101221010

SPIS TREŚCI PRZEDMOWA .......................................................................................................

9

JAK KORZYSTAĆ Z TEJ KSIĄŻKI? ................................................................

11

ROZDZIAŁ 1

MIĘDZYNARODOWY UKŁAD JEDNOSTEK MIAR (SI) .........................

13

3RGVWDZRZH MHGQRVWNL XNğDGX PHWU\F]QHJR 6, ............................................

1.2. Zapis podstawowych jednostek miar ............................................................ =DPLDQD MHGQRVWHN REMĎWRıFL ............................................................... =DPLDQD MHGQRVWHN SRMHPQRıFL ..........................................................

1.2.3. Zamiana jednostek masy .....................................................................

1.2.4. Zamiana jednostek czasu .................................................................... =DGDQLD VSUDZG]DMĂFH .....................................................................................

3RGVXPRZDQLH ² QDMZDŃQLHMV]H ZLDGRPRıFL GR ]DSDPLĎWDQLD ..................

7HVW SRGVXPRZXMĂF\ ........................................................................

13 15 15 15 15 16 16 20 20

ROZDZIAŁ 2

RODZAJE DAWEK I ZASADY PODAWANIA LEKÓW W ZALEŻNOŚCI OD POSTACI LEKU ............................................................

5RG]DMH GDZHN ZHGğXJ )3 ..............................................................................

'URJL SRGDZDQLD OHNX .....................................................................................

3RGDZDQLH OHNyZ SRGMĎ]\NRZR ........................................................

3RGDZDQLH OHNyZ RNRğRSROLF]NRZR .................................................

3RGDZDQLH OHNyZ Z]LHZQLH ² LQKDODFMH ..........................................

3RGDZDQLH OHNyZ QD VSRMyZNĎ RND ...................................................

3RGDZDQLH OHNyZ QD SRZLHU]FKQLĎ VNyU\ ........................................

2.2.6. Kremy i czopki aplikowane doodbytniczo i dopochwowo ............

0LDU\ GRPRZH Z GDZNRZDQLX OHNyZ ...........................................................

6SRVRE\ GDZNRZDQLD OHNyZ GOD G]LHFL ² Marta Czekirda, Noemi Jaszyna .................................................................................................. =DVDG\ RERZLĂ]XMĂFH SU]\ SRGDZDQLX OHNyZ ...............................................

7HVW SRGVXPRZXMĂF\ ......................................................................................

23 23 24 24 25 26 30 33 36 37 40 46 47

6

6SLV WUHyFL

ROZDZIAŁ 3

ETYKIETY LEKÓW ...............................................................................................

49

(W\NLHW\ WDEOHWHN L NDSVXğHN ...........................................................................

(W\NLHW\ UR]WZRUyZ L ]DZLHVLQ GRXVWQ\FK ....................................................

(W\NLHW\ OHNyZ GR LQLHNFML ..............................................................................

49 52 55

ROZDZIAŁ 4

SPOSOBY OBLICZANIA DAWEK LEKÓW ...................................................

58

6SRVRE\ Z\UDŃDQLD VWĎŃHġ OHNyZ ................................................................... 58 2EOLF]DQLH OLF]E\ WDEOHWHN NDSVXğHN .............................................................. 60 =DGDQLD VSUDZG]DMĂFH ....................................................................... 61 3U]HOLF]DQLH GDZHN OHNyZ Z ]QDQHM REMĎWRıFL ............................................... 66 =DGDQLD VSUDZG]DMĂFH ....................................................................... 70 2EOLF]DQLH GDZHN OHNyZ Z UR]WZRU]H R ]QDQ\P VWĎŃHQLX .......................... 74 5R]FLHġF]DQLH SUHSDUDWyZ VWDğ\FK L UR]WZRUyZ ........................................... 75 5R]FLHġF]DQLH SUHSDUDWyZ VWDğ\FK ................................................... 75 5R]FLHġF]DQLH UR]WZRUyZ ................................................................ 75 =DGDQLD VSUDZG]DMĂFH ....................................................................... 77 'DZNRZDQLH OHNyZ Z MHGQRVWNDFK PLĎG]\QDURGRZ\FK ............................. 79 =DGDQLD VSUDZG]DMĂFH ....................................................................... 80 'DZNRZDQLH OHNyZ Z PLOLHNZLZDOHQWDFK .................................................... 81 =DGDQLD VSUDZG]DMĂFH ....................................................................... 82 2EOLF]DQLH GDZHN OHNyZ GOD GRURVğ\FK L G]LHFL ² Marta Czekirda, Noemi Jaszyna ..................................................................... 83 2EOLF]DQLH GDZHN OHNyZ GOD G]LHFL ZHGğXJ Z]RUyZ RSDUW\FK

QD GDZNDFK ] )3 .............................................................................................. 90 2EOLF]DQLH GDZHN OHNyZ GOD G]LHFL ZHGğXJ GDZHN SHGLDWU\F]Q\FK ............ 91 =DGDQLD VSUDZG]DMĂFH ....................................................................... 102 2EOLF]DQLH SRZLHU]FKQL FLDğD GRURVğ\FK L G]LHFL ² Marta Czekirda, Noemi Jaszyna ..................................................................... 103 =DGDQLD VSUDZG]DMĂFH ....................................................................... 104 2EOLF]DQLH GDZHN OHNyZ ZHGğXJ SRZLHU]FKQL FLDğD ..................................... 105 =DGDQLD VSUDZG]DMĂFH ....................................................................... 106 2EOLF]DQLH GDZHN OHNyZ Z ]DZLHVLQLH QD SRGVWDZLH XNğDGDQLD proporcji ........................................................................................................... 108

