Medical term:

SIMV



ventilation

 [ven″tĭ-la´shun]
1. the process or act of supplying a house or room continuously with fresh air.
2. in respiratory physiology, the process of exchange of air between the lungs and the ambient air; see alveolar ventilation and pulmonary ventilation. See also respiration (def. 1). Called also breathing.
3. in psychiatry, verbalization of one's problems, emotions, or feelings.
alveolar ventilation a fraction of the pulmonary ventilation, being the amount of air that reaches the alveoli and is available for gas exchange with the blood.
assist/control mode ventilation positive pressure ventilation in the assist-control mode; if the spontaneous ventilation rate falls below a preset level, the ventilator enters the control mode.
assisted ventilation artificial respiration.
assist mode ventilation positive pressure ventilation in which the ventilator is in the assist-control mode; see also control mode ventilation and assist/control mode ventilation.
controlled ventilation (control mode ventilation) positive pressure ventilation in which the ventilator is in control mode, with its cycle entirely controlled by the apparatus and not influenced by the patient's efforts at spontaneous ventilation.
high-frequency ventilation a technique of mechanical ventilation that uses very high rates (over 80 breaths per minute) and small tidal volumes (equal to or less than dead space); it may either be positive pressure ventilation or be delivered in the form of frequent jets of air. It is used to lower the peak airway pressure applied to the lung, thus decreasing the risk of barotrauma.
high-frequency jet ventilation a type of high-frequency ventilation characterized by delivery of gas through a small catheter in the endotracheal tube.
high-frequency percussive ventilation a type of high-frequency ventilation characterized by delivery of pressure-limited breaths in short bursts of gas from a venturi mask.
high-frequency positive pressure ventilation a type of high-frequency ventilation characterized by low compressible volume circuit and tidal volume delivery of 3 to 4 mL per kg.
impaired spontaneous ventilation a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a state in which an individual's decreased energy reserves result in inability to maintain breathing adequate to support life. See also spontaneous ventilation.
intermittent mandatory ventilation (IMV) a type of control mode ventilation in which the patient breathes spontaneously while the ventilator delivers a prescribed tidal volume at specified intervals and allows the patient to breathe spontaneously between cycles. The ventilator rate is set to maintain the patient's PaCO2 at desired levels and is reduced gradually to zero as the patient's condition improves. See also intermittent positive-pressure breathing.
intermittent mandatory ventilation, synchronized (SIMV) positive pressure ventilation in which the patient breathes spontaneously while the ventilator delivers a positive-pressure breath at intervals that are predetermined but synchronized with the patient's breathing.
intermittent positive pressure ventilation (IPPV) intermittent positive pressure breathing.
maximal voluntary ventilation (maximum voluntary ventilation (MVV)) the maximum volume that can be exhaled per minute by the patient breathing as rapidly and deeply as possible. Called also maximal breathing capacity.
mechanical ventilation
1. ventilation accomplished by extrinsic means, usually distinguished as either negative pressure or positive pressure ventilation. See also spontaneous ventilation.
2. in the nursing interventions classification, a nursing intervention defined as the use of an artificial device to assist a patient to breathe.
minute ventilation the total volume of gas in liters expelled from the lungs per minute. See also minute volume. Called also total ventilation.
negative pressure ventilation a type of mechanical ventilation in which negative pressure is generated on the outside of the patient's chest and transmitted to the interior of the thorax in order to expand the lungs and allow air to flow in; used primarily with patients having paralysis of the chest muscles. See also ventilator.
noninvasive ventilation mechanical ventilation that does not use an artificial airway, such as positive pressure ventilation with a nasal or face mask.
partial liquid ventilation ventilatory support in which the lungs are filled to the level of the functional residual capacity with a liquid perfluorocarbon; mechanical ventilation is then superimposed and oxygen and carbon dioxide are transferred through the liquid.
positive pressure ventilation any of numerous types of mechanical ventilation in which gas is delivered into the airways and lungs under positive pressure, producing positive airway pressure during inspiration; it may be done via either an endotracheal tube or a nasal mask. See also ventilator.
pressure control ventilation positive pressure ventilation in which breaths are augmented by air at a fixed rate and amount of pressure, with tidal volume not being fixed; used particularly for patients with acute respiratory distress syndrome.
pressure support ventilation positive pressure ventilation in which the patient breathes spontaneously and breathing is augmented with air at a preset amount of pressure, with tidal volume not being fixed.
proportional assist ventilation positive pressure ventilation in which the ventilator can sense the patient's level of inspiratory flow and deliver pressure support to achieve a given tidal volume.
pulmonary ventilation a measure of the rate of ventilation, referring to the total exchange of air between the lungs and the ambient air, usually in liters per minute.
spontaneous ventilation term used to denote breathing accomplished naturally, without any artificial aids, as opposed to mechanical ventilation and other forms of artificial respiration.
total ventilation minute ventilation.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

