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Effects on gram-positive microorganisms are usually provided by cephalosporins or vancomycin, and on gram-negative ones by aminoglycosides.
Initially, loading doses are administered intravenously, and a constant plasma concentration is maintained by the administration of an antibiotic intraperitoneally.
Since the intraperitoneal concentration of the drug is equalized with its plasma level, the concentration of the drug in the dialysate should be the same as that required in the plasma.
For example, if a concentration of 7 mg / dl is desired, a concentration of 7 mg / dl should also be maintained in the dialysate.
The penetration of a drug substance through the skin depends on its permeability, blood flow, moisture and the presence of damage.
The highest permeability during transdermal administration is possessed by fat-soluble preparations applied to wet skin.
Currently, the only systemic drugs commonly used percutaneously are nitroglycerin, clonidine, fentanyl, and scopolamine.
Since the distribution of the drug through the skin often requires a significant period, the onset of exposure is usually delayed.
The skin acts as a reservoir, so the removal of medicines (for example, fentanyl stickers, nitroglycerin paste) does not immediately stop the action of the drug.
Resorption (systemic absorption of dermatological preparations
High concentration local corticosteroids, applied to large areas, sometimes provide significant systemic absorption.
Long-term use of long-acting fluorinated local corticosteroids inhibits the function of the pituitary-adrenal system, especially if they are applied to inflamed skin under dressings.
Some topical antibiotics used to treat burns can also cause metabolic acidosis (mafenide) or salt loss (sodium nitrate) (see chapter 41).
Even eye drops can be absorbed in significant concentration if they are used frequently or in high doses or if there is significant inflammation or trauma to the cornea.
Corticosteroids and P-blockers (e.g. timolol) have a systemic effect if they are injected into the eyes. (Intraocular P-blockers are contraindicated in asthma or congestive heart failure.)
Oral administration of drugs
The bioavailability of orally administered drugs is limited by exposure to an acidic environment, poor penetration through the intestinal wall and metabolism during the first passage through the liver.
Effective oral therapy requires good intestinal motility, adequate blood supply to the mucous membrane, and epithelial integrity.
Patients with intestinal obstruction, insufficient intestinal perfusion, atrophic or damaged epithelium are unsuitable objects for oral therapy.
Medicines in the form of aqueous solutions are absorbed faster than those administered in oil solutions.
Non-ionized drugs are absorbed more intensely than ionized ones.
Some poorly absorbed medicines (for example, vancomycin, polymyxin) are specially administered orally to locally affect the gastrointestinal tract.
Means that are destroyed by acidic pH can be partially protected by a special coating, others, on the contrary, require an acidic medium for activation or absorption, for example, sucralfate, ketoconazole and iron.
This circumstance deserves special attention if the patient receives antacids.
Liquid oral preparations such as sodium potassium ion exchange resin (Kayexalate) or intestinal preparations, such as saline or polyethylene glycol, may result in fluid overload, although this is not often taken into account.
Since only minimal amounts of drugs are absorbed through the intact oral epithelium, powerful and fat-soluble preparations are suitable for effective sublingual (sublingual) administration.
Nitroglycerin is one of the few drugs that satisfy these requirements.
In case of ingestion and absorption through the intestine, nitroglycerin is rapidly destroyed by the metabolism of the first passage through the liver.
However, since the drug absorbed from the hyoid plexus penetrates directly into the superior vena cava, its bioavailability increases.
Rectal administration of certain drugs is sometimes convenient to use in children who resist patients, in patients with unsecured venous access, persistent vomiting and / or bowel obstruction.
The hepatic metabolism of the first passage, although less active with rectally applied drugs than with oral administration, is quite significant.
Unfortunately, rectal administration often leads to incorrect and incomplete absorption, and therefore it is less desirable than oral or parenteral administration.
Rectal administration is best limited to sedatives, antiemetics, antipyretic and mild laxatives, as well as theophylline preparations.
Amphotericin bladder lavage is commonly used when yeast is found in the urine, although this procedure is of limited value.
If the microflora of Candida or Aspergillus is detected in the bladder, as evidenced by fungal forms, or accumulations of fungi in the urine, or histological confirmation of their introduction into the walls of the bladder, you should turn to the intravenous administration of amphotericin.
Yeast in the patient's urine in the absence of clinical symptoms rarely requires treatment, especially in patients with prolonged standing of urinary catheters.
If treatment is necessary, oral administration of imidazole is effective.
Intravesical administration can lead to hyponatremia if aqueous solutions are used, and the use of isotonic saline can cause fluid overload.
To eliminate bleeding after surgery on the urinary tract, bladder lavage is often used with solutions containing glycine.
