Respiratory failure medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 4: Line 4:


==Overview==
==Overview==
There is no treatment for [disease name]; the mainstay of therapy is supportive care.
There is no treatment for respiratory failure; however, medication may be used to allow for easier intubation and to ease anxiety in the patient. Recently, studies have demonstrated a strong recommendation against the use of sedatives or analgesics. The use of these agents has been implicated in decreasing the success rates of ventilation mechanisms.
 
OR
 
Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
 
OR
 
The majority of cases of [disease name] are self-limited and require only supportive care.
 
OR
 
[Disease name] is a medical emergency and requires prompt treatment.
 
OR
 
The mainstay of treatment for [disease name] is [therapy].
 
OR
 
The optimal therapy for [malignancy name] depends on the stage at diagnosis.
 
OR
 
[Therapy] is recommended among all patients who develop [disease name].
 
OR
 
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
 
OR
 
Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
 
OR
 
Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
 
OR
 
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].


==Medical Therapy==
==Medical Therapy==
*Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
*Naloxone:
*Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
**Naloxone is used as an antidote to opioid overdose - induced respiratory depression.
*Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
*Flumazenil:
*Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
**Flumazenil is used as an antidote in benzodiazepine overdose - induced respiratory depression.
===Disease Name===
*Sedatives, activated charcoal and gastric emptying are all not recommended except in the rare case of hypercapnic respiratory failure with progressive respiratory acidosis with:
**Anxiety
**Rapid shallow breathing
**Respiratory arrest 
**Moderate to severe expiratory airway resistance
**Dynamic hyperinflation


* '''1 Stage 1 - Name of stage'''
===Respiratory failure===
** 1.1 '''Specific Organ system involved 1'''
* '''1 Opiate overdose'''
** 1.1 '''Naloxone'''
*** 1.1.1 '''Adult'''
*** 1.1.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 100 mg PO q12h for 10-21 days '''(Contraindications/specific instructions)'''  
**** Preferred regimen (1): Naloxone  0.05 mg IV initially, then titrated in increasing amounts every 5 minutes with a respriatory rate of 12 or greater
**** Preferred regimen (2): [[drug name]] 500 mg PO q8h for 14-21 days
**: '''Note (1):''' Apneic patients with suspected opiate overdose should receive higher first doses of naloxone between 0.2 - 1 mg
**** Preferred regimen (3): [[drug name]] 500 mg q12h for 14-21 days
**: '''Note (2)''': Cardiorespiratory with suspected opiate overdose should receive a minimum of 2 mg of naloxone
**** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days  
* 2 '''Benzodiazepine overdose'''
**** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
** 2.1 '''Flumazenil'''
**** Alternative regimen (3): [[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.1 '''Adult'''
*** 1.1.2 '''Pediatric'''
***** Preferred regimen (1):Flumazenil 0.2 mg IV over 30 seconds
**** 1.1.2.1 (Specific population e.g. '''children < 8 years of age''')
**: '''Note (1):''' Repeated doses of 0.2 mg up to 1 mg if desired effect not achieved
***** Preferred regimen (1): [[drug name]] 50 mg/kg PO per day q8h (maximum, 500 mg per dose) 
**: '''Note (2)''': Maximum dose of 3mg is given within any hour
***** Preferred regimen (2): [[drug name]] 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
***** Alternative regimen (1): [[drug name]]10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
****1.1.2.2 (Specific population e.g. ''''''children < 8 years of age'''''')
***** Preferred regimen (1): [[drug name]] 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
***** Alternative regimen (1): [[drug name]] 10 mg/kg PO q6h (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h (maximum, 500 mg per dose) 
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
** 1.2 '''Specific Organ system involved 2'''
*** 1.2.1 '''Adult'''
**** Preferred regimen (1): [[drug name]] 500 mg PO q8h
*** 1.2.2  '''Pediatric'''
**** Preferred regimen (1): [[drug name]] 50 mg/kg/day PO q8h (maximum, 500 mg per dose)


