More Fake-'Olins: (To view the top 171 'olins click here)The following list has been prepared to further specific aid to the respiratory therapist's understanding of breathing treatments that have been clear to registered nurses and doctors for years. Symptom: hypoxia, high CO2, pulmonary edema
Effect: The patient wearing a 75 percent non rebreather mask to maintain an spo2 of 90% must be given Ventolin because it causes the patient to become hypoxic during the treatment. Yes, you read that right. The goal here is that the 5-10 minutes of hypoxia that occurs during the treatment will increase the patient's respiratory rate in order to blow off excess CO2. Respiratory Therapist grumbling to be expected.
Note for doctors who barely passed med school: A breathing treatment from an oxygen source provides approximately 60 percent oxygen. A nonrebreather does not produce 100 percent oxygen because one flap is always missing due to litigation purposes, and this results in an estimated FiO2 of 75 percent.
If 75% Fio2 was maintaining a 90% SpO2 you can expect the patient's SpO2 to drop to 85 percent during this highly recommended therapy. In England this exercise is called hypoxia therapy, yet here in America we don't want to be that obvious, so we just call it an Albuterol breathing treatment.
173. 0.5cc Postoponepherine
Symptom: post operative stridor, ghasping noises due to inadequate breathing, low spo2,
Diagnosis: Noted bronchospasm. The RT will say patient has sleep apnea, but we know it's bronchospasm. What the hell, bronchospasm is the only thing that can cause such annoying lung sounds.
Frequency: Q1
Effect: Patient will eventually wake up from the anesthesia and we can give credit to the breathing treatment.
Symptom: Hearing voices, delusions, disorganized speech, social and occupational dysfunction
Diagnosis: Schizophrenia
Frequency: QID
Effect: The Greek term skhizein means to split. By inexplicable means the S(hit) isomer of the Aluterol molecule is believed to un-split the personality, thus making it easier to for the person to communicate. Side effect may include innocuous mumbling and faux obstructive lung disease.
176. 0.5cc Hiccuputerol
Symptom: Patient has hiccups
Diagnosis: Any
Frequency: Q4
Effect: Crosses blood brain barrier, specifically targets the phrenic nerve, and, ultimately, connects with receptor sites on the diaphragm to cause it to relax. May or may not cause immediate effect, but hiccups will eventually go away
177. 0.5cc Husholin
Symptom: Patient talking too much
Diagnosis: Generic
Frequency: Q4 or QID
Effect: The theory is that a patient can't atlk with a pipe stuffed in his mouth. Don't be shocked if patient talks nonstop during treatment. Not to be confused with microphonuterol.
178. 0.5cc Microphonuterol
Symptom: Patient annoyingly talks to much
Diagnosis: Any
Frequency: Q4
Effect: Albuterol nebulizer acts as a microphone encouraging the patient to talk and talk and talk and talk about nothing you want to talk about. The idea here is similar to
RN rule #62 whereas the patient is annoying so respiratory therapy must be involved in patient care.
179. 1.25mg Taciturnex
Same as Husholin but with a cooler name.
180. 1.25 Fluidenex
Symptom: Patient rattling can be heard across room, rhonchi/ rhales, initially patient in respiratory distress, patient may initially present in failure with a pH of less than 7.30. BiPAP may or may not be utilized.
Diagnosis: CHF, MI, pulmonary edema, fulmonary edema
Frequency: Continuous then Q4
Effect: This is isomer of Ventoiln actually works by simply adding moisture to an already wet lung. We know this sounds crazy, but the extra fluid in lungs actually helps push fluid out of lungs into bloodstream where it is excreted with help of any diuretic. Works best if in conjunction with BiPAP. This works better than BiPAPuterol due to cardiac cause.
181. 0.5cc BiPAP uterol
A cheaper version of Fluidenex
182. 0.5cc Revivolin
Symptom: Obtunded patient
Diagnosis: Generic
Frequency: QID
Effect: Crosses blood brain barrier to stimulate brain cells and increases patient alertness. Some patients may actually, eventually open their eyes.
182. 0.5cc Biodunculator
Symptom: Surgery
Diagnosis: Abdominal, thoracic
Frequency: QID for 3 days post operative
Effect: Simple spelling change proves that surgery is an indication for bronchodilator.