6SLV WUHyFL

ROZDZIAŁ 5

RODZAJE STRZYKAWEK DO INIEKCJI ........................................................ 129 5.1. Strzykawki standardowe, jednorazowe ......................................................... 129 =DGDQLD VSUDZG]DMĂFH ....................................................................... 134 5.2. Strzykawki turberkulinowe ............................................................................ 135 =DGDQLD VSUDZG]DMĂFH ....................................................................... 136 5.3. Strzykawki insulinowe .................................................................................... 138 =DGDQLD VSUDZG]DMĂFH ....................................................................... 142 ROZDZIAŁ 6

OBLICZANIE DAWEK LEKÓW PODAWANYCH W INIEKCJI ................. 145 =DVDG\ SRGDZDQLD OHNyZ Z LQLHNFML ............................................................... 146 2EOLF]DQLH GDZHN OHNyZ SRGDZDQ\FK Z LQLHNFML GRŃ\OQHM .......................... 147 (W\NLHW\ OHNyZ GR LQLHNFML GRŃ\OQHM ................................................. 148 =DGDQLD VSUDZG]DMĂFH ....................................................................... 150 2EOLF]DQLH GDZHN OHNyZ SRGDZDQ\FK Z LQLHNFML GRPLĎıQLRZHM ................. 158 (W\NLHW\ OHNyZ GR LQLHNFML GRPLĎıQLRZHM ........................................ 158 =DGDQLD VSUDZG]DMĂFH ....................................................................... 162 7HVW SRGVXPRZXMĂF\ ...................................................................................... 163 2EOLF]DQLH GDZHN LQVXOLQ\ ............................................................................. 168 6.5.1. Rodzaje insulin .................................................................................. 168 'REyU ZVWU]\NLZDF]D GR LQVXOLQ\ ................................................... 173 6SRVyE SRGDZDQLD LQVXOLQ\ .............................................................. 178 =DVDG\ RERZLĂ]XMĂFH SU]\ Z\NRQ\ZDQLX

ZVWU]\NQLĎĄ LQVXOLQ\ ......................................................................... 179 6.5.5. Czytanie etykiet insulin ................................................................... 180 =DGDQLD VSUDZG]DMĂFH ....................................................................... 181 ROZDZIAŁ 7

OBLICZANIE DAWEK LEKÓW W KROPLOWYM WLEWIE DOŻYLNYM ......................................................................................... 185 .URSORZ\ ZOHZ GRŃ\OQ\ ................................................................................. 185 2EOLF]DQLH F]DVX ]DNRġF]HQLD NURSORZHJR ZOHZX GRŃ\OQHJR .................... 192 2EOLF]DQLH F]DVX ]DNRġF]HQLD NURSORZHJR ZOHZX GRŃ\OQHJR

QD SRGVWDZLH F]DVX UR]SRF]ĎFLD L F]DVX WUZDQLD ZOHZX ................ 192 =DGDQLD VSUDZG]DMĂFH ....................................................................... 193 2EOLF]DQLH F]DVX SU]HSğ\ZX ZOHZX GRŃ\OQHJR QD SRGVWDZLH OLF]E\

NURSOL QD JRG]LQĎ PLQXWĎ ² RSLV\ZDQLH HW\NLHW .......................................... 194

7

8

6SLV WUHyFL

=DGDQLD VSUDZG]DMĂFH ....................................................................... 198 7HVW SRGVXPRZXMĂF\ ........................................................................ 200 2EOLF]DQLH SUĎGNRıFL SU]HSğ\ZX NURSORZHJR ZOHZX GRŃ\OQHJR ................ 202 =DGDQLD VSUDZG]DMĂFH ....................................................................... 206 2EOLF]DQLH GDZHN KHSDU\Q\ Z NURSORZ\P ZOHZLH GRŃ\OQ\P .................... 209 =DGDQLD VSUDZG]DMĂFH ....................................................................... 212 3RGDZDQLH OHNyZ ]D SRPRFĂ SRPS LQIX]\MQ\FK .......................................... 212 3RGDQLH OHNX Z SRPSLH Z RNUHıORQHM MHGQRVWFH F]DVX

QD NLORJUDP PDV\ FLDğD ...................................................................... 219 7HVW SRGVXPRZXMĂF\ ........................................................................ 222 ROZDZIAŁ 8

LEKI STOSOWANE W TERAPII NOWOTWORÓW ORAZ TERAPIA WSPOMAGAJĄCA ............................................................................................... 224 /HNL VWRVRZDQH Z WHUDSLL QRZRWZRUyZ ........................................................ 224 /HNL VWRVRZDQH Z WHUDSLL QRZRWZRUyZ MDNR WHUDSLD ZVSRPDJDMĂFD ............ 238 =DGDQLD VSUDZG]DMĂFH ..................................................................................... 246

