR (2-3); high INR --MOA - inhib syn of thromboaxane A2; prevent platelet aggreg Use - primary prophylaxis for Acute MI; also analgesic, antipyretic, anti-inflamm SE: gastric ulcer, bleeding, anemia, Reye's syndrome (kids get acute encelphalopathy & fatty liver), tinnitis fever, hypo TN, inflamm, coag Alt C' pathway & coag pathway (DIC) activateedheat stable, rel IL-1, 6, 8 (fever), TNF-alpha (hemorrhagic tissue necrosis), nitrous oxide (hypo TN/shock), platelet activ factor (hypo TN)hyperviscosity, thrombocytosis HA, vertigo, pruritis after shower, thrombosis signs, splenomegaly, pleothora of face, INC RBC mass, INC EPO in response to INC RBC, INC H/H, WBC, platelets, leukocyte alkaline phosphatase, bilirubin, B12polycythemia vera - malig prolif of RBCs in bone marrow erythromelalgia - red, burning ext relieved by aspirin & cold temp; worse w/ warmth Complications - CVA, MI, DVT, PETx - hydroxyurea, chronic phlebotomy Primary/PV: low EPO, high RBC, normal Sa O2Hypoxia/Secondary: high EPO, HIGH RBC, low Sa O2 (or normal if d/t tumor)Relative: low plasma vol intoxicated pts "sat night palsy," using crutchesweakness of wrist/finger extensors, can't supinate forearm, loss of thumb abduction (abd pollicus longus), sensory dorsolat hand, dorsal 1st, 2nd, 3rd digitacute tubular necrosis - caused ischemia (hypo TN, shock), meds (NSAIDs antimicrobial), radiocontrast, rhabdomyolysis, transfusion rxnshard to disting fr prerenal dz (dehydration - normal microscopy, FENa erythroblastosis fetalis - hemolytic dz of newborn d/t Rh isoimmunization (Rh (-) mom exposed to fetal RBC that are Rh and dev Abs to fetal Rh ("D") Ag.…
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