Professional Documents
Culture Documents
ReadthePatientInformationLeafletprovidedbyyourpharmacistbeforeyoustarttakingitraconazole
andeachtimeyougetarefill.Ifyouhaveanyquestions,consultyourdoctororpharmacist.
Takethismedicationbymouthwithafullmeal,usuallyonceortwicedailyorasdirectedbyyour
doctor.Thecapsulesmustbeswallowedwhole.
Thedosageisbasedonyourmedicalcondition,responsetotreatment,andothermedicationsyoumay
betaking.Besuretotellyourdoctorandpharmacistaboutall
Nooneeversaidthatacareerinmedicinewasgoingtobeeasy.Althoughclinicianscanandshould
shareinthejoysandthesorrowsoftheirpatientsandpracticeinamannerthatplacesapremiumon
patientcenteredcare,itcanbedifficulttomaintainequanimityandempathy.Everyonewhohas
workedinhealthcareforanymeaningfullengthoftimehasexperiencedanabusivepatient.
Verbalabusefrompatientscertainlyoccursmorefrequentlyinspecifichealthcaresettings,including
thepsychiatricinpatientunit.StewartandBowersevaluatedthephenomenonofverbalabusein
psychiatricunitsinastudypublishedintheApril2013issueoftheJournalofPsychiatricandMental
HealthNursing.[1]Theresearchfocusedon522inpatientsfrom84centers.Amongthesepatients,1398
incidentsofaggressivebehaviorwerereportedduringthefirst2weeksofadmission.Halfofthestudy
samplewasverballyaggressiveatsomepointduringthisperiod.
Themostcommontypesofverballyaggressivebehavior,indescendingorderoffrequency,were
abusivelanguage,shouting,threats,expressionsofanger,andracistcomments.However,alarge
numberofchartentriesdidnotspecifythetypeofverbalaggression.Mostofthecommentswere
directedathospitalstaffasopposedtoclinicians.Ahistoryofviolentbehaviorandsubstanceabuse
werepatientvariablesmostassociatedwithverbalaggression.
Althoughnotthemostcommoncategoryofverbalaggressioninthisstudy,thedatastillshowthat
racistcommentsfrompatientsoccurwithsomeregularity.Thereareanumberofethicalandlegal
issuesintreatingracistpatients,andthisisalsoacriticalareaforjobsatisfactionandburnoutamong
healthcareproviders.
"Somanyphysiciansofcolorcanrecallatleastonetimeintheircareerwhenthiscameup,"shesaid,
"andtherearen'tmeaningfulguidelinesforhowtobalancetheinterestsatstakewhentheseissues
arrive."
DrPaulEmilewroteanarticlefortheUCLALawReviewaboutthisissuefromthelegalperspective
severalyearsago.[2]Severalphysicianssincethenhaveaskedhertoaddressitinamedicaljournal,so
sheand3othersnowpresentaframeworkforhowtoconsiderthesesituationsinaperspectivepiece
publishedintheFebruary25issueoftheNewEnglandJournalofMedicine.[3]
"Apatient'srefusalofcarebasedonthetreatingphysician'sraceorethnicbackgroundcanraisethorny
ethical,legal,andclinicalissuesandcanbepainful,confusing,andscarringforthephysicians
involved,"DrPaulEmileandcolleagueswrite.
Evenifsuchasituationdoesnotoccuroften,"itcausesalotofheartachewhenitdoes,"coauthor
AliciaFernndez,MD,fromtheDivisionofGeneralInternalMedicineattheUniversityofCalifornia,
SanFrancisco,toldMedscapeMedicalNews.DrFernndezherselfexperiencedsuchasituationasa
resident.
Nooneeversaidthatacareerinmedicinewasgoingtobeeasy.Althoughclinicianscanandshould
shareinthejoysandthesorrowsoftheirpatientsandpracticeinamannerthatplacesapremiumon
patientcenteredcare,itcanbedifficulttomaintainequanimityandempathy.Everyonewhohas
workedinhealthcareforanymeaningfullengthoftimehasexperiencedanabusivepatient.