PIŚMIENNICTWO ................................................................................................ 249

24

5R]G]LD

2.2. DROGI PODAWANIA LEKU 2.2.1. Podawanie leków podjęzykowo /HNL SRGDZDQH SRGMĎ]\NRZR ZFKğDQLDMĂ VLĎ ] EğRQ\ ıOX]RZHM MDP\ XVWQHM GRıĄ V]\ENR L QLH VĂ QDUDŃRQH QD G]LDğDQLH F]\QQLNyZ V]NRGOLZ\FK 6SRVyE WHQ PRŃQD Z\NRU]\VWDĄ MHGQDN W\ONR ZWHG\ JG\ OHN MHVW ğDWZR UR]SXV]F]DOQ\ Z ZRG]LH RUD] JG\ GDZND QLH MHVW ]E\W GXŃD /HNL SRGDZDQH SRGMĎ]\NRZR Z\VWĎSXMĂ Z SRVWDFL DHUR]ROX OLQJZHWHN JUDQXOHN KRPHRSDW\F]Q\FK L NDSVXğHN 6WRVXMĂF OHN Z SRVWDFL DHUR]ROX QDOHŃ\ SDPLĎWDĄ ŃH G]LDğD RQ MXŃ SR NLONX VHNXQGDFK /LQJZHWNL WDEOHWNL SRGMĎ]\NRZH XPLHV]F]D VLĎ SRG MĎ]\NLHP JG]LH UR]SXV]F]DMĂ VLĎ Z ıOLQLH 6XEVWDQFMD OHF]QLF]D ] OLQJZHWHN ZFKğDQLD VLĎ UyZQLHŃ SR NLONX VHNXQGDFK SU]H] EğRQĎ ıOX]RZĂ MDP\ XVWQHM DOH OHN ]DF]\QD G]LDğDĄ GRSLHUR SR NLONX PLQXWDFK /HNL SRGDZDQH SRGMĎ]\NRZR QDMF]ĎıFLHM Z\ZLHUDMĂ RJyOQ\ ZSğ\Z QD RUJDQL]P L VĂ VWRVRZDQH NLHG\ ]DFKRG]L NRQLHF]QRıĄ X]\VNDQLD MDN QDMV]\EV]HJR HIHNWX WHUDSHXW\F]QHJR 1DMF]ĎıFLHM WĂ GURJĂ SRGDMH VLĎ OHNL VWRVRZDQH Z FKRURELH QLHGRNUZLHQQHM VHUFD QD SU]\NğDG QLWURJOLFHU\QĎ RUD] VğXŃĂFH GR V]\ENLHJR REQLŃHQLD FLıQLHQLD NUZL QD SU]\NğDG &DSWURSLO U\F 3RGDQLH OLQJZHWNL SROHJD QD XPLHV]F]HQLX MHM SRG MĎ]\NLHP SDFMHQWD U\F D OXE SRGDQLX RNRğRSROLF]NRZ\P U\F E

RYCINA 2.1 &DSWRSULO OHN VWRVRZDQ\ SRGMÚ]\NRZR

RYCINA 2.2 a

E

3RGDQLH OHNöZ GRXVWQLH a ļ SRGDQLH OHNX SRGMÚ]\ NRZR E ļ SRGDQLH OHNX RNRïRSROLF]NRZR

5RG]DMH GDZHN L ]DVDG\ SRGDZDQLD OHNÏZ Z ]DOH QRyFL RG SRVWDFL OHNX

25

1DMEDUG]LHM ]QDQ\P OHNLHP SRGDZDQ\P SRGMĎ]\NRZR MHVW &DSWRSULO U\F :\VWĎSXMH RQ Z NLONX GDZNDFK WM PJ PJ RUD] PJ 'URJĂ SRGDQLD MHVW RERZLĂ]NRZR SRGDQLH SRGMĎ]\NRZH 2SUyF] QLHNRU]\VWQ\FK F]\QQLNyZ G]LDğDMĂF\FK QD VXEVWDQFMĎ OHF]QLF]Ă Z SU]HZRG]LH SRNDUPRZ\P R NWyU\FK ZVSRPQLDQR ZDUWR QDGPLHQLĄ WDNŃH HIHNW SLHUZV]HJR SU]HMıFLD 7R ]MDZLVNR XQLHF]\QQLHQLD OHNX Z ZĂWURbie wskutek jego przemian metabolicznych. Ponad 70% leku ulega dezaktywacji i warWRıĄ WHUDSHXW\F]QD OHNX SRğNQLĎWHJR YV ZFKğRQLĎWHJR SRGMĎ]\NRZR EH]SRıUHGQLR GR Ń\ğ\ JğyZQHM JyUQHM MHVW ]QLNRPD 'ODWHJR QLH]Z\NOH LVWRWQH MHVW DE\ SUHSDUDW ]RVWDğ ZFKğRQLĎW\ VSRG MĎ]\ND R F]\P U]DGNR VLĎ PyZL D MHVW WR QDMF]ĎıFLHM VWRVRZDQ\ OHN GR SU]HU\ZDQLD QDJğ\FK Z\VRNLFK ZDUWRıFL VNRNyZ FLıQLHQLD NUZL 6]\ENRıĄ G]LDğDQLD WDN SU]\MĎWHJR OHNX MHVW QLH]QDF]QLH PQLHMV]D RG SRGDQLD GRŃ\OQHJR 2SUyF] &DSWRSULOX QD SROVNLP U\QNX GRVWĎSQH VĂ SUHSDUDW\ SRGMĎ]\NRZH ]DZLHUDMĂFH z

SURJHVWHURQ /XWHLQD SRGMĎ]\NRZD ² ŃHġVNL KRUPRQ SğFLRZ\ Z\NRU]\VW\ZDQ\ P LQ Z ]DEXU]HQLDFK F\NOX PLHVLĂF]NRZHJR

z

QDORNVRQ ² DQWDJRQLVWD OHNyZ RSLRLGRZ\FK ]QRV]ĂF\ HIHNW\ RıURGNRZH L REZRGRZH Z\ŃHM Z\PLHQLRQ\FK OHNyZ

z

IHQWDQ\O ² VLOQ\ OHN QDUNRW\F]Q\ R G]LDğDQLX SU]HFLZEyORZ\P ² G]LDğD õ VLOQLHM RG PRUILQ\

z

EXSUHQRUILQĎ ² OHN RSLRLGRZ\ R G]LDğDQLX GğXJRWUZDğ\P Z VWRVXQNX GR LQQ\FK OHNyZ ] WHM JUXS\ ² VWRVRZDQ\ Z OHF]HQLX EyOyZ SU]HELMDMĂF\FK

z

QLWURJOLFHU\QĎ ² QDSDG\ FKRURE\ QLHGRNUZLHQQHM VHUFD Z FHOX SU]HU\ZDQLD EyOX ZLHġFRZHJR

z

QLNRW\QĎ ² WDEOHWNL SRGMĎ]\NRZH Z\NRU]\VW\ZDQH Z QLNRW\QRZHM WHUDSLL ]DVWĎSF]HM X RVyE X]DOHŃQLRQ\FK RG Z\UREyZ W\WRQLRZ\FK

z

PHODWRQLQĎ ² WDEOHWNL SRGMĎ]\NRZH X]XSHğQLDMĂFH QLHGRERU\ KRUPRQX RGSRZLHG]LDOQHJR ]D UHJXODFMĎ U\WPX GRERZHJR ² SUREOHP\ ] ]DV\SLDQLHP L GğXJRıFLĂ VQX

