• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • Home
  • About
  • Consumer Info
  • Guideline Notes
  • Medicine and Media
  • Pharmacogenomics
  • Visit My Etsy Store

Digital PharmD

Informatics in Pharmacy

Critical Care

Substance Abuse Disorders

August 13, 2018 By Dr. G, PharmD

Alcohol Withdrawal – Tremors start around 6 hours, seizures around 12 hours, but can occur 3-5 days later. Mortality can be as high as 35%. 3 Ts – Increase temp, tremor and tachycardia Treatment: correct electrolyte imbalances, benzos, can use propofol or barbiturates in refractory cases, magnesium, alpha 2 agonists, Beta blockers, calcium channel blockers Avoid: […]

Skeletal Muscle Relaxants

August 13, 2018 By Dr. G, PharmD

baclofen – seizure in overdose

Acid-Base Disturbances

August 12, 2018 By Dr. G, PharmD

Summary of Acid-Base Disturbances   pH (7.3 – 7.4) H+ HCO3 (22-26) pCO2 (34-45) K+ metabolic acidosis ↓ ↑ ↓ ↓↓↓ ↑ metabolic alkalosis ↑ ↓ ↑ ↑↑↑ ↓ respiratory acidosis ↓ ↑ ↑↑↑ ↑ ↑ respiratory alkalosis ↑ ↓ ↓↓↓ ↓ ↓ Multiple arrows means it is a compensatory mechanism. PCo2 is usually 1.5 times the bicarb + […]

Pressors and Ionotropes

August 12, 2018 By Dr. G, PharmD

Drug Name Receptor affected HR BP CO Uses Norepinephrine α, β1 ↔ ↑↑↑ ↔ or ↑ cardiogenic shock Epinephrine α, β1, β2 ↑↑↑ ↑↑↑ ↑↑↑ cardiogenic shock  and anaphylaxisepi activates everything) Dopamine α, β1, dopaminergic ↑↑ ↑ ↑↑ cardiogenic and neurogenicshock, if not tachy Phenylephrine α ↔ or ↓ ↑↑↑ ↓ septic shock only, can use if […]

Shock

August 12, 2018 By Dr. G, PharmD

Hypovolemic shock: Restore intravascular volume and oxygen carrying capacity. If hemoglobin < 7, administer blood products. Patients may need pressers. Obstructive shock: Must treat actual obstruction. Fluids may improve end-organ perfusion temporarily. Vasodilatory shock: Usually sepsis Septic Shock: Treat with sepsis bundles. Within 3 hours: Obtain labs. Start broad-spectrum antibiotics, ideally within the first hours (obtain […]

Analgesics

August 12, 2018 By Dr. G, PharmD

  Morphine Fentanyl Hydromorphone Onset (min) 5-10 1-2 5-10 Duration (h) 2-4 1-5 2-6 Prolonged in renal yes no no Prolonged in hepatic yes yes yes T 1/2 in hours 1-4 2-5 2-3 Active metabolites yes no no Hypotension yes no yes Flushing yes no yes Bronchospasm yes no no Constipation yes yes yes For […]

Neuromuscular Blockade and Sedation

August 12, 2018 By Dr. G, PharmD

Assessment Tools: Critical Care Pain Observation Tool (CPOT) (0-8) Behaviour Pain Scale (BPS) Sedation is Richmond Agitation Sedation Scale (RASS) or Sedation-Agitation Scale (SAS) Sedation Agents: Propofol: Rapid onset (1-2 minutes) Short duration (3-5 minutes). Avoid prolonged infusions greater than 50 mcg/kg/min. Monitor BP, triglycerides, adjust lipid calories Monitor for propofol infusion syndrome: metabolic acidosis, hemodynamic instability, cardiac […]

Hypersensitivity Reactions

August 12, 2018 By Dr. G, PharmD

Type 1 Hypersensitivity is IgE mediated.  It’s anaphylaxis and the one we’re most concerned with in critical care. Treatment: Epinephrine, Benadryl, albuterol or racepinephrine, IV fluids, and pressors Steroids will help biphasic reaction, but not acute reaction. Monitor for 4-6 hours. Keep overnight if you have to re-intervene. Send home with 2 epi-pens, oral steroids for 3-5 […]

Primary Sidebar

Newsletter

More to See

What You Need to Know About the 2022 Avian Influenza Outbreak

March 20, 2022 By Dr. G, PharmD

Endocarditis Guideline Review

February 24, 2022 By Dr. G, PharmD

Sinus Troubles: When Should I See My Doctor

January 5, 2022 By Dr. G, PharmD

Tags

acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020

Footer

Medical Disclaimer

The medical information on this website is provided “as is” without any representations or warranties, express or implied. GoPharmD makes no representations or warranties in relation to the medical information on this website.

GoPharmD does not warrant that:

  • the medical information on this website will be constantly available, or available at all; or
  • the medical information on this website is complete, true, accurate, up-to-date, or non-misleading.
  • You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider.
  • If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.

Recent

  • Smoking
  • What You Need to Know About the 2022 Avian Influenza Outbreak
  • Endocarditis Guideline Review
  • Sinus Troubles: When Should I See My Doctor
  • Common Pharmacogenomic SNPs and Interactions

Search

Tags

acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020