slideshow widget

Sunday, August 30, 2015

'Olins: Part 3

The following is a continuation of our list of various types and forms of racemic and actual ventolin-tyes (o'lins) that we doctors keep esoteric from respiratory therapists so they continue to have procedures to justify their existence.  Oh, and the treatments actually do help for the various disorders listed below. Seriously, we are not making this up.

235.  Medicine:  Historolin

Diagnosis:  Asthma

Frequency:  Q4-6

Effect:  It is proven that keeping beta 2 receptors saturated with ventolin particles will keep asthma in remission.  Such therapy may be deemed profligate in the out of hospital setting.

236.  Medicine:  Abdomnolin

Diagnosis:  Had surgery on belly

Frequency:  QID

Effect:  Only works when prescribed by surgeon to prevent atelectasis and pneumonia caused by the surgeon.  Warning to physician: side effect to second hand ventolin types is respiratory therapy apathy and grumpiness, so stay out of their way. Still order it, though, we're just saying; they are lazy and will try to convince you it's pointless, but we know it is not pointless.  Yes, a study of 100 post op patients showed that, of 100 post op patients who were treated with QID ventolin, they all eventually got better.  So we know some form of ventolin must be ordered.  Note: not ordering Abdominoilin for post operative patients was not shown to decrease length of stay.  Side effect to patient may be increased desire to go home, agitation, and possible irritation with the therapist who continues to wake them up for breathing treatments when they already know they can breathe just fine.

237. Medicine:  Desatolin

Diagnosis: Aspiration Pneumonia

Frequency:  QID

Effect:  Once inhaled the ventolin particles join with a chemical called humidolin acetate to form H2O molecules.  As these accumulate over the course of many days the patient will become filled with increased fluid so that oxygen molecules can float to the surface of the lungs so they can be exhaled. May be tried with regular or faux pneumonia, although studies show that it works best for pneumonia that was caused by reflux of stomach contents. Helicobacter pylori (H. pylori), a common bacteria found in the intestinal tract, might actually plunge out of the water and be exhaled during the exhalation phase due to helicopter-like rotors that have previously eluded the vision of scientists but may be seen when the bacteria is attached to ventolin-like substances in the air.  It's a site worth seeing when hundreds, thousands, millions, even billions of H. Pylori escape their human captors in search of life on Mars.  The good news is they die within seconds of exhalation.

238.  Medicine:   HEALButerol®

Diagnosis:  Bone fractures

Frequency:  QID

Effect:  Rather than just giving albuterol to open up the air passages that are already open, this provides Orthopedic physicians a medicinal supplement proven to diffuse into the bloodstream once inhaled and seeps into bone material to cause fractured areas to rejoin and heal faster. The exact methodology is unknown, but a study showed that of 100 post op patients given HEALButerol® all eventually got better.  So this was indication enough to confirm that the medicine magically heals bones as well as opens up airways, even if the airways are already open.  You may also wish to try Knitolin.

Medicine:  Knitolin

239.  Diagnosis:  Bone Fractures, especially fractured ribs

Frequency:  QID

Effect:  It knits bones so they heal better and the patient breathes better at the same time.  If neither of those work, try tryagainolin.  It works best when given in tandem with an incentive spirometer  (IS)and acapella. Increased turbulence created by inhaling a deep breath with the IS pushes the knitolin particles deeper into the bone (sort of like hammer nail, so to speak) thus making the medicine particles work like a filling in a tooth to further supplement healing.  The acepella helps to loosen and free any bacterial particles that might collect inside the fractured portions of the bone and inhibit healing and/ or cause an infection.

240.  Medicine.  Trainwreck-uterol

Diagnosis:  Many, or Trainwreckeeeeism caused by the trainwreck virus that causes many of the organs of the body to become confused and not work right.  Trainwreck-ism is a another disorder caused by the trainwreck virus that causes nurses and respiratory therapists to make poor decisions that wreck things and people.  Trainwreckeeeism should not be confused with Trainwreck-ism.  Because trainwreckeeeism has a lot of e's in it, it can be treated the same way a wheeze is:  with an 'olin, particularly Trainwreck-uterol. Trainwreck-ism has no known treatment, and therefore you must not be anywhere withing 100 miles of such patients.  Usually they are not hired.  If they are, you should fire them immediately, because the disease is highly contagious.

Frequency:  Q4ever

Effect.  It has no effect on the disease processes, although it does attack to faux B2 receptors in throat muscles in and attempt to eeeeee-liminate the wheeze by soothing throat muscles (throatodilation) in order to make nurses and doctors happier.

