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Question: Explain your role in responding to a Malignant Hypertherma crisis.

Answer: Multiple tasks should take place when the anouncement of MH is heard. It is important for everyone to know who is to respond and how to respond. JDJ Consulting performs MH drills annually to all clients. If you have questions or need additional assistance please contact us at: john@jdjconsulting.net.

Happy New Year!

(hint: there are 5 items)

Answer: 1. U for unit

2. IU for international unit

3. QD, QOD for daily, every other day 

4. trailing zero and lack of leading zero

5. MS, MSO4, MgSO4  for morphine and magnesuim sulfate.

Answer: Treatment of paroxysmal supraventricular tachycardia (PSVT) including that associated with accessory bypass tracts (Wolff-Parkinson-White syndrome); when clinically advisable, appropriate vagal maneuvers should be attempted prior to adenosine administration; not effective in atrial flutter, atrial fibrillation, or ventricular tachycardia

Paroxysmal supraventricular tachycardia (Adenocard®): I.V. (rapid - over 1-2 seconds, via peripheral line): 6 mg; if not effective within 1-2 minutes, 12 mg may be given; may repeat 12 mg bolus if needed; maximum single dose: 12 mg.

Follow each I.V. bolus of adenosine with normal saline flush.

High alert medication: The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

ANSWER:  50% Magnesium Sulfate Injection, USP must be diluted to a concentration of 20% or less prior to I.V. infusion (typically 1-2 gm diluted in 50-100ml NSS). Rate of administration should be slow and cautious, to avoid producing hypermagnesemia. The 50% solution also should be diluted to 20% or less for intramuscular injection in infants and children. The adverse effects of parenterally administered magnesium usually are the result of magnesium intoxication. These include flushing, sweating, hypotension, depressed reflexes, flaccid paralysis, hypothermia, circulatory collapse, cardiac and central nervous system depression proceeding to respiratory paralysis. Magnesium intoxication is manifested by a sharp drop in blood pressure and respiratory paralysis. Disappearance of the patellar reflex is a useful clinical sign to detect the onset of magnesium intoxication. In the event of overdosage artificial ventilation must be provided until a calcium salt can be injected intravenously to antagonize the effects of magnesium.

Answer:  The United States Pharmacopeia (USP) is the official public standards-setting authority for all prescription and over-the-counter medicines, dietary supplements, and other healthcare products manufactured and sold in the United States. USP sets standards for the quality of drug products and works with healthcare providers to help them meet the standards. Chapter 797 will affect anyone or any facility that handles injectables and other products that require sterility. This includes injections, aqueous bronchial and nasal inhalations, baths and soaks for live organs and tissues, irrigations for wounds and body cavities, ophthalmic drops and ointments, and tissue implants. USP 797 went through its final revision approval in December. The new standard becomes official June 1, 2008.

Please contact JDJ Consulting for assistance in meeting these standards.

Answer: All of the volatile inhalation anesthestics and one muscle relaxant, Succinycholine.

Remember, JDJ Consulting offers annual MH drills to all current clients.

http://www.fda.gov/bbs/topics/NEWS/2008/NEW01858.html

http://www.fda.gov/cder/drug/InfoSheets/HCP/fluoroquinolonesHCP.htm

http://www.fda.gov/cder/drug/infopage/fluoroquinolones/default.htm

Contact JDJ Consulting for additional information.