Lec 3

Question 1

standardized, structured approach to identifying drug-related problems in the ICU

Answer 1

FASTHUG-MAIDENS

Question 2

F is for

Answer 2

F is for Feeding

Question 3

Patients in the ICU may receive nutrition by a variety of methods, such as

Answer 3

parenteral nutrition, tube feeding, sips of fluids, diet as tolerated, and no oral intake.

Question 4

This variety means there are severa

Answer 4

opportunities to optimize drug therapy, such as changing medications to the oral route from the parenteral route or vice versa,

Question 5

sustained-release medications administered in a form

Answer 5

cannot be crushed

Question 6

alternative dosage form,

Answer 6

liquid formulation or an immediate-release form, could be recom- mended to achieve equivalent total daily doses

Question 7

If the patient is not tolerating enteral feeding and is experiencing high gastric residual volumes,

Answer 7

Prokinetic agents such as metoclopramide or erythromycin

Question 8

possibility of an interaction between a drug and a nutritional formulation administered by feeding tube that might affect

Answer 8

absorption of the drug

Question 9

For patients receiving parenteral nutrition, the pharmacist can monitor

Answer 9

laboratory parameters

Question 10

A is for

Answer 10

A is for Analgesia

Question 11

Pain can be readily assessed with a

Answer 11

pain scale, and the patient’s level of pain should be checked routinely

Question 12

the patient’s situation and make suggestions about the most appropriate method for delivering analgesic medications, such as

Answer 12

infusions,
regularly scheduled intermittent doses,
or longer-acting forms combined with as-needed doses.

Question 13

S is for

Answer 13

S is for Sedation

Question 14

The most common type of sedative used in the ICU is

Answer 14

benzodiazepines, including drugs such as midazolam and lorazepam

Question 15

only short-term sedation.

Answer 15

propofol

Question 16

longer-term sedation

Answer 16

benzodiazepines

Question 17

checked routinely

Answer 17

For A

Question 18

The pharmacist should assess each patient daily

Answer 18

For S

Question 19

T is for

Answer 19

T is for Thromboembolic prophylaxis

Question 20

critically ill patients may not be receiving chemical thromboembolic prophylaxis

Answer 20

because of certain medical conditions (e.g., intracranial or active gastrointestinal bleeding)

Question 21

For ill how cannot tak T what should ph do

Answer 21

plan for the timing of initiation of appropriate thromboembolic prophylactic medications

Question 22

The various types of prophylactic therapy include

Answer 22

low-molecular-weight heparins, unfractionated heparin, sequential compression devices, and intravascular filters.

Question 23

H is for

Answer 23

H is for Hyperactive or Hypoactive delirium

Question 24

Untreated delirium can lead to

Answer 24

an increased length of stay in the ICU, as well as increases in costs, morbidity, and mortality

Question 25

Tools such as for HeHeHeHe

Answer 25

Intensive Care Delirium Screening Checklist9 or the Confusion Assessment Method

Question 26

Treatments involving for HeHeHeHe

Answer 26

supportive and environmental measure and pharmacological intervention with an antipsychotic and routinely assess

Question 27

U is for

Answer 27

U is for stress Ulcer prophylaxis

Question 28

risk of stress ulcers

Answer 28

receiving mechanical ventilation

Question 29

most commonly used agents for | this indication for U

Answer 29

histamine receptor antagonists and proton pump inhibitors.

Question 30

Once the patient’s condition improves and | there is no longer a risk of stress ulcers

Answer 30

prophylactic agent can be discontinued

Question 31

G is for

Answer 31

G is for Glucose control

Question 32

the blood glucose concentration of an ICU patient may fluctuate

Answer 32

glucocorticoids, propofol, and atypical antipsychotics.

Question 33

M is for

Answer 33

M is for Medication reconciliation

Question 34

What ph should do for M

Answer 34

reviewing medications that the patient was receiving before admission and deciding which drugs need to be restarted

Question 35

Ideally, medication reconciliation is performed

Answer 35

upon admission and before discharge.

Question 36

medications taken before admission are not restarted

Answer 36

acute medical conditions preclude their use

Question 37

dentifying discontinued medications for which there is a high risk of experiencing withdrawal symptoms

Answer 37

benzodiazepines and selective serotonin reuptake inhibitors).14 Typically, these medications should be restarted

Question 38

A is for

Answer 38

A is for Antibiotics or Anti-infective | agents

Question 39

pharmacists can play a crucial role in antimi- crobial

Answer 39

stewardship selecting the optimal antimicrobial agent and de-escalating treatment once culture and susceptibility results are available

Question 40

I is for

Answer 40

I is for Indications for medications

Question 41

D is for

Answer 41

D is for drug Dosing

Question 42

renal and hepatic function may | fluctuate frequently

Answer 42

For D

Question 43

pharmacist is in an ideal position to | suggest dose adjustments based on

Answer 43

clinical parameters

Question 44

adjust doses as the patient’s condition begins to improve,

Answer 44

prevent underdosing.

Question 45

E is for

Answer 45

E is for Electrolytes, hematology, and other | laboratory tests

Question 46

N is for

Answer 46

N is for No drug interactions, allergies, | duplication, or side effects

Question 47

S is for

Answer 47

S is for Stop dates

Question 48

drugs that may require a | stop or reassessment date include (but are not limited to)

Answer 48

corticosteroids and anti-infective agents

Question 49

Benefit

Answer 49

essential aspects of pharmaceutical care are met consistently. reduce anxiety and apprehension among pharmacists not familiar with the ICU setting by providing a stepwise approach to identifying drug-related problem good teaching tool for hospital pharmacy students and residents with little or no ICU experience