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RxPrep

Septic Shock/Pressors/HAP/VAP

QuestionAnswer
Which pressor is first line? Norepinephrine
Which pressors can cause hyperglycemia? Mainly epi, also dopamine at higher doses
When does the book say to use double coverage for PSA? IV abx in last 90 days, local resistance > 10%, in hopstial > 5 days prior to VAP
Which 3rd gen ceph covers PSA? Ceftazidime
When does the book say to cover MRSA in HAP/VAP? IV abx in last 90 days, MRSA prevalance > 20%, prior MRSA infection, (+) MRSA nare
Which FQs can be used for respiratory infections? Moxi and Levo (NOT Cipro)
When is monotherapy with FQs appropriate in CAP? Non-severe admission, DO NOT USE monotherapy FQs in severe inpatient CAP
What is the dosing for dopamine? 3 different dosings Low: 1-4mcg/kg/min Medium: 5-10 High: 10-20mcg/kg/min
Which pressors cause extravasation All of them
Drug use to treat extravasation? Phentolamine
Max duration of NTG? Tachyphylaxis after 48 hours
Side effects of NTG? Tachycardia, headache, Avoid when SBP < 90
Warnings of NTG? Severe hypotension, Increased intracranial pressure.
Which nitrate can cause cyanide toxicity? nitroprusside (thiocyanate toxicity), worse in renal/hepatic impairment
What are the inotrope drugs used in critical care? Dobutamine (beta-1 agonist) and milrinone (PDE-3 inhibitor)
What is MAP goal on pressors? MAP >/= 65
1st line for hypovolemic shock? Fluids (mainly crystalloids like LR)
Sepsis/Septic shock is what type of shock? Distributive shock
How do NE and EPI work differently? Epi: a1, b1, and b2 NE: mainly a1, > b1 (no beta-2)
Created by: cdaughtry
 

 



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