SIMV

Abbreviation for synchronized intermittent mandatory ventilation.
Farlex Partner Medical Dictionary © Farlex 2012

SIMV

Abbreviation for synchronized intermittent mandatory ventilation.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


simvastatin

 [sim´vah-stat″in]
an antihyperlipidemic agent that acts by inhibiting cholesterol synthesis, used in the treatment of hypercholesterolemia and other forms of dyslipidemia and to lower the risks associated with atherosclerosis and coronary heart disease; administered orally.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

simvastatin

Apo-Simvastatin (CA), Co Simvastatin (CA), Dom-Simvastatin (CA), Gen-Simvastatin (CA), Novo-Simvastatin (CA), Nu-Simvastatin (CA), PHL-Simvastatin (CA), PMS-Simvastatin (CA), Ranzolont (UK), Ratio-Simvastin (CA), Riva-Simvastatin (CA), Sandoz Simvastatin (CA), Simvador (UK), Zocor

Pharmacologic class: HMG-CoA reductase inhibitor

Therapeutic class: Antihyperlipidemic

Pregnancy risk category X

Action

Inhibits hepatic enzyme HMG-CoA reductase, interrupting cholesterol synthesis and low-density lipoprotein (LDL) consumption. Net effect is total cholesterol and serum triglyceride reductions.

Availability

Tablets: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg

Indications and dosages

Adjunct to diet to reduce risk of coronary heart disease (CHD) deaths, cardiovascular events, and hyperlipidemia

Adults: Initially, 10 to 20 mg P.O. daily in the evening. For patients at high risk for a CHD event due to existing CHD, diabetes, peripheral vessel disease, or history of stroke or other cerebrovascular disease, initial dosage is 40 mg/day. Range is 5 to 40 mg/day. Restrict use of 80-mg dose to patients who have been taking simvastatin 80 mg long term (for example, for 12 months or more) without evidence of muscle toxicity. Patients unable to achieve their LDL-C goal utilizing 40-mg dose should not be titrated to 80-mg dose, but should be placed on alternative LDL-C-lowering treatment that provides greater LDL-C lowering effects.

Adjunct to other lipid-lowering treatments (such as LDL apheresis) or if such treatments are unavailable for patients with homozygous familial hypercholesterolemia

Adults: 40 mg/day P.O. in the evening.

Heterozygous familial hypercholesterolemia after failure of an adequate trial of diet therapy

Adolescent boys and postmenarchal girls ages 10 to 17: Initially, 10 mg P.O. daily in the evening. Range is 10 to 40 mg/day; maximum dose is 40 mg/day. Adjust at intervals of 4 weeks or longer.