2.2.2. Podawanie leków okołopoliczkowo /HNL SRGDZDQH RNRğRSROLF]NRZR Z\ZLHUDMĂ G]LDğDQLH RJyOQH 0RJĂ SU]H] GğXŃV]\ F]DV SU]\OHJDĄ GR EğRQ\ ıOX]RZHM SROLF]ND OXE JyUQHJR G]LĂVğD ]DZLHUDMĂ SROLPHU\ ELRDGKH]\MQH Z\ND]XMĂF SU]HGğXŃRQH G]LDğDQLH QD SU]\NğDG QLWURJOLFHU\QD 3RGDZDQLH OHNX RNRğRSROLF]NRZR SROHJD QD ZSURZDG]HQLX WDEOHWNL PLĎG]\ SROLF]HN D ]ĎE\ ]DJLĎFLH SROLF]NRZR G]LĂVğRZH JG]LH SRZLQQD VLĎ RQD UR]SXıFLĄ 3U]HG SRGDQLHP OHNX QDOHŃ\ XVXQĂĄ UHV]WNL SRNDUPX ] ]DJLĎFLD SROLF]NRZR G]LĂVğRZHJR SU]H] SU]HSğXNDQLH MDP\

26

5R]G]LD

XVWQHM L SRLQIRUPRZDĄ SDFMHQWD ŃH OHN SRZLQLHQ SR]RVWDĄ Z PLHMVFX GR FKZLOL FDğNRZLWHJR UR]SXV]F]HQLD -DQLFNL

2.2.3. Podawanie leków wziewnie – inhalacje 3RGDZDQLH OHNyZ GURJĂ LQKDODFML XPRŃOLZLD X]\VNDQLH V]\EV]HJR G]LDğDQLD OHNX Z RJQLVNX FKRURE\ ZSğ\ZD QD ]PQLHMV]HQLH GDZNL OHNX L RVLĂJQLĎFLH GXŃHJR VWĎŃHQLD OHNX Z GURJDFK RGGHFKRZ\FK SU]\ MHGQRF]HVQ\P EDUG]R PDğ\P MHJR VWĎŃHQLX ZH NUZL FR PLQLPDOL]XMH RJyOQRXVWURMRZH G]LDğDQLD QLHSRŃĂGDQH 3UHSDUDW\ GR LQKDODFML VWDQRZLĂ Sğ\QQH OXE VWDğH SUHSDUDW\ SU]H]QDF]RQH GR SRGDZDQLD Z SRVWDFL SDU OXE DHUR]ROL GR SğXF Z FHOX X]\VNDQLD G]LDğDQLD PLHMVFRZHJR OXE RJyOQHJR U\F ² =DZLHUDMĂ MHGQĂ OXE ZLĎFHM VXEVWDQFML F]\QQ\FK NWyUH PRJĂ E\Ą UR]SXV]F]RQH OXE ]DZLHV]RQH Z RGSRZLHGQLP QRıQLNX )3 ;,,, : SU]\SDGNX Z]LHZHN LQKDODFML ZDUWR ZVSRPQLHĄ R V]HUHJX RGSRZLHGQLNyZ Z\PLHQLRQHJR QD U\FLQDFK 3XOPLFRUWX -HVW WR P LQ 1HEEXG %XGL[RQ 1HE %HQRGLO %'6 1 3UHSDUDW\ Z\VWĎSXMĂ Z GDZNDFK PJ P/ PJ P/ L PJ P/ Z DPSXğNDFK SR PO FR GDMH ğĂF]QĂ GDZNĎ OHNX RGSRZLHGQLR PJ P/ PJ P/ RUD] PJ P/ ,VWRWQH VĂ ]DSLV\ GDZNL JG\Ń EDUG]R F]ĎVWR VSRW\NDP\ VLĎ ] ]DSLVHP Z 2 mL, czyli Z FDğHM ]DZDUWRıFL DPSXğNL %DUG]R ğDWZR R EğĂG SRQLHZDŃ QD RSDNRZDQLDFK R]QDF]RQH MHVW VWĎŃHQLH VXEVWDQFML Z\UDŃRQH QD 1 mL. Przy zapisie 0,25 mg/2 mL odruchowo PRŃQD VLĎJQĂĄ SR GDZNĎ 0,25 mg/mL, F]\OL GZXNURWQLH ZLĎNV]Ă 'RW\F]\ WR JğyZQLH preparatu 1HEEXG PJ P/, Z NWyU\P SURGXFHQW R]QDF]\ğ VWĎŃHQLH QD RSDNRZDniu jako 0,25 mg/2 mL, a nie tak jak u konkurencji 0,125 mg/mL, GODWHJR WDN ZDŃQH MHVW GRNğDGQH RGF]\W\ZDQLH ]DUyZQR RUG\QDFML OHNDUVNLHM MDN L HW\NLHW\ SUHSDUDWX /HNL SRGDZDQH Z SRVWDFL DHUR]ROL SRGDMH VLĎ ]D SRPRFĂ LQKDODWRUyZ F]\OL XU]ĂG]Hġ JHQHUXMĂF\FK DHUR]RO OHF]QLF]\ (OHPHQWHP LQKDODWRUD MHVW QHEXOL]DWRU F]\OL SRMHPQLN QD OHN Z NWyU\P QDVWĎSXMH Z\WZRU]HQLH DHUR]ROX R RNUHıORQHM ZLHONRıFL F]ĂVWHN : ZDUXQNDFK GRPRZ\FK VWRVXMH VLĎ NLHV]RQNRZH LQKDODWRU\ SURV]NRZH OXE FLıQLHQLRZH EĂGŁ ZLĎNV]H SU]HQRıQH LQKDODWRU\ XOWUDGŁZLĎNRZH OXE SQHXPDW\F]QH &LFKRFND -DURV] .ZLQWD

