Acute & Crit Care Medicine

Question 1

What are the ratio strengths for Epinephrine?

IV push vs IM injection

Answer 1

Epinephrine 1:1,000 is used in epinephrine products designed for intramuscular or subcutaneous administration
vs
1: 10,000 for IV push

The Institute for Safe Medication Practices (ISMP) has advocated for changes to epinephrine labeling due to frequent errors associated with confusion between the available strengths (1:1,000 vs. 1:10,000).

Question 2

Risk Factors for development of stress ulcers?

Answer 2

• Mechanical ventilation > 48 hours
• Coagulopathy
• Sepsis
• Traumatic brain injury
• Major burns
• Acute renal failure
• High dose systemic steroids

Question 3

What is a medication that can be used to reduce secretions in critical care patients?

Answer 3

Glycopyrrolate

Question 4

What is the correct combination of dose-effect relationships for dopamine?

Answer 4

• Low (renal) dose: 1-4 mcg/kg/min
  Dopamine-1 agonist
• Medium dose: 5-10 mcg/kg/min
  Beta-1 agonist, postive inotrophic effect
• High dose: 10-20 mcg/kg/min
  Alpha-1 agonist, vasopressor effects

Question 5

What is Hypokalemia?

Answer 5

• When K < 3.5 - common in hospitals
• The Drop of 1 in serum K below 3.5 = deficit of 100 - 400 mEq

Question 6

What is hypomagnesemia

Answer 6

• When Mg < 1.3
• When Mg < 1 mEq/L with life-threatening symptoms (seizures, arrythmias), IV magnesium sulfate replacement is recommended