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Glossary entry

English term or phrase:

shot gunning

English answer:

multiple small injections

Added to glossary by Stephanie Ezrol
Nov 14, 2010 08:33
13 yrs ago
English term

shot gunning

English Medical Medical (general)
Alpha, Beta and Ganglionic Blocker Drugs:

1. Phentolamine, used for shot gunning tissue after infiltration;
Responses
3 +2 multiple small injections
References
Drug Therapy in Nursing - Google Books R...
Change log

Nov 16, 2010 20:56: Stephanie Ezrol Created KOG entry

Discussion

Gerard Burns Jr. Nov 15, 2010:
Unless you find it explained elsewhere in the book (do look if you haven't), I think this is a question that ought to be kicked back to the author. It is obviously very important to get this right, but the use of "shot gunning" is not at all common for the meaning suggested by my colleague, although I could see it being used because the area of injection would look like it had been hit by shotgun pellets, and yet I can't be confident of my answer either even though it is based on a common use of "shotgun" in therapy. What is worse is that at this point, with the quality of the people commenting, but not offering answers, I suspect that it will be difficult to find an answer on ProZ that you ought to be confident of.
Please contact the author. Frankly, she shouldn't have used the term without clarification (unless you find it explained elsewhere in the book).
liz askew Nov 14, 2010:
BTW, what comes after "infiltration"?
MMUlr Nov 14, 2010:
@meirs, exactly ;-) nice book, indeed.
Filippe Vasconcellos de Freitas Guimarães Nov 14, 2010:
"Shotgun anesthesia" "Shotgun therapy" is the practice of using an unnecessary variety of drugs, for various and sometimes conflicting purposes, with little regard for proper dosage, potential for interactions, or whether the patient actually needs them. It is a rather extreme form of "empiric therapy"—the term is well established and has been used in the literature for over a century, for anesthesia, antibiotics, and several other forms of drug therapy.

I DON'T think it's what is meant here, however. The only use for phentolamine in anesthesia, as far as I am aware, is to revert local anesthesia very quickly without waiting for the infiltrated anesthetic to wear off.
meirs Nov 14, 2010:
Nurse Anesthesia Pocket Guide Nurse Anesthesia Pocket Guide: A Resource for Students and Clinicians
By Lynn Fitzgerald Macksey (page 80)

Responses

+2
8 hrs
Selected

multiple small injections

This is about the use of phentolamine, and may be what your author means by shot gunning.

Administration: I.V.

Vasoconstrictor (alpha-adrenergic agonist) extravasation: Infiltrate the area of extravasation with multiple small injections using only 27- or 30-gauge needles and changing the needle between each skin entry. Be careful not to cause so much swelling of the extremity or digit that a compartment syndrome occurs. If infiltration is severe, may also need to consult vascular surgeon.

http://www.merck.com/mmpe/print/lexicomp/phentolamine.html




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Note added at 17 hrs (2010-11-15 02:12:25 GMT)
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I think Michael's analogy of shot gunning/peppering helps make the use of the language more clear. Here is another example:

PHENTOLAMINE (Regitine)
AVAILABLE AS: 5mg vial for injection
RECOMMENDED DOSAGE:
0.1mg/kg up to maximum dose of 2.5mg SC, infiltrated into the area of extravasation within
12 hours. Divide dose into multiple small injections. May repeat if necessary.
http://www.metrohealth.org/documents/patient services/neonat...

Peer comment(s):
agree Michael Barnett : Yes exactly. You "pepper" the extravasation site with multiple small injections.
6 hrs
Thank you Michael !
agree MMUlr : *After* infiltration with local anesthetics to counteract vasoconstriction: http://www.ineedce.com/courses/1597/PDF/Phentolaminerev.pdf
13 hrs
Thanks !
Something went wrong...
4 KudoZ points awarded for this answer. Comment: "Thanks a lot!"

Reference comments

8 hrs
Reference:

Drug Therapy in Nursing - Google Books Result
Diane S. Aschenbrenner, Samantha J. Venable - 2008 - Medical - 1344 pages
Phentolamine Unlike prazosin, phentolamine (Regitine) blocks both alpha- 1 and alpha-2 receptors. It is used in the management of tissue necrosis caused by ...
books.google.co.uk/books?isbn=0781765870...

http://webcache.googleusercontent.com/search?q=cache:1acyt2i...

so, it would seem that “shotgun” here = administer

???


--------------------------------------------------
Note added at 9 hrs (2010-11-14 17:36:12 GMT)
--------------------------------------------------

here is something else

http://webcache.googleusercontent.com/search?q=cache:kRMA9nH...


ntibiotic resistance can also occur when antibiotics are used improperly, such as the 'shot-gunning' method. 'Shot-gunning' involves administering one antibiotic after another to a population of fish, frequently at improper dosages, for shortened treatment times, and without the aid of proper diagnosis (i.e., without culture and sensitivity tests). If shot-gunning is used frequently at a facility, resistance is almost certain to occur. In some cases, the problem may not be due to bacteria, but rather poor water quality or other management issues that have not been properly investigated.

While shot-gunning may work occasionally, over time, it introduces too great a risk of producing populations of bacteria that are resistant to multiple antibiotics, which can result in the very real possibility of a 'superinfection,' where the bacteria cannot be controlled with antibiotics. Once a system has a superinfection, it is usually necessary to sacrifice the entire affected population, completely break down and disinfect the affected system, and start over. This is obviously not a desirable outcome. The importance of using antibiotics wisely (running culture and sensitivity tests, using proper dosages and adhering to proper treatment times) cannot be overstressed.

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Note added at 9 hrs (2010-11-14 17:36:54 GMT)
--------------------------------------------------

so I would say

administer in quick succession

but hey, think about this one, this is why I need more context after "infiltration"....

--------------------------------------------------
Note added at 9 hrs (2010-11-14 17:37:41 GMT)
--------------------------------------------------

even

targeting

could work here!
Something went wrong...
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