183. 0.5cc Tachypnolin
Symptom: Tachypnea (speedy respiratory rate)
Diagnosis: Hyperventolating patient, anxiety
Frequency: Q1 time
Effect: We don't know what else to do to slow down the respiratory rate so why not try a bronchodilator. May alternate with Coolovent or Preventolin.
184. 0.5cc Nosocomialmenicocciwestnilevirusolin
Symptom: Anal problems
Diagnosis: Generic
Frequency: Q4 ATC
Effect: Um, we're sure it does something to make patient get better eventually.
185. 1.25 Expandenex
Symptom: Fever
Diagnosis: Atelectasis, post op, pneumo
Frequency: Q4
Effect: The med magically shrinks to 1 microns and passes through bronchioles to alveolar region and fills the alveoli up with ventolin molecules and, thus, expanding them. Works similar to PEEP.
186. PEEPuterol
Similar to Expandenex except the S(hit) isomer binds with the R-isomer to prevent the medicine from sticking to the ventilator/BiPAP circuit.
187. 0.5cc Becauseolin
Symptoms: Weak, fell, possible ETOH, roting skin, malnutrition, poor general health, patient homeless or simply poor self care, possible gangrene, possible non compliant patient
Diagnosis: Unknown, GI bleed, MRSA, ETOH, possibly even sepsis, pneumonia, c-diff, hepatitis, Aids, metabolic disturbance, electrolyte imbalance, etc.
Frequency: Now and Q4 if patient admitted.
Effect: Has no known effect, but we know that if patient has a morbid smell or is obnoxious RT should be involved in patient's care (
see RT rule #62). Studies are inconclusive, but we have to keep ordering it because there is still that one percent chance it might have some sort of effect.
188. Leavemyassaloneolin
Symptom: No signs of respiratory distress. May have smoked once. May have had asthma once. Stridor. Cardiac wheeze.
Diagnosis: General, nosocomial COPD
Frequency: Ordered Q4, but patient will refuse
Effect: Works same as Ventolin. Dr. was called so many times by the RT that he simply ordered treatmetns just to get the RN to quit paging him.
189. 0.5cc InfluVentolin
Symptom; General malaise
Diagnosis: Influenza
Frequency: One amp
Effect: The influenza virus binds with the Ventolin and is exhaled by patient. A famous advertising slogan for this new medicine is: "In flew Enza, in flew Ventolin, out flew influenza."
190. Ventolin MRSA
Symptoms: General
Diagnosis: Spontaneous MRSA, usually patient who has been in hspital at least a week
Frequency: Q4
Effect: Ventolin leaves lungs and hunts down MRSA bugs and eats them up. Okay, so this isn't true, but we don't know what else to do, so we might as well annoy RT.
191. Ventolin PIA
Symptom: General
Diagnosis: Pain in the ass patient (PIA)
Frequency: Q4
Effect: This is a medicine like Duoneb, ni which it is a mixture of Becausolin and Leavemyassaloneolin. The theory is that if the patient is a PIA, we need to get RT involved (see
RN Rule #64)
192. Toolateolin
Symptom: Varying critical symptoms from grim to post CPR
Diagnosis: See list in the effects section below
Frequency: Continuous
Effect: Most effective treatment for hopeless conditions. Use should be initiated by RN only. Drug has demonstrated no untoward effect when used for pulmonating edema, pneumothorax, cardiac tamponade, severe chest trauma, upper airway obstruction, nor agonal breathing. Like Xopenex, this drug comes ni varying doses for cardiopulmonary arrest, v-tach, prolonged apnea, multi-system failrue, end stage mets, pulmonary infarct, rigor mortis or any other condition threatening imminent mortality
Note: Technically speaking, this should be alternated with Fuckonex, but at this point which medicine you use is basically a crapshoot anyway, but we gotta do something.
193. Tryagainolin
Symptom: Varying critical symptoms from grim to post CPR
Diagnosis: SGD, HGD, STD
Frequency: Continuous
Effect: A version of Toolatolin (as described above). Used continuous for prolonged periods should result in relief for all involved, with exception of patient and RT.