5RG]DMH GDZHN L ]DVDG\ SRGDZDQLD OHNÏZ Z ]DOH QRyFL RG SRVWDFL OHNX

a

E

F

RYCINA 2.3 D ļ 3XOPLFRUW OHN GR VWRVRZDQLD Z SRVWDFL Sï\QQHM GR LQKDODFML E ļ 9HQWROLQ OHN Z SRVWDFL Sï\QQHM GR LQKDODFML F ļ $WURYHQW OHN GR VWRVRZDQLD Z SRVWDFL Sï\QQHM GR LQKDODFML ] QHEXOL]DWRUD

RYCINA 2.4 1HEEXG

27

28

5R]G]LD

RYCINA 2.5 %HURGXDO SU]\NïDG OHNX ZbSRVWDFL Sï\QQHM GR LQKDODFML

RYCINA 2.6 6HUHWLGH '\VN

1D U\FLQLH SRND]DQR VSRVyE SU]\JRWRZDQLD DHUR]ROX D QD U\FLQLH ² VSRVyE dozowania leku w postaci aerozolu. ,QKDODWRU\ SQHXPDW\F]QH PRŃQD ]DVWRVRZDĄ SU]\ SRGDZDQLX DQW\ELRW\NyZ JHQWDP\F\QD z FKHPLRWHUDSHXW\NyZ SHQWDPLG\QD z OHNyZ UR]V]HU]DMĂF\FK PLĎıQLH JğDGNLH RVNU]HOL EURQFKRG\ODWDF\MQ\FK E2 PLPHW\NyZ VDOEXWDPRO ȕ DGUHQHUJLF]Q\FK V]\ENR L NUyWNR G]LDğDMĂF\FK VDOEXWDPRO RUD] GğXJR G]LDğDMĂF\FK VDOPHWHURO z OHNyZ UR]V]HU]DMĂF\FK RVNU]HOD SU]H] KDPRZDQLH G]LDğDQLD DFHW\ORFKROLQ\ ]DSRELHJDMĂF\FK RGUXFKRZHPX VNXUF]RZL RVNU]HOL Z\ZRğ\ZDQHPX SU]H] Z]LHZQH F]\QQLNL GUDŃQLĂFH OHNL FKROLQROLW\F]QH Z W\P NUyWNR G]LDğDMĂFH QD SU]\NğDG $WURYHQW z OHNyZ KDPXMĂF\FK V\QWH]Ď PHGLDWRUyZ ]DSDOQ\FK ]PQLHMV]DMĂF\FK RGF]\Q ]DSDOQ\ ² JOLNRNRUW\NRVWHURLGyZ %HFRWLGH %XGH]RQLG )OL[RWLGH z OHNyZ SU]HFLZDOHUJLF]Q\FK L SU]HFLZ]DSDOQ\FK ,QWDO &URPRJHQ 7LODGH NURPRQ\ z

66

5R]G]LD

4.3. PRZELICZANIE DAWEK LEKÓW W ZNANEJ OBJĘTOŚCI :LĎNV]RıĄ OHNyZ PD SRGDQĂ ]DZDUWRıĄ VXEVWDQFML OHF]QLF]HM Z P/ UR]WZRUX 'ODWHJR PXVLV] ]ZUyFLĄ XZDJĎ QD SRMHPQRıĄ EXWHONL OXE DPSXğNL Z MDNLHM SRGDQ\ jest dany lek.

WZ z<B ϭ 2GQRV]ĂF VLĎ GR HW\NLHW\ OHNX /RPRWLO ] U\FLQ\ SU]HOLF] QD PLOLOLWU\ GDZNL leku, jakie podasz zgodnie ze zleceniem. =OHFRQR SRGDQLH PJ GLIHQRNV\ODWX 2,5 mg – 5 mL. 2. Zlecono podanie 5 mg leku Lomotil.

6SRVyE REOLF]HQLD ] SURSRUFML 2,5 mg – 5 mL 5 mg – x x = 10 mL.

RYCINA 4.14 /HN /RPRWLO

Odpowiedzi: 1. 5 mL

2. 10 mL

WZ z<B Ϯ /HN 7DUID]ROLQ U\F ]DZLHUD J FHID]ROLQ\ )LRONĎ OHNX J QDOHŃ\ UR]SXıFLĄ Z PO 1D&O =DPLHġ JUDP\ QD PLOLJUDP\ J PJ D QDVWĎSQLH REOLF] Z MDNLHM REMĎWRıFL OHNX ]QDMGXMH VLĎ PJ VXEVWDQFML OHF]QLF]HM

6SRVRE\ REOLF]DQLD GDZHN OHNÏZ

67

2EOLF]HQLD ] SURSRUFML 5 mL – 1000 mg x mL – 200 mg x = 1 mL 'OD GDZNL PJ SRELHU]HV] P/ GOD GDZNL PJ ² P/ GOD GDZNL 500 mg – 2,5 mL, dla dawki 600 mg – 3 mL, dla dawki 700 mg – 3,5 mL, dla dawki 800 mg – 4 mL, dla dawki 900 mg – 4,5 mL, dla dawki 1000 mg – 5 mL.

RYCINA 4.15 /HN 7DUID]ROLQ

WZ z<B ϯ = XORWNL OHNX &RUGDURQH U\F Z\QLND ŃH Z P/ ]QDMGXMH VLĎ PJ OHNX SRMHPQRıĄ DPSXğNL Z\QRVL P/ ZLĎF DE\ REOLF]\Ą FDğĂ ]DZDUWRıĄ DPSXğNL WU]HED SRPQRŃ\Ą PJ SU]H] P/ 2WU]\PDP\ ZWHG\ ]DZDUWRıĄ FDğHM DPSXğ ki, tj. 150 mg w 3 mL.