Verbalabusefrompatientscertainlyoccursmorefrequentlyinspecifichealthcaresettings,including
thepsychiatricinpatientunit.StewartandBowersevaluatedthephenomenonofverbalabusein
psychiatricunitsinastudypublishedintheApril2013issueoftheJournalofPsychiatricandMental
HealthNursing.[1]Theresearchfocusedon522inpatientsfrom84centers.Amongthesepatients,1398
incidentsofaggressivebehaviorwerereportedduringthefirst2weeksofadmission.Halfofthestudy
samplewasverballyaggressiveatsomepointduringthisperiod.
\
SomewomenwithrecurrentBVmaybenefitfromevaluationortreatmentofGvaginaliscolonization
intheirsexualpartner(controversial)
Patientsshouldbeadvisedtostopdouchingorusingbubblebathoranyotheroverthecounter
vaginalhygieneproducts
Patientsshouldwashonlywithhypoallergenicbarsoapsornosoapatallandshouldavoidliquid
soapsandbodywashes
Surgeryisnotindicated
Testingforotherinfections(eg,Ngonorrhoeae,Ctrachomatis,orherpessimplexvirus[HSV]1)
maybeappropriate
Therapywithmetronidazoleorclindamycinmayalterthevaginalfloraandpredisposethepatient
todevelopmentofvaginalcandidiasis
GeneralprinciplesoftreatmentofBVincludethefollowing:
Antibioticsarethemainstayoftherapy
DataontheefficacyofdietarysupplementationwithLactobacillus(acidophilus)are
conflicting
AsymptomaticwomenwithGvaginaliscolonizationdonotneedtreatment
BVoccurringinpregnantwomenshouldbetreated
Treatmentbeforecesareandelivery,totalabdominalhysterectomy,orinsertionofanIUDis
alsorecommended
Uncomplicatedcasestypicallyresolveafterstandardantibiotictreatment
BVthatdoesnotresolveafteronecourseoftreatmentmaybecuredbygivingasecondcourse
ofthesameagentorbyswitchingtoanotheragent(eg,frommetronidazoletoclindamycinor
fromclindamycintometronidazole)
Apa saja Penyebab Mual dan Muntah ? Kondisi medis atau penyakit
penyebab Mual dan muntah, antara lain: Mabuk kendaraan (motion
sickness) Hamil muda (mual terjadi pada sekitar 50% -90% dari
seluruh kehamilan, muntah pada 25% -55%) Obat pencetus muntah
Rasa sakit yang sangat Stres emosional (seperti rasa takut) Makan
berlebihan (kekenyangan) Penyakit kandung empedu, misalnya Batu
Empedu Keracunan makanan Infeksi virus saluran cerna (diare)
DosisRanitidin
Dosisdanjangkawaktupenggunaanranitidintergantungkepadakondisiyangdiobatidantingkat
keparahannya.Padaumumnyaranitidindikonsumsisebanyak300mgperhari.Dosisinibisadiminum
sekaligusataudibagimenjadidua.Ranitidinbisadiberikanselama212minggu,tergantungpada
kondisidanresponspasienterhadappengobatan.
Ranitidindalambentuktablettersediadalamukurandosis75mg,150mg,dan30mg.Ranitidindalam
bentuksiruptersediadalamukurandosis15mg/ml.Sedangkanranitidindalambentukcairanuntuk
disuntikantersediadalamukurandosis1mg/mldan25mg/ml.Cairansuntikantersebutdapat
disuntikanlangsungkedalampembuluhdarahataukedalamotot.
Dosisranitidinuntukorangdewasaialah150mgduakalisehariatau300mgsekalisehari.Untuk
peradangankerongkongan,ranitidindapatdiberikanhingga150mgtigakalisehari.Dosisuntukanak
anakialah24mg/kgberatbadanduakalisehari.Dosismaksimaluntukanakanakialah300mg
sehari.
Ranitidindalambentuktablettersediadalamukurandosis75mg,150mg,dan30mg.Ranitidindalam
bentuksiruptersediadalamukurandosis15mg/ml.Sedangkanranitidindalambentukcairanuntuk
disuntikantersediadalamukurandosis1mg/mldan25mg/ml.Cairansuntikantersebutdapat
disuntikanlangsungkedalampembuluhdarahataukedalamotot.
Dosisranitidinuntukorangdewasaialah150mgduakalisehariatau300mgsekalisehari.Untuk
peradangankerongkongan,ranitidindapatdiberikanhingga150mgtigakalisehari.Dosisuntukanak
anakialah24mg/kgberatbadanduakalisehari.Dosismaksimaluntukanakanakialah300mg
sehari.