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.pharmocology > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

ECF

A

Na+ primary cation for extracellular osmolarity

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2
Q

ICF

A

K+ primary cation for intracellular osmolality

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3
Q

Na+/K+ ATPase pump

A

Maintains balance of Na+ outside of cell and K+ inside cells

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4
Q

CBC indicating fluid therapy

A

Hematocrit and plasma protein (dehydration)
PO2, PCO2, base excess, HCO3-, total CO2
Na+, K+, Cl-
BUN and creatinine

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5
Q

Indication for fluid therapy in cats

A

Hypothermia, bradycardia and hypotension

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6
Q

Shock and dehydration

A

Patient could be hypovolemic, hypotensive or dehydrated or all 3

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7
Q

4% dehydration

A

History of fluid loss, moist mm, thirst

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8
Q

5-6% dehydration

A

Subtle loss of skin elasticity
Dull