RYCINA 4.16 /HN &RUGDURQH PJ P/

68

5R]G]LD

WZ z<B ϰ Lek o nazwie Lincocin przedstawiony na rycinie 4.17 zawiera 1 mL gotowego UR]SXV]F]DOQLND =DZDUWRıĄ ILRONL MHVW RNUHıORQD PJ P/ F]\OL Z P/ ]QDMGXMH VLĎ PJ OHNX -HıOL ]OHFRQR SRGDQLH PJ OHNX SRGDV] P/ OHNX

RYCINA 4.17 /HN /LQFRFLQ

WZ z<B ϱ 1D U\FLQLH SU]HGVWDZLRQR HW\NLHW\ OHNX *HQWDPLFLQ Z DPSXğNDFK Z\VWĎSXMĂFHJR QDMF]ĎıFLHM Z GDZNDFK PJ L PJ =DSLV QD HW\NLHFLH PJ P/ R]QDF]D ŃH Z P/ MHVW PJ OHNX D ]DSLV PJ P/ ² ŃH Z P/ MHVW PJ OHNX

RYCINA 4.18 /HN *HQWDP\FLQ

6SRVRE\ REOLF]DQLD GDZHN OHNÏZ

69

WZ z<B ϲ /HNDU] ]OHFLğ SRGDQLH PJ OHNX =DZDUWRıĄ ILRONL PJ OHNX =LQDFHI FHIXURNV\P U\F UR]SXıFLV] ]JRGQLH ] ]DOHFHQLHP Z P/ 1D&O 2EOLF] MDNĂ REMĎWRıĄ UR]WZRUX QDOHŃ\ SRGDĄ SDFMHQWRZL 1DOHŃ\ XğRŃ\Ą SURSRUFMĎ 6 mL – 750 mg x – 125 mg x = 1 mL

RYCINA 4.19 /HN =LQDFHI

2GSRZLHGŁ -HıOL PJ OHNX UR]SXV]F]Ď Z P/ 1D&O WR PJ ]QDMG]LH VLĎ Z P/ VSRU]ĂG]RQHJR roztworu.

WZ z<B ϳ /HNDU] ]OHFLğ SRGDQLH G]LHFNX PJ OHNX %LRIXURNV\P %LRIXURNV\P SURGXNRZDQ\ MHVW Z ILRONDFK ]DZLHUDMĂF\FK UyŃQH GDZNL OHNX PJ PJ PJ RUD] J 'OD G]LHFND NWyUH PD RWU]\PDĄ PJ RGSRZLHGQLD EĎG]LH ILROND ]DZLHUDMĂFD PJ OHNX 5R]SXV]F]DP\ ]DZDUWRıĄ ILRONL ]JRGQLH ] ]DOHFHQLHP SURGXFHQWD w 4 mL rozpuszczalnika.

'RNRQXMHP\ REOLF]HQLD 250 mg – 4 mL 200 mg – x [ P/ WDNĂ LORıĄ OHNX QDOHŃ\ SRGDĄ

Rozdział

7

OBLICZANIE DAWEK LEKÓW W KROPLOWYM WLEWIE DOŻYLNYM 3R ]DSR]QDQLX VLÚ ]bWUHĂFLÈ UR]G]LDïX RUD] Z\NRQDQLX ]DSODQRZDQ\FK ]DGDñ &]\WHOQLN EÚG]LH SRWUDğï

2EOLF]\Ê GDZNL OHNöZ SRGDZDQ\FK ZbNURSORZ\P ZOHZLH GRĝ\OQ\P 2EOLF]\Ê GDZNL OHNöZ SRGDZDQ\FK SU]H] SRUW\ GRĝ\OQH 5R]UöĝQLÊ Xĝ\ZDQH VNUöW\ 2EOLF]\Ê GDZNL OHNöZ SRGDZDQ\FK ZbSRPSDFK LQIX]\MQ\FK

7.1. KROPLOWY WLEW DOŻYLNY -HVW WR ]DELHJ QDOHŃĂF\ GR JUXS\ DVHSW\F]Q\FK ]DELHJyZ WHUDSHXW\F]Q\FK SROHJDMĂF\ QD QDNğXFLX Ń\ğ\ L ZSURZDG]HQLX ıURGND OHF]QLF]HJR GR RUJDQL]PX Z SRZROQ\P ZOHZLH =DELHJ WHQ Z\NRQ\ZDQ\ MHVW QD ]OHFHQLH OHNDUVNLH &HOHP ZOHZX GRŃ\OQHJR MHVW SR]DMHOLWRZH GRVWDUF]HQLH Sğ\QyZ L OHNyZ SDFMHQWRZL 2EOLF]HQLD ]ZLĂ]DQH ] GRŃ\OQ\P SRGDZDQLHP OHNyZ Z\PDJDMĂ ]QDMRPRıFL SRGVWDZRZ\FK ]DVDG WHUDSLL GURJĂ LQLHNFML L Y 5R]G]LDğ WHQ ]DSR]QD &LĎ ] ]DVDGDPL REOLF]DQLD GDZHN OHNyZ SRGDZDQ\FK GURJĂ NURSORZ\FK ZOHZyZ GRŃ\OQ\FK SRPS LQIX]\MQ\FK RUD] SRUWyZ :VND]DQLD GR SU]HWDF]DQLD Sğ\QyZ VNRU\JRZDQLH ]DEXU]Hġ JRVSRGDUNL ZRGQR HOHNWUROLWRZHM XUHJXORZDQLH UyZQRZDJL NZDVRZR ]DVDGRZHM z ]ZLĎNV]HQLH REMĎWRıFL Sğ\QyZ NUĂŃĂF\FK z X]XSHğQLHQLH XE\WNyZ LORıFLRZ\FK L MDNRıFLRZ\FK ZLWDPLQ VNğDGQLNyZ HQHUJHW\F]Q\FK RUD] ELDğND z F]ĎıFLRZH OXE FDğNRZLWH RGŃ\ZLDQLH SR]DMHOLWRZH z SRGDZDQLH OHNyZ Z\PDJDMĂF\FK GXŃHJR UR]FLHġF]HQLD L SRGDQLD Z ZROQ\P FLĂJğ\P ZOHZLH z z