* 2 '''Stage 2 - Name of stage'''
** 2.1 '''Specific Organ system involved 1 '''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.1.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.1.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) ''''''(Contraindications/specific instructions)''''''
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] '''(for children aged ≥ 8 years)''' 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)
** 2.2  '<nowiki/>'''''Other Organ system involved 2''''''
**: '''Note (1):'''
**: '''Note (2)''':
**: '''Note (3):'''
*** 2.2.1 '''Adult'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 2 g IV q24h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 2 g IV q8h for 14 (14–21) days
***** Alternative regimen (2): [[drug name]] 18–24 MU/day IV q4h for 14 (14–21) days
**** Oral regimen
***** Preferred regimen (1): [[drug name]] 500 mg PO q8h for 14 (14–21) days
***** Preferred regimen (2): [[drug name]] 100 mg PO q12h for 14 (14–21) days
***** Preferred regimen (3): [[drug name]] 500 mg PO q12h for 14 (14–21) days
***** Alternative regimen (1): [[drug name]] 500 mg PO q6h for 7–10 days 
***** Alternative regimen (2): [[drug name]] 500 mg PO q12h for 14–21 days
***** Alternative regimen (3):[[drug name]] 500 mg PO q6h for 14–21 days
*** 2.2.2 '''Pediatric'''
**** Parenteral regimen
***** Preferred regimen (1): [[drug name]] 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
***** Alternative regimen (1): [[drug name]] 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
***** Alternative regimen (2):  [[drug name]] 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
**** Oral regimen
***** Preferred regimen (1):  [[drug name]] 50 mg/kg/day PO q8h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Preferred regimen (2): [[drug name]] 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
***** Preferred regimen (3): [[drug name]] 30 mg/kg/day PO q12h for 14 (14–21) days  (maximum, 500 mg per dose)
***** Alternative regimen (1):  [[drug name]] 10 mg/kg PO q6h 7–10 days  (maximum, 500 mg per day)
***** Alternative regimen (2): [[drug name]] 7.5 mg/kg PO q12h for 14–21 days  (maximum, 500 mg per dose)
***** Alternative regimen (3): [[drug name]] 12.5 mg/kg PO q6h for 14–21 days  (maximum,500 mg per dose)


==References==
==References==
Line 143: Line 38:
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category: (name of the system)]]
[[Category:Surgery]]
[[Category:Up-To-Date]]
[[Category:Primary care]]
[[Category:Medicine]]
[[Category:Emergency medicine]]

Revision as of 21:19, 9 March 2018

Respiratory failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Respiratory Failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Electrocardiogram

CT

MRI

Echocardiography and ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical therapy

Oxygen therapy

Mechanical ventilation

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Respiratory failure medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Respiratory failure medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Respiratory failure medical therapy

CDC on Respiratory failure medical therapy

Respiratory failure medical therapy in the news

Blogs on Respiratory failure medical therapy

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Respiratory failure medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There is no treatment for respiratory failure; however, medication may be used to allow for easier intubation and to ease anxiety in the patient. Recently, studies have demonstrated a strong recommendation against the use of sedatives or analgesics. The use of these agents has been implicated in decreasing the success rates of ventilation mechanisms.

Medical Therapy

  • Naloxone:
    • Naloxone is used as an antidote to opioid overdose - induced respiratory depression.
  • Flumazenil:
    • Flumazenil is used as an antidote in benzodiazepine overdose - induced respiratory depression.
  • Sedatives, activated charcoal and gastric emptying are all not recommended except in the rare case of hypercapnic respiratory failure with progressive respiratory acidosis with:
    • Anxiety
    • Rapid shallow breathing
    • Respiratory arrest
    • Moderate to severe expiratory airway resistance
    • Dynamic hyperinflation

Respiratory failure

  • 1 Opiate overdose
    • 1.1 Naloxone
      • 1.1.1 Adult
        • Preferred regimen (1): Naloxone 0.05 mg IV initially, then titrated in increasing amounts every 5 minutes with a respriatory rate of 12 or greater
      Note (1): Apneic patients with suspected opiate overdose should receive higher first doses of naloxone between 0.2 - 1 mg
      Note (2): Cardiorespiratory with suspected opiate overdose should receive a minimum of 2 mg of naloxone
  • 2 Benzodiazepine overdose
    • 2.1 Flumazenil
      • 2.1.1 Adult
          • Preferred regimen (1):Flumazenil 0.2 mg IV over 30 seconds
      Note (1): Repeated doses of 0.2 mg up to 1 mg if desired effect not achieved
      Note (2): Maximum dose of 3mg is given within any hour


References

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Respiratory_failure_medical_therapy&oldid=1453778"