Note: Repeated use on multiple patients of Toolateolin, Waytoolatolin, or tryagainolin may result in changes. Normally witty RTs may respond to reasonable treatment requests with caustic cynicism. Normally, cynical RTs may respond to idiot requests with unconcealed anger. Normally, angry RTs may become despondent and resort to tears after self mutilating their heads on teh closest brick wall.
194. Waytoolateolin
Symptom: Very critical symptoms from grim to post CPR
Diagnosis: SGD, HGD, STD
Frequency: Continuous
Effect: A version of Toolateolin (as described above). Used continuous for prolonged periods should result in relief of all involved, with exception of patient and RT.
Further precautions: Treatments with Toolateolin, Muchtoolateolin and Waytoolateolin must be carefully documented. Charted comments such as "this treatment was a worthless waste of time," or "patient remained apneic post treatment," may prove to be uncomfortable for doctors, RNs and RT department supervisors resulting in further unenhanced working conditions or threatened continued employment.
195. Muchtoolateolin
Symptom: Apnea, flatline
Diagnosis: Death
Frequency: continuous
Effect: May help bring the patinet back.
196. 0.5cc MI-olin
Symptoms: Chset pain maybe, hypoxemia, EKG that shows elevated ST segment, No respiratory distress. May present with low SpO2 (75%) which increases with NRB
Diagnosis: General
Frequency: Q1 (may repeat)
Effect: The medicine diffuses across the pulmonary membranes, to the bloodstream, and works its way to the heart, increasing the affinity of oxygen to necrotic tissue. It also dissolves clots in the coronary arteries. This should be followed by a STAT EKG, which should show that what was previously thought to be an MI is now. RT will cringe about the treatment, and groan about the oxygen boost fixing the patient.
Note: Should alternate with coronoryolin and angioplastybuterol
197. Angioplastybuterol
Symptoms: Chest pain maybe, hypoxemia, EKG shows elevated ST segment, No respiratory distress. May present with low SpO2 (75%) which increases with NRB.
Diagnosis: General, MI
Frequency: Q1 (may repeat)
Effect: The Ventolin molecules shrink to 1 micron and travel across the alveolar capillary regions, through the bloodsteam and back to the heart where they collect around the clot and build-up over time. After a while there will be enough ventolin molecules in front of the clot that the artery will dilate. This will negate the need for a balloon angioplasty or any other annoying test for the patient.
Note: Should alternate with MI-olin and S
198. Insulinolin
Symptoms: Various. Basically doctor has no clue
Diagnosis: Various
Frequency: Various
Effect: The patient's just not right, so we better just do a treatment. Who cares that the patient's insulin is 40.
199. Insulinex
Same as Insulinolin except the deletion of the R-Isomer makes the Albuterol molecule more slick and provides quicker access to the body.
200. Mucobuterol
Symptom: Crackles in one base, mild sob, perhaps a dry, harsh barking, nonproductive cough
Diagnosis: Mostly pneumonia, but possibly a little pulmonary edema
Frequency: Q1 and then again in an hour and then an hour after that and an hour after that... until patient is good enough to no longer need the ER
Effect: Why waste your time writing the order for mucomyst with Ventolin when all you need to do is order mucobuterol, which works more quickly adn easily than mucomyst. The bonds of Albuterol blend in with the mucous and the receptor cells of the Albuterol turn into little tiny scissors and chop up the mucous to make it easy to cough up.
Note: Usually patient will be discharged to home without being able to expectorate anything, but that doesn't mean the therapy might not work at some point in the couple weeks.
201. Angioplastybuterol
Symptom: CP, EKG changes, ST elevation, pt denies any distress whatsoever, patient may present with low SpO2 that increases with NRB.
Diagnosis: MI
Frequency: Q1
Effect: This med must be given just prior and immediately after placing patient on NRB. Repeat EKG will show that ST elevation is gone. RT will grumble this is result of oxygen boost, but we know it was the treatment. By some magic power Albuterol now is capable of dissolving a clot in the coronary arteries and fixing an MI
202. Sputum-thinner-olin
Symptom: Denies SOB, Dr. wants a sputum specimin. Spo2 mid 80s
Diagnosis: Who knows
Frequency: Q1 hour in ER until patient is admitted to floor or discharged to home
Effect: It works more powerfully than mucomyst to thin secretions that really don't need thinning. It's also supposed to increase the sat, although it doesn't increase the sat (the oxygen does). Okay, well, this is too complicated to explain to an RT. So, just give them this line and listen to them grumble and groan: "Because her sats were in the mid 80s, I thought a treatment would help with that. I also think she has thick sputum, and the treatment might loosen things up a bit." Just memorize that line.
203 Procedurecountuterol
Symptom: General
Diagnosis: General
Frequency: Q4 ever
Effect: Creates work for RT so they don't have to file for unemployment
204. Apneabuterol
Symptom: Apnea, stridor, snoring, grunting with inspiration instead of getting air
Diagnosis: Obstructive Sleep Apnea
Frequency: Q1 post operative
Effect: The patient is grunting with inspiration and not breathing adequately so the patient must be having bronchospasm. May alternate with postopenepherine (see above).
205. Ipso facto buterol
Symptom: General
Diagnosis: General
Frequency: General
Effect: Ipso facto is a Latin phrase that means "by the fact itself." This means that an effect is a direct consequence of an action. For example, the ordering of Albuterol for all annoying lungsounds and all shortness of breath is ipso facto stupid because it's done as a cover for something else, such as lack of intelligence. In this way the act (the ordering of albuterol) puts the actions of the doctor in question.
206. Muco-hopo-myst
Symptom: None apparent, doctor not sure what to do for patient
Diagnosis: Doctor not sure
Frequency: Every other treatment
Effect: The idea here is if one medicine is good adding a second medicine is great and adding three is even better. What else can we throw at the patient. We throw everything we have at the patient and hope something works, and then we give credit to the nebulized medicine.
207. Ciliabuterol
Symptom: congested airway, trouble breathing
Diagnosis: Aspiration pneumonia, pneumonia, chronic bronchitis
Frequency: Q4
Effect: The albuterol rains out on the cilia in order to increase ciliary action. This rainout works like watering a vegetable garden, and causes the cilia (like vegetables) to grow full and thick and function well. This allows for improved mucociliary clearance.
208. B2 Uterol
Symptom: Rapid onset dyspnea
Diagnosis: Emphysema, pneumothorax
Frequency: Continuous for one hour
Effect: If you give the treatment long enough you'll assure there are at least two beta adrenergics sitting on each beta adrenergic receptors. The goal is that once the chest tube is inserted the air will come out twice as fast (b2 = beta *2 or twice the effect)
209. Virtigobuterol:
Symptom: Virtigo
Diagnosis: Virtigo
Frequency: Once is plenty.
Effect: Ventolin grabs CO2 and holds tight and goes along for ride acoss blood brain barrier to steady the infrastructure in your head so you don't feel like your movin no more. It also can be squirted in the ear to relieve virtigo caused by inflammation of the inner ear.
210. Flatulin
Symptom: General
Diagnosis: Any post op
Frequency: Q4
Effect: Gives em gas eventually. Helps get the bowel's moving. It's a gas. Given post op to get 'em farten.
211. Achoobuterol
Symptom: Sneeze
Diagnosis: Allergies
Frequency: Q4
Effect: None noted, yet it sounded like a cool name. Maybe the mist spewing from your mouth has some bronchodilitating properties. Ah, probably not.
212. ASID-userol
Symptoms: Shortness of breath, rapid deep breathing,
Diagnosis: Metabolic Acidosis
Frequency: Q4
Effect: All metabolic acidosis conditions must be treated with ASID (Albuterol Solves Increment Disorders).
213. RT Buterol
Symptom: Pt doesnt' look quite right
Diagnosis: Faux Pneumonia
Frequency: Q4 and 2prn
Effect: The fake diagnosis of pneumonia automatically requires RT to be in room every 4-6 hours to assess patient. May alternate with assessuterol.
213. NFR buterol
Symptom: Inconventiently low spo2
Diagnosis: Post op patient who was supposed to go home two hours ago but can't because the dog gone sat won't go up higher than 88 percent.
Frequency: Once
Effect: No F-ing reason for the treatment the surgeon was getting tired of watching the pulse ox and finally realized he couldnt' wish it higher so a breathing treatment was the only option left that he could think of. Hah, this way the RT can take over watching the pulse ox monitor. This sort of plays along the old theory: When in doubt, call RT.
214. Infiltratuterol
Symptom: Inconveniently low SpO2
Diagnosis: Post op patient who was supposed to go home two hours ago but can't because the dog gone sat won't go up higher than 88 percent and we've already tried NFR buterol and it didn't do any good.
Frequency: Once after trial of NFR buterol and X-ray taken
Effect: The X-Ray surprisingly showed new infiltrate so -- based on the x-ray alone -- the patient MUST have Albuterol. Note: Infiltrate in this case must also mean bronchospasm. It has absolutely nothing to do with overloading the patient with fluid during surgery. ABG must be ordered 30 minutes after bronchodilator to check efficacy of therapy
215. X-Ray Buterol
Symptom: Low SpO2, respiratory distress,
Diagnosis: Faux pneumonia, fulmonating pulmonary edema, pedal edema, post operative with invonveniently low spo2, inexplicable dyspnea
Frequency: Q once
Effect: Observation of inexplicable infiltrates on x-ray means Albuterol must be indicated.
216. ABGuterol
Symptoms: Abnormal ABG
Diagnosis: General
Frequency: Once
Effect: So the ABG wasn't normal Albuterol must be indicated. ABG must be repeated one hour after ABGuterol. Note: Such an order is proven to cause RT to get the ABGbies.
217. Advairuterol
Symptom: NARDN
Diagnosis: pre operative, general
Frequency: Once
Effect: The patient forgot his Advair so Ventilin is indicated just prior to the surgery.
218. 1.25 Slowpenex
Symptom: Rapid heart rate
Diagnosis: COPD
Frequency: Q6
Effect: Cardiac muscle has a high affinity for this inhaled medicine. It has the soothing ability to talk the heart down to a rythm doctors like. It should slow down within 4-8 hours, or at least by the time the patient is discharged. Medicine must be continuously in system to have a chance to work, so most experts recommend a dosage every six hours. Most studies show the heart rate should be slowed down by the 5th treatment, but just in case the order should be maintained until patient discharge.
219. Ipatropium Slowmide
Symptom: Rapid heart rate
Diagnosis: COPD, general
Frequency: QID
Effect: Generally used in conjunction with slowpenex. Ipatropium slowmide has this uncanny ability to conjoin with slowpenex molecules to speed up it's effect in slowing the heart.
220. Fastuterol
Symptom: Slow heart rate
Diagnosis: General
Frequency:
Effect:
221. Slopenex (not to be confused with slowpenex)
Symptom: General
Diagnosis: COPD
Frequency: Q4-6 ATC
Effect: Helps create a sliding scale whereby the doctor can adjust the SpO2 to the preferred slope along the oxyhemoglobin disassociation curve. Ideal for CO2 retainers.
222. Conincidentonex
Symptom: High heart rate, dyspnea with exertion
Diagnosis: CHF, pericardio effesion, asthma, COPD, atrial fibrillation
Frequency: Q6
Effect: Patient presents with high heartrate due to exacerbation of disease process and has received one or more amps of Albuterol. A simple change from Albuterol to Xopenex and the heart rate will eventually, coincidentally go down. We must give credit to the Xopenex for the decrease in heart rate.
223. Coincidentonex
Symptom: Dyspnea
Diagnosis: COPD/CHF, pericardioeffusion,
Frequency: Q4-6
Effect: Must be given in conjunction with diuretic. Study showed 100 patients given diuretic and ventolin together eventually got better, and credit is given every time to the bronchodilator.
224. Good-to-the-last-drop-uterol
Symptom: Dyspnea
Diagnosis: COPD
Frequency: Q4
Effect: Must puff on neb until every drop of fluid mists from the cup. Studies show medicine is gone long before last drop of water, yet psychological benefit further dilates bronchioles.
225. Pericardioeffusolin
Symptom: Dyspnea
Diagnosis: Pericardoeffusion
Frequency: Q6 ATC
Effect: By powers unbenownsed to RTs Albuterol particles somehow work to absorb fluid from pericardial sac to decrease dyspnea. Note: Dyspnea may not be reduced, but this doesn't mean medicine isn't working. May alternate with absorbolin because one or the other might work.