186

5R]G]LD

5R]WZRU\ GR ZOHZyZ Z ]DOHŃQRıFL RG LFK RVPRODUQRıFL G]LHOLP\ QD 1. Izotoniczne ² P2VPRO NJ ² MHVW WR UR]WZyU R FLıQLHQLX RVPRW\F]Q\P UyZQ\P FLıQLHQLX UR]WZRUX SRUyZQ\ZDQHJR QD SU]\NğDG FLıQLHQLH RVPRW\F]QH 1D&O FLıQLHQLX RVPRW\F]QHPX NUZL 2. Hipotoniczne SRQLŃHM P2VPRO NJ ² MHVW WR UR]WZyU R FLıQLHQLX RVPRW\F]Q\P PQLHMV]\P QLŃ FLıQLHQLH UR]WZRUX SRUyZQ\ZDQHJR SU]HZRGQLHQLH NUZLQHN SRZRGXMH LFK KHPROL]Ď 3. Hipertoniczne SRZ\ŃHM P2VPRO NJ ² MHVW WR UR]WZyU R FLıQLHQLX RVPRW\F]Q\P ZLĎNV]\P QLŃ FLıQLHQLH UR]WZRUX SRUyZQ\ZDQHJR NUZLQNL F]HUZRQH VLĎ Z QLP NXUF]Ă ² RGZRGQLHQLH NRPyUHN İOXVDUVND =DU]\FND =DKUDGQLF]HN 0RŃQD Z\UyŃQLĄ NURSORZH ZOHZ\ GRŃ\OQH NUyWNRWUZDğH F]DV WUZDQLD GR JRG]LQ z GğXJRWUZDğH F]DV WUZDQLD SRQDG GREĎ z V]\ENLH ² Z EROXVLH SRGDQLH FDğHM REMĎWRıFL Z NUyWNLP F]DVLH z

5R]WZRU\ GR LQIX]ML GRVWĎSQH VĂ Z REMĎWRıFL L P/ Z EXWHONDFK V]NODQ\FK ] WZRU]\ZD V]WXF]QHJR RUD] Z ZRUNDFK SODVWLNRZ\FK 'R UR]WZRUyZ LQIXzyjnych zaliczamy: NU\VWDORLG\ 1DWULXP &KORUDWXP *OXFRVXP *OXFRVXP 6ROXWLR 5LQJHUL Sğ\Q ZLHORHOHNWUROLWRZ\ L]RWRQLF]Q\ 3:( RUD] NRORLG\ 0DQQLWRO 'HNVWUDQ 'HNVWUDQ WDE TABELA 7.1. 5R]WZRU\ GR ZOHZöZ GRĝ\OQ\FK ¥OXVDUVND =DU]\FND =DKUDGQLF]HN Roztwory elektrolitów

1D&O 5R]WZöU 5LQJHUD -RQRVWHULO 1RUPRIXQGLQ 6WHURIXQGLQ 3ï\Q ğ]MRORJLF]Q\ ZLHORHOHNWUROLWRZ\ 3ï\Q MHOLWRZ\ ]DSRELHJDZF]\ L]RWRQLF]Q\ 3ï\Q ĝRïÈGNRZ\ ]DSRELHJDZF]\ L]RWRQLF]Q\

Środki osoczozastępcze

'HNVWUDQ 3ODVPDVWHULO $OEXPLQ\ 9ROXYHQ +(6 *HODIXQGLQ

Roztwory węglowodanów

*OXNR]D *OXNR]D *OXNR]D

187

2EOLF]DQLH GDZHN OHNÏZ Z NURSORZ\P ZOHZLH GR \OQ\P

CD. TABELI 7.1.

Płyny specjalne

0DQQLWRO 7+$0 :RGRURZÚJODQ VRGX

3U]\NğDGRZ\ ]HVWDZ GR NURSORZHJR ZOHZX GRŃ\OQHJR 6SyMU] QD U\FLQĎ SU]HGVWDZLDMĂFĂ UR]WZRU\ GR LQIX]ML RUD] U\FLQĎ QD NWyUHM ]QDMGXMH VLĎ W\SRZ\ SRGVWDZRZ\ ]HVWDZ GR Z\NRQ\ZDQLD NURSORZHJR ZOHZX GRŃ\OQHJR

a

E

F

RYCINA 7.1 5R]WZRU\ GR LQIX]ML Dbļ EXWHOND V]NODQD E ļ EXWHOND ]bWZRU]\ZD V]WXF]QHJR F ļ ZRUHN SODVWLNRZ\

188

5R]G]LD

RYCINA 7.2

a

F

3U]\NïDGRZ\ ]HVWDZ GR NURSORZHJR ZOHZX GRĝ\OQHJR Dbļ JOXNR]D P/ E ļ DSDUDW GRbNURSORZHJR ZOHZX ĝ\OQHJR F ļ ]HVWDZ

E

3U]HG SRGğĂF]HQLHP ]HVWDZX GR LQLHNFML L XPLHV]F]HQLHP JR QD VWDW\ZLH QDOHŃ\ SDPLĎWDĄ R ]DPNQLĎFLX ]DFLıQLĎFLX ZV]\VWNLFK ]DFLVNyZ SR Z\SHğQLHQLX GR SRğRZ\ ŁUyGHğND U\F (WDS WHQ ]DSRELHJD WZRU]HQLX VLĎ SĎFKHU]\NyZ SRZLHWU]D Z SU]HZRG]LH DSDUDWX GR NURSOyZHN 3UDZLGğRZ\ SR]LRP Sğ\QX Z NRPRU]H NURSOyZNRZHM SRZLQLHQ ]QDMGRZDĄ VLĎ QD Z\VRNRıFL SRğRZ\ ŁUyGHğND -HVW WR LVWRWQH ]H Z]JOĎGX QD NRQLHF]QRıĄ PLHU]HQLD OLF]E\ liczonych kropli.

