AKI/ICU Flashcards
For which med is CVVH first line-therapy for intoxication?
Never; its too slow. HD first, then filter
Do you use RRT for tylenol overdose?
Dry gas, windshild wiper fluid. What ingestion? What clinical findings?
Methanol
Blindness
HAGMA and OG
Antifreeze. What ingestion? What clinical findings?
Ethylene glycol
Renal failure with oxaluria
(cardiovascular collapse)
HAGMA and OG
Rubbing alcohol.
What ingestion? What clinical findings?
Isopropranol
OG but no anion gap
What are the different metabolites for the alcohols? What is the medicaton for treatment?
When do you give fomepizole? Before or after dialysis?
Give after, because it is dialyzable
Do you dialyze methanol?
What are the indications?
HD for acidosis
Dumbell crystals?
CaOx monohydrate
(M looks like a dumbell)
Diamond/envelope crystals?
CaOx dihydrate
(2 pyramids stuck on top of each other)
What kind of alcohol ingestion gives you oxalate stones?
Ethylene glycol
Do you dialyze ethylene glycol, and if so what are the indications?
Renal failure
MetAc, heart failure, pulm edema, AMS
What happens to the gaps?
OG turns into AG with the metabolism process
Can you dialyze propylene glycol?
What med do you find this in?
What kind of AB DO?
Can dialyze
Lactic acidosis without a source
Why do you treat patients with salicylate poisoning with NABC?
Move the salicylate out the CNS and into the blood (not to treat the MetAc)
Indication for HD with salicylate intoxication?
renal failure; non-cardiogenic pulmonary edema, SZ or persistent CNS symptoms, and severe acid-base disorder
If they are tacypneic - then they have CNS involvement (aka if they have a RespAlk, you should HD)
When do you dialyze for Li toxicity?
HD for levels > 4 and gfr < 60
AMS, decreased consciousness, SZ or dysrhythmias (regardless of the Li levels)
Use intermittent HD
Rebound Li after HD is good; it means that you are clearing and the Li is moving out of the intracellular space
When do you dialyze for metformin?
Lactic acid > 20, pH ≤ 7, shock, failure of standard supportive measures
HD is more important for the acidosis, rather than the removal of the drug
Can you HD for dabigitran?
Yes