Dosage adjustment

• Severe renal impairment

• Concurrent use of amiodarone, amlodipine, diltiazem, fibrates, niacin, ranolazine, verapamil, or voriconazole

• Elderly patients

Contraindications

• Hypersensitivity to drug or its components

• Active hepatic disease or unexplained persistent serum transaminase elevations

• Concurrent use of cyclosporine, danazol, gemfibrozil, or strong CYP3A4 inhibitors

• Women who are pregnant or may become pregnant

• Breastfeeding patients

Precautions

Use cautiously in:

• severe renal impairment; severe acute infection; hypotension; severe metabolic, endocrine, or electrolyte problems; uncontrolled seizures; visual disturbances; myopathy; major surgery; trauma; alcoholism

• history of hepatic disease, liver enzyme abnormalities

• concurrent use of amiodarone, amlodipine, colchicine, digoxin, diltiazem, and lipid-modifying dosages (1 g/day or more) of niacincontaining products, other fibrates, ranolazine, verapamil, or warfarin

• concurrent use of simvastatin in dosages exceeding 20 mg/day with lipid-modifying dosages (1 g/day or more) of niacin-containing products in Chinese patients (avoid use)

• large quantities of grapefruit juice (avoid use)

• elderly patients

• children younger than age 10 (safety not established).

Administration

• Check liver function tests before starting therapy.

• Give with evening meal. Don't give with large amounts of grapefruit juice.

Adverse reactions

CNS: headache, asthenia

GI: nausea, vomiting, diarrhea, constipation, abdominal pain or cramps, flatulence, dyspepsia

Musculoskeletal: myalgia, rhabdomyolysis

Respiratory: upper respiratory infection

Interactions

Drug-drug. Amiodarone, calcium channel blockers (such as amlodipine, diltiazem, verapamil), colchicine, other lipid-lowering drugs (such as fibrates or lipid-modifying doses of niacin-containing products), ranolazine, voriconazole: increased risk of myopathy including rhabdomyolysis

Cyclosporine, danazol, diltiazem, gemfibrozil, nefazodone, strong CYP3A4 inhibitors (clarithromycin, erythromycin, HIV protease inhibitors, itraconazole, ketoconazole, posaconazole, telithromycin): increased risk of severe myopathy or rhabdomyolysis

Digoxin: slightly increased digoxin blood level

Warfarin: modestly increased anticoagulant effects

Drug-diagnostic tests. Alanine aminotransferase, aspartate aminotransferase: increased levels

Drug-food. Grapefruit juice (more than 1 qt daily): increased drug blood level, greater risk of adverse reactions

Drug-behaviors. Alcohol use: increased risk of hepatotoxicity

Patient monitoring

Watch closely for myositis and other adverse musculoskeletal reactions. Know that drug may cause rhabdomyolysis.

• Monitor liver function tests, CBC, and lipid levels.

• In patients receiving warfarin concurrently, closely monitor prothrombin time and International Normalized Ratio.

Patient teaching

• Advise patient to take with evening meal, but not with large amounts of grapefruit juice.

• Tell patient drug may take up to 4 weeks to be effective.

Caution patient to stop taking drug and contact prescriber if she suspects she is pregnant.

Teach patient to recognize and report signs and symptoms of myopathy or hepatic disorders.

• Instruct patient to avoid alcohol use.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

simvastatin

(sĭm′və-stăt′n)
n.
A statin, C25H38O5, that blocks the body's synthesis of cholesterol and is administered especially to individuals at risk for heart disease.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

simvastatin

A lipid-lowering HMG-CoA reductase inhibitor used to improve lipid profiles and reduce mortality from coronary heart diseasse, diabetes and stroke.
 
Effect
Decreases total cholesterol by 27%, LDL-C by 35–60%, triglycerides by 20–37%, and increases HDL-C by 5–9%.
 
Adverse effects
Constipation, flatulence, dyspepsia, abdominal pain, myalgia, muscle weakness.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

simvastatin

Zocor® Therapeutics A lipid-lowering HMG-CoA reductase inhibitor used in hypercholesterolemia, to improve lipid profiles and ↓ mortality from CAD, DM, TIAs, stroke Adverse effects Constipation, flatulence, dyspepsia, abdominal pain, myalgia, muscle weakness. See Cholesterol-lowering drugs, Gemfibrozil, HMG-CoA reductase inhibitors, Hypercholesterolemia, Statin.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

simvastatin

A statin drug used to treat raised blood cholesterol levels. A very large seven-year trial of the drug suggested that it reduces the chances of a heart attack or a stroke by one third. A brand name is Zocor. See STATINS for an account of the drug's action.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


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