2EOLF]DQLH GDZHN OHNÏZ Z NURSORZ\P ZOHZLH GR \OQ\P

189

RYCINA 7.3 :\SHïQLHQLH ěUöGHïND GR SRïRZ\

.URSORZ\ ZOHZ GRŃ\OQ\ MHVW ]DELHJLHP VWRVRZDQ\P Z SU]\SDGNDFK JG\ Sğ\Q\ OXE UR]FLHġF]RQH OHNL PXV]Ă E\Ą DSOLNRZDQH GR Ń\ğ\ Z VSRVyE NDOLEURZDQ\ SRZROQ\ SU]H] ZLHOH JRG]LQ :\NRU]\VW\ZDQ\ MHVW JğyZQLH GR SU]HWDF]DQLD Sğ\QyZ Z ]DEXU]HQLDFK KRPHRVWD]\ Z RNUHVLH SRRSHUDF\MQ\P SRGF]DV GğXJRWUZDğHJR RGŃ\ZLDQLD SR]DMHOLWRZHJR RUD] Z UD]LH NRQLHF]QRıFL SRGDZDQLD OHNyZ Z UR]FLHġF]HQLX ,VWQLHMH PRŃOLZRıĄ GRGDQLD GR Sğ\QX LQIX]\MQHJR OHNX Z WUDNFLH SRGDZDQLD SDFMHQWRZL MHGQDN PXVLV] SDPLĎWDĄ ŃH QLH PRŃHV] ZVWU]\NLZDĄ UR]WZRUyZ QD SU]\NğDG FKORUNX SRWDVX ]D SRPRFĂ LJğ\ GR ZLV]ĂFHM NURSOyZNL JG\Ń PRŃH WR JUR]LĄ GXŃ\PL ZDKDQLDPL VWĎŃHġ L E\Ą ]DJURŃHQLHP GOD Ń\FLD SDFMHQWD 3U]HG SRGDQLHP OHNX GR ZRUND ] Sğ\QHP QDOHŃ\ ]GH]\QIHNRZDĄ NRUHN U\F 1DMF]ĎıFLHM Sğ\Q\ LQIX]\MQH SRGDMH VLĎ Z NURSORZ\P ZOHZLH GRŃ\OQ\P U\F 6]\ENRıĄ SRGDZDQLD Sğ\QX PXVL E\Ą GRVWRVRZDQD GR PRŃOLZRıFL NRPSHQVDF\MQ\FK RUJDQL]PX -HıOL Sğ\Q MHVW L]RRVPRW\F]Q\ PRŃQD SRGDZDĄ NURSOL QD PLQXWĎ =D]Z\F]DM Z VWRVRZDQ\FK NRPRUDFK NURSORZ\FK SRMHG\QF]H NURSOH PDMĂ REMĎWRıĄ P/ ] F]HJR Z\QLND ŃH Z P/ ]QDMGXMH VLĎ NURSOL U\F

190

5R]G]LD

RYCINA 7.4

RYCINA 7.5

'H]\QIHNFMD NRUND SU]HG SRGDQLHP OHNX GR NURSOöZNL

3RGDQLH OHNX GR ZRUND ]bSï\QHP LQIX]\MQ\P

RYCINA 7.6 .URSORZ\ ZOHZ GRĝ\OQ\

2EOLF]DQLH GDZHN OHNÏZ Z NURSORZ\P ZOHZLH GR \OQ\P

RYCINA 7.7 :\SHïQLHQLH ěUöGHïND GR SRïRZ\ RUD] UHJXODFMD NURSOL SU]H] SU]HVXQLÚFLH ]DFLVNX URONRZHJR

191

192

5R]G]LD

5R]WZRU\ KLSHURVPRW\F]QH R FLıQLHQLX RVPRW\F]Q\P Z\ŃV]\P RG IL]MRORJLF]QHJR SRGDMH VLĎ ZROQLHM ] V]\ENRıFLĂ RGZURWQLH SURSRUFMRQDOQĂ GR LFK FLıQLHQLD RVPRW\F]QHJR (PXOVMH ]DZLHUDMĂFH ID]Ď ROHMRZĂ SRGDMH VLĎ EDUG]R RVWURŃQLH L SRZROL ] V]\ENRıFLĂ ² NURSOL QD PLQXWĎ

RYCINA 7.8

RYCINA 7.9

2WZRU]HQLH ]DFLVNX URONRZHJR LbXVWDZLHQLH SUÚGNRĂFL LQIX]ML

:\SHïQLHQLH ěUöGHïND GR SRïRZ\ RUD] RGEH]SLHF]HQLH ]DFLVNX GR UHJXODFML SU]HSï\ZX NURSOL

7.2. OBLICZANIE CZASU ZAKOŃCZENIA KROPLOWEGO WLEWU DOŻYLNEGO 7.2.1. Obliczanie czasu zakończenia kroplowego wlewu dożylnego na podstawie czasu rozpoczęcia i czasu trwania wlewu 2EOLF]HQLH F]DVX ]DNRġF]HQLD ZOHZX NURSORZHJR W]Q REOLF]HQLH R NWyUHM JRG]LQLH ]RVWDQLH SRGDQD FDğD REMĎWRıĄ Sğ\QX SRGğĂF]RQD EXWHOND OXE ZRUHN LQIX]\MQ\ EĎGĂ RSUyŃQLRQH GDMH PRŃOLZRıĄ ZF]HıQLHMV]HJR ]DSODQRZDQLD RUD] SU]\JRWRZDQLD QDVWĎSQHJR roztworu do podania choremu.