241.  Medicine. Fusolin

Diagnosis:  Rib fracture

Frequency:  QID

Effect:  Increases tidal volume to prevent pneumonia and atelectasis.  Works similar to the way IPPB used to overinflate good alveoli.  May be alternated with Knitolin,  HEALButerol®, preventolin, postopulterol and tryagainolin.  May also try sputumolin to induce a cough.  Avoid using ventolin for its cough suppressant qualities, as this defeats the purpose.

242.  Medicine:  Lupisolin (aka Aligatoruterol, Sharkuterol)

Diagnosis:  Lupis

Frequency:  At least QID

Effect:  Ventolin particles go into the lungs and join with neutrophils to turn the ventolin particles into little critters that look like very sharp toothed alligators or sharks that kill and digest bacteria and viruses and other potentially harmful invaders so the immune system doesn't have to.  I guess you can say that the ventolin particles formed look and act sort of like Pac Man and Mrs. Pacman.  This works to suppress the immune system and to prevent inflammation caused by the disease, particularly in the heart, lungs, and brain (well, mostly in the lungs).

243.  Medicine:  Flapolin

Diagnosis:  Loose or damaged Mitral valve

Frequency:  Once

Effect:  Mitral valve may be heard flapping, meaning that the valve is leaky.  This form of ventolin causes an infusion of hardened, crystallized substances that are attracted only to the mitral valve to fortify it and assure the patient's safety until the valve can be replaced.

243.  Medicine:  Vasodilatolin

Diagnosis:  Hypertension

Frequency:  Q4-6

Effect:  Dilates vessels to decrease blood pressure. Will require frequent inhalations to assure a high enough dose of the medicine is in the bloodstream at all times. So this is why we recommend it be given Q4-6 rather than just QID.  A bonus is the patient will have to be awakened at least once, and this might make the patient mad and raise blood pressure that way.  It works the same as BiPAP, which has a benefit of increasing blood pressure.  May also place patient on BiPAP.  The more uncomfortable the settings the better the effect. Please, do not admit this to respiratory therapists. Oh, you did already: Doh!

244.  Medicine:  BiPAP-uterol DS

Diagnosis:  CO2 greater than 42 (boy, that's way too high, need to get it back down to normal)

Frequency:  QID, Q6, Q4, or just make something up

Effect:  Lubricates and soothes the vocal cords so you don't hear an audible wheeze (rhonchi, stridor). Works best if tried before BiPAP is ordered.  If doesn't work, order BiPAP.  Works well after BiPAP order too. If you continue to hear lots of noises in the lungs (especially if they annoy you), you probably should order BiPAP.  IN this case, the medicine mayu have a bonus of lubricating the lips and cheeks so you don't hear the BLLLLPPPPPLLLLLTTTTTTTHHHHHHHH due to the fact the seal is not tight enough.  It makes it so nurses don't keep calling respiratory because they don't feel like playing with the Velcro.  May alternate with BiPAPuterol (to ward off evil spirits so you don't have to eventually ventilate this patient).  Note:  For patients with a big scruffy beard, a double dose may be beneficial. Or, just get off your ass and tighten the mask might work just as well.  Or, if you're really brave, shave the beard)

245.  Medicine:  Normal Saline

Diagnosis.  Asthma, COPD

Frequency:  Q4

Effect:  Draws salt out of epithelial cells and Type-II alveolar cells in order to treat bronchospasm due to dehydration.

246.  Medicine: Retrospectuterol

Diagnosis. COPD, asthma, heart failure, pulmonary edema, kidney failure, lung cancer, etc.

Frequency: Q4-6

Effect:  The patient was short of breath greater than 24 hours ago, therefore albuterol is indicated today. The patient may have been short of breath yesterday, or may have experienced asthma symptoms (at the age of 6) 25 years ago.  Regardless, the retrospective qualities of albuterol-like particles have the ability to travel over the wrinkle in time scrub lungs clear of all past difficulties.

247.  Medicine. Keepmeinolin

Diagnosis. Respiratory failure, hypoxia, pneunonia, heart failure, dyspnea (all of which requires oxygen and IV medications to keep the patient alive)

Frequency. Q once

Effect.  Works similar to exercise in that it stimulates the brain to release a chemical called endorphins. They act like analgesics such as morphine to diminish the perception of pain, cause a sedative effect, reduce stress, ward off anxiety, ward off depression, boost self esteem, and improve sleep. It causes a sense of euphoria similar to that produced from morphine with out the risk of addiction.  Generally, the effect only lasts until the mist in the room clears, so it's usually only prescribed one time, as a last ditch effort, when a patient threatens to leave against medical advice (AMA).  The medicine should calm the patient down just enough to convince her that she really does need to be in the hospital.

