Acute & Critical Care Medicine Flashcards
(55 cards)
Define crystalloid
contains various concentrations of sodium and/or dextrose that pass freely between semipermeable membranes. most of the volume does not remain in the intravascular space (inside the blood vessels), but moves into the extravascular space or interstitial space
- less costly
- fewer adverse reactions
Define colloids
large molecules (typically protein or starch) dispersed in solutions that primarily remain in the intravascular space and increase oncotic pressure
- more expensive
- have not shown clear clinical benefit over crystalloids
What product is used when water is needed intracellularly
dextrose b/c it contains “free water”
What products are used for volume resuscitation in shock states
LR
normal saline
What products are used in patients with significant edema (e.g. cirrhosis)
albumin
list crystalloids
D5W
NS
LR
multiple electrolyte injection (plasma-Lyte a)
List colloids
albumin
define hyponatremia
Na < 135
hypotonic hypovolemia hyponatremia treatment
NaCl
hypotonic hypervolemic hyponatermia treatment
diuresis with fluid restriction
max rate of Na repletion
12 mEq/L over 24 hours
above this is associated with ODS (osmotic demyelination syndrome)
Define hypernatremia
Na > 145
associated with water deficit and hypertonicity
a drop of potassium of 1 mEq/L below 3.5 represents what
total body deficit of 100-400 mEq
how to administer potassium
- route
- rate
- max concentration
peripheral line
max rate < 10 mEq/L
max concentration of 10 mEq/100mL
Define hypophosphatemia
serum phosphate < 1 mg/dL
What does an APACHE 2 score tell you
determine patient prognosis and estimate ICU mortality risk
Vasopressor MOA
stimulate alpha receptors which cause vasoconstriction and increases systemic vascular resistance (SVR) which increases BP
epinephrine MOA
alpha-1, beta-1, beta-2 agonists
norepinephrine MOA
alpha-1 agonist > beta-1 agonist
phenylephrine MOA
alpha-1 agonist
vasopressin MOA
vasopressin receptor agonist
list vasopressors
dopamine epinephrine norepinephrine phenylephrine vasopressin
dopamine MOA
low dose 1-4 mcg/kg/min -dopamine-1 agonist medium dose 5-10 mcg/kg/min -beta-1 agonist high dose 10-20 mcg/kg/min -alpha-1 agonist
Define vesicants
cause tissue damage/necrosis with extravasation (leakage of drug from blood vessel into surrounding tissue)