226. Babysittolin
Symptom: General
Diagnosis: General
Frequency: At least Q6
Effect: It's essential that if the doctor thinks the patient bears watching aerosolized medicine must be ordered at a regular frequency so RT can assess the patient every so often. It gets the doctor out of having to assess the patient and takes off pressure from nurses. The RT, in effect,
babysits the patient for duration of therapy. RTs may complain that they aren't neb jockies, yet we beg to differ. WE KNOW BABYSITTERS are essential.
227.
SedateuterolSymptom: No symptoms at all, in fact patient is lying in bed all comfortable and showing no signs of respiratory distress whatsoever
Diagnosis: Sedated post operative, sedate due to detox
Frequency: Q6 prn but must do treatment because RN insists
Effect: The patient was refusing need for bronchodilator when he was awake. Yet now that he's too sedate to speak for himself he must be having bronchospasm.
228.
T.O. XopenexSymptom: Continuous calls from RN that the patients sats are low, rhonchi, shallow breathing due to sedation
Diagnosis: general
Frequency: Q4
Effect: Telephone Order (TO) Xopenex is indicated following formal assessment of the patient over the phone
and the patients stated heart rate is greater than 100.
229.
T.O. AlbuterolSymptom: Continous calls from RN that the patients sats are low, rhonchi, shallow breathing due to sedation
Diagnosis: general
Frequency: Q4
Effect: Telephone Order (TO) Albuterol is indicated following formal assessment of the patient over the phone
and the patient's stated herat rate is less than 100. May alternate with ESPuterol and Assessolin
230.
R.N. Albuterol (a.k.a. RNA)
Symptom: General
Diagnosis: General
Frequency: Any
Effect: The pt doesn't need the treatment but the nurse said so. So there!!!!
231. TB Buterol
Symptom: none
Diagnosis: Tumor of the cecum/ history of TB in the 1920s
Frequency: QID
Effect: Immuno-impressive properties of the proventil prevent tuberculosis from returning
232. Annoying LS Buterol
Symptom: Annoying lung sounds (LS)
Diagnosis: general
Frequency: QID
Effect: Patient has annoying lung sounds so patient must be treated as an asthmatic.
Note: A common remark from these patient's is: "They say I'm short of breath but I feel fine." Don't let this stump you, the patient is still having bronchospasms.
233. PODuterol
Symptoms: General
Diagnosis: General
Frequency: Q4 or greater
Effect: POD is an acronym for pissed off doctor The only known effect is to cool off a tempered physician.
211. Deflatuterol -- side effect pneumo
Symptom: Dyspnea,
Diagnosis: Emphysema
Frequency: Q4
Effect: Deflates overdistended alveoli
211. Bullshituterol
Symptom: Any
Diagnosis: Any
Frequency: Any
Effect: None. No contraindications
212. O-buterol: Indicated for those old, toothless folks who lie around snoring through that big O. There's an old lyric that goes something like: O-buterol, O-buterol, O how I love O buterol.
213. Aerobuterol: The patient has good air movement so B2 agonist indicated to make sure it stays this way. May be rotated with preventolin. May also use preventolatorolin, keepmealiveolin, or helpmecrosstheperlygatesolin. Choose the most appropriate Ventolin.
214. Nococomialin. Yes, that's an old one but a good one. If I remember right it works to prevent nosocomial COPD. I can't remember the action, do you?
215. ESPreventolin: Starts dilating air passages before treatment given and even before patient admitted. Must be ordered Q1 while patient still in ambulance
216. Peptobuterol: Indicated for dyspnea caused by bloated, rock hard stomach. Attaches to fake B2 Receptors in stomach to enhance effect of antacids. Should be ordered Q1 until discharge.
217. PR Buterol: The mist has a special spin to convince RNs that you are not lazy and trying to get out of work.
218: Drierbuterol: Someone comes in with foaming pulmonary edema it must be given stat. Effect: Albuterol molecules turn into little hair driers and blow warm air over wet alveoli to dry them out. Dryerbuterol? Perhaps the fact I spelled it wrong makes it work better.
219. VentOILin: An oil-like substance that helps to lubricate the space between the heart and the lungs. It's beneficial for any condition of the pleural space that causes friction, especially pleurisy. If an EKG is ordered at the same as as VentOILin you should do the treatment first because a reduction of friction may make the EKG look smoother. May also help with insertion of chest tubes if one dose given approximately 30 miniutes prior to procedure.