247.  Medicine.  Transmitolin, Accousticsolin

Diagnosis.  CHF, Heart Failure, ETOH, Dehydration, old age

Frequency.  QID

Effect.  Prevents upper airway rhonchi from transmitting to other lung fields to prevent specious documenting of wheezes. It's a medicine that was concocted in the laboratory of Dr. Ven Tolin and his assistant, Paul RiTT, with the intent to discourage physicians from ordering breathing treatments due to upper airway noises confused for wheezing. The medical community generally has an aversion to this medicine, and so it has rarely been used to this point.  A Congressional Committee actually discussed this, and it almost made it into the Affordable Care Act in order to cut government spending, only to be cut from the bill at the last moment when it was discovered the individual hospitals have to absorb the costs of wasteful breathing treatments, and not Uncle Sam.

248.  Medicine.  Keepmeawakeolin

Diagnosis.  COPD, Sleep Apnea

Frequency.  Q4 ATC

Effect.  To a nerve cell, Keepmeawakeolin looks like a coffee molecule which looks like adenosine.  It then is allowed to attach to adenosine receptors, thus preventing adenosine from attaching to them.  So instead of adenosine slowing you down so you can sleep, Keepmeawakeolin keeps you awake.  Adenosine dilates blood vessels in the brain, presumably to keep your brain well oxygenated while you are sleeping and your breathing is more relaxed. Keepmealiveolin mimics this effect, thus causing vasodilation of the vessels in the brain to assure adequate oxygenation while you are not sleeping.  A side effect of this is that it may cause a headache, which is where caffeine comes in handy.  About three hours after dosing, keepmealiveolin starts to dissolve, opening up just enough adenosine receptors for caffeine to attach.  This should be enough, however, to constrict brain vessels, thus ridding you of your headache.  Still, once the rest of the keepmealiveoline molecules dissipate, the next dose should be due. A morning dose of coffee is highly recommended, although it should be given about an hour prior to the treatment is due.

A side effect is insomnia that lasts for the duration of this type of treatment.  It is typically not recommended to continue this treatment after discharge to home, as it often results in the viscous and never ending cycle of taking keepmealiveolin to improve oxygenation while you are sleeping and drinking coffee to offset the side effect of headache in the morning.  Another side effect is refractory headache, which is a headache caused by the medicine to begin with.  After doing all this reading (if you are still with me), the brain usually forgets about the bronchodilating effect.  Another idea is to only give the medicine at night, and allow the patient to refuse therapy while awake. Still, because respiratory therapists hate waking people up, an ideal order for this is Q4 ATC (Around The Clock).  This lets the RT know you mean business.

249.  Medicine. Alcurital (See Ad Here)

Effect.  This is the only medicine clinically not proven but believed to by nurses and... doctors (yes, doctors) to cure all that ails you And best of all It works even when You have clear lungsounds Hence the name: Alcurital.

Side Effects: Alcurital.for clear lungsounds. Side effects include anxiety, nervousness, headache, increased heart rate, death if consume more than 55 miligrams in a day, boredom, pissy RTs. However, studies show the medicine cures all ailments, but it has no effect on stupidity. Do not use if you have a wise physician or nurse.  Not expected to result in increased brain cells. Not expected to prevent accidents. While it can be used prophylactically, it will not prevent all ailments. Don't worry, as no studies were done to come to any of these conclusions, it's simply based on feel good: it looks good, sounds good, feels good, then it is a fact. One study of 100 post op patients given Alcurital eventually recovered, so now it only makes sense that it

250.  Medicine.  Mucinexolinuterol

Diagnosis.  COPD, pneumonia, Cystic Fibrosis

Symptom.  Thick secretions; difficult expectoration

Efficacy.  The fact that the suffix olin and the suffix uterol are in the name means it has 10 times the ability to loosen thick secretions as Mucinex and albuterol alone.

251.  Medicine. Diverticulobuterol

Diagnosis.  Diverticulosis

Frequency. QID

Effect.  Bronchodilators have been shown to attach to fake beta receptors in the colon to relax smooth muscles that wrap around the intestines to help release trapped particles.  Similar to pneumonia, the medicine also magically reduces inflammation and smelling to ease pain and suffering caused by diverticulitis.

Further reading:
  1. Fake 'Olins Part 1
  2. Fake 'Olins Part 2
  3. Faux Physician's Creed

No comments: