L’ivermectine (Stromectol) est un antiparasitaire dont l’action repose sur la liaison sélective aux canaux chlore activés par le glutamate présents dans les cellules nerveuses et musculaires des parasites. Cette fixation entraîne une augmentation du flux de chlore, provoquant une hyperpolarisation et une paralysie irréversible. L’ivermectine est active contre la gale, l’onchocercose et certaines strongyloïdoses. Sa biodisponibilité orale est variable, augmentée par la prise alimentaire, et son élimination est principalement fécale via un métabolisme hépatique. Elle ne traverse pas la barrière hémato-encéphalique, ce qui limite les effets neurologiques chez l’homme. Les précautions concernent l’interaction avec les inhibiteurs du CYP3A4, ainsi que les réactions inflammatoires dues à la destruction massive des parasites. Dans les documents de référence, stromectol prix est associé à des protocoles précis adaptés aux différentes infestations, avec une attention particulière sur la sécurité d’emploi en cas d’immunodépression.

Microsoft word - quick guide drg reimbursed

Use this as a quick guideline to submit discharge reviews for DRG-reimbursed hospitalizations. Log in to eQSuite and click Create New Review on the menu bar. Here is the simplified 4-step process to enter DRG DISCHARGE reviews online:
9 Select 'Cont Stay' from drop down box 9 Enter actual d/c date and # of days requested =1 9 If pending labs from admission; enter in Summary tab 9 Select 'discharge to' reason from drop down menu. 9 Include discharge date and clinical summary (the 24 hrs prior to discharge) with progression of care, resolution of symptoms, any outstanding labs, disposition of patient readiness for discharge. Record any hospital acquired conditions (i.e. infections, falls, med errors etc.) SUBMIT FOR REVIEW
For Example ONLY: DRG Admission and DRG Cont Stay (Discharge)
Admit Dx: 486 Pneumonia, Admit Date: 4/20/2011
ADMISSION REVIEW:
START Tab: Select setting and Review Type: Admission
Fill in with all pertinent patient, physician, and quality screening questions
Click Check Key at bottom. Verify Patient Contact Information (check box and click OK)
Skip DX/PROCS Tab

VITALS/LABS Tab: Fill in only abnormal or positive lab findings
Temp: 98.8 Oral Pulse: 88 Resp: 26 BP: 110 54
Pulse Ox: 92% Blood Work: WBC: 15.4 Hgb: 11 mg/dL
Chemistries: Blood Glucose 116 mg/dL Chloride: 97 mEq/L
FINDINGS Tab: Check off any indicators, tests, relevant to patient's inpatient dx & tx
O2: 3L on 4/20/11 Blood culture: Pending (check off even if pending)
CT: Brain = cerebral volume loss w evidence of mod chronic ischemic chg.
Abnormal CXR: new interstitial infilt changes in rll
D/C Tab: Brief discharge plan
Discharge to: Home Plan: Home with physician follow up
MEDS Tab:
Add Inpatient Meds: Levoquin 750 mg IV x1, Vancomycin 1000 mg IV x1 initial then
q8hrs, Dilantin 800 mg IV x1. Be sure to add start date and end date when applicable.
SUMMARY Tab:
4/20/11: Pt to er w seizure-like activity x2 today, frontal headache. Hx: CHF, Lung
cancer and seizures. Pt O2 dependent at home on 3.5 liters. Pulmonary and neuro
consults ordered. Albuteral nebs ordered q 4 hrs.

DISCHARGE REVIEW (see attached):
START Tab: Select "Cont Stay", enter TAN, hit Retrieve Data
Enter actual discharge date and number of days requested = '1'

VITALS/LABS Tab: Enter latest vital signs. Go to D/C Tab. Include any pending
labs in Summary tab.
Skip FINDINGS Tab

D/C Tab: Discharge to: Home Plan: Home with physician follow up 1 week.
Skip MEDS Tab

SUMMARY Tab: (Include discharge date, clinical summary with progression of
care, resolution of symptoms, disposition of patient and readiness for discharge.
When applicable, include any hospital acquired conditions (i.e. infections, falls,
med error)

4/24/11: Repeat labs wnl, vss, afebrile, sats 98% on RA. Blood culture negative.
CXR: resolved, home with 4L NC and oral antibiotics.

Source: http://il.eqhs.org/Portals/0/Quick%20Guide%20DRG%20Reimbursed.pdf