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- Methods of drug administration
All methods of administering drugs are divided into two types: • without violating the integrity of the skin: orally (inside), rectally, inhalation, intranasally, sublingually, transdermally; • with violation of the integrity of the skin: subcutaneously, intramuscularly, intravenously, in the pleural cavity, peritoneum, joints, intralumbal, in the ventricles of the brain. In the early stages of life, there are features of both recycling and
- Ways of additional nutrition: introduction to the small intestine
The many benefits of nutrition through the small intestine almost always make it more preferable than parenteral nutrition (Table 16.2). Small intestinal nutrition is cheaper, it prevents the formation of ulcers of the gastrointestinal tract and maintains the integrity of the mucous membrane and the function of the small intestine better than intravenous nutrition. This way of introducing nutrition stimulates the secretion of insulin,
- Vaccination tactics. Vaccine Administration Methods
The selection of adults and children for vaccination is carried out by a medical assistant on the FAP. Vaccinations are provided by trained medical personnel. Before vaccinations, it is necessary to carefully check the quality of the drug, its labeling, the integrity of the ampoule (vial). The following vaccines are not subject to use: 1) with inappropriate physical properties; 2) with violation of the integrity of the ampoules; 3) with unclear or absent
- Abstract. Methods of contraception How to avoid pregnancy, 2006
Introduction Methods of contraception. Mechanical methods. Chemical methods. Biological methods. Emergency contraception. Intrauterine devices. Physiological methods. Sterilization. Use of contraception by adolescents. Conclusion: List of used
- Mode of application
Before the introduction of the IUD, it is necessary to conduct an appropriate medical examination, which includes: 1) a thorough medical history to exclude possible contraindications to the introduction of the IUD; 2) bacteriological examination of smears from the vagina and cervix; 3) clinical blood and urine tests; 4) a detailed examination for sexually transmitted infections (STIs) from cervical
- FEEDING METHODS
There are several ways to feed cats. 1) Feeding with free access to feed. 2) Time-limited feeding. 3) Feeding limited in amount of feed. With free feeding, feed is available to animals at any time. With time-limited feeding, animals are given for a certain period of time (usually 5-30 minutes) an amount of feed exceeding them
- Five ways to read
In our last conversation, completing the first tasks, you identified your reading shortcomings and its initial speed. We are often asked: is a person who has mastered fast reading now so fast and reads everything in a row? Of course not. Fast reading has physical application limits. We suggest splitting all reading methods into five groups. Each time, before you start reading, you must select a specific
- ANIMAL FIXING METHODS
Methods of fixation of animals, the main methods of which are depicted in Fig. 4 to 10 are needed to perform the healing
- Lesson 9. Support Methods
Purpose: training in different ways of support. The facilitator introduces the group members to different types of support, writing down the appropriate wording on the board:? try to understand how the other person feels; ? talk about your feelings about the situation; ? indicate the complexity of the situation; ? pay attention to the capabilities of the interlocutor; ? offer assistance; ? tell you
- Methods of inhibition of the sexual function of fattening pigs
With the onset of puberty, pigs come and hunt. During this period, they are very worried, injure each other, injuries are complicated by a purulent infection. Animals eat food poorly, and some refuse at all. During this period, there is no increase in live weight, and individual pigs even give plumb. In veterinary practice, the following methods of inhibition of the sexual function of pigs are used: chemical,
- Methods for disinfecting manure
Depending on the technology of keeping animals, litter (humidity 68-85%), semi-liquid (humidity 86-92%), liquid (humidity up to 97%) and manure runoff (humidity more than 97%) are obtained. Manure removal, processing, storage, transportation and use of manure is carried out taking into account environmental protection requirements, ensuring maximum cleanliness of premises and recommended
- Ways to wean a baby
A sharp excommunication If a woman first of all focuses on her condition, fatigue from feeding, external factors, she can simply leave the child for 3–7 days. In this case, the baby is confronted with the fact: there is no mother, and he will have to do without a chest. If the child was already ready for excommunication, the method is quite effective. However, large babies already have a good memory and can
- Chemical methods
Chemical contraceptives include creams, tampons, gels, balls, aerosol foams, candles, sponges containing spermicides. Spermicides are substances (usually nonoxynol-9 and octoxynol-9) that destroy the outer shell of sperm, reduce their motility, and therefore their ability to fertilize1. In addition, spermicides prevent a number of sexually transmitted diseases, since
- Biological methods
Biological agents include hormonal drugs, namely injectable and oral contraceptives (OK). The most popular in the world are OK - birth control pills. • Oral contraceptives It is difficult to overestimate the role of a small pill, which allows millions of people to enjoy the joys of sex without the risk of conception. Operating principle
- Ways to improve water quality
The main ways to improve water quality are clarification, discoloration, deodorization and disinfection. By clarification of water is understood the removal of suspended particles from it. Discoloration - removal of stained colloids or solutes. The purpose of disinfecting (or disinfecting) water is to neutralize the pathogenic bacteria and viruses contained in the water. Sometimes have
- New ways to improve ventilation
The main goals of mechanical ventilation are to provide adequate alveolar ventilation and improve oxygen metabolism. Until recently, volume-oriented ventilation, used alone (controlled and assisted ventilation) or in combination with spontaneous breathing (CPAP), was the only form of hardware support for adult patients. Similar
- The production of metal coatings by galvanic method
Calculation of the maximum (g / s) and gross (t / g) emissions of harmful (polluting) substances (pollutants) from organized sources of galvanic sections (workshops) according to the values of specific indicators should be carried out according to the “Methodology for calculating the emissions (emissions) of pollutants in atmosphere during the production of metal coatings by the galvanic method (according to the values of specific indicators) .
- Delivery methods, management of labor
Indications for caesarean section are severe forms of gestosis, including preeclampsia in the absence of the effect of therapy, eclampsia and its complications. Caesarean section should also be taken in the presence of CDW, chronic fetal hypoxia, and during delivery of patients if the gestational age does not exceed 34-35 weeks. In conditions of endotracheal anesthesia, providing reliable neurovegetative
- Emergency conditions and methods for their relief
Paroxysmal tachyarrhythmias. In a matter of minutes before providing emergency care, it is necessary to establish, at least tentatively, the cause of arrhythmia. It is especially important to do this with paroxysm that occurs in a patient for the first time in his life. According to the anamnesis, objective status, ECG method, a judgment is made about myocardial infarction, angina pectoris, hypertensive crisis, psychoemotional stress. In the process