Acute Care Medicine Flashcards
Crystalloid Examples
Dextrose
Normal Saline
Lactated Ringers
Plasma-Lyte A
Colloids Example
Albumin (Albutein, AlbuRx)
Larger molecules that stay in the intravacular spaces
How fast should you correct sodium?
No more than 12 mEq/L/24 hours
*faster than this would cause osmotic demyelinolysis ===== paralysis and seizures
SIADH treatment
conivaptan or tolvaptan (arginine vasopression receptor antagonists)
Hypotonic hypovolemic hyponatremic treatment
Diuresis
***fluid overload, sodium is falsely low :(
Hypotonic hypovolemic hyponatremia
Correct cause (Diuretics, Vomiting/diarrhea, blood loss)
Hypertonic saline if Na < 120
What medications cause HYPOkalemia?
Insulin
Amphocerin B
What is the maxium rate of potassium through a peripheral line?
10 mEq/hr
With hypokalemia, what other labs do you want to check before treatment with potassium?
Magnesium!
A patient’s potassium dropped to 3.2. What amount of potassium replacement is recommended?
60 mEq PO or IV
3.3 -3.5 40 mEq PO or IV
3 - 3.2 60 mEq PO or IV
2.6 - 2.9 80 mEq IV
Octagam
IV immunoglobin (IgG)
**DO NOT SHAKE OR FREEZE
used for MS, myasthenia gravis, and Guillain-Barre syndrome
What should you treat extravasation of vasopressors with?
Phentolamine
What vasopressin’s MOA is dependent on the dose?
Dopamine
Low 1-4 mcg/kg = DA-1
5-10 mcg/kg = Beta-1
10-20 mcg/kg = alpha-1
What vasopressin is an agonist of beta-1, beta-2, and alpha 1?
Epinephrine (Adrenalin)
Counseling on Vasopressins
-ALL administered through central line!
-SE: arrhythmias, tachycardia, necrosis
-treat extravastion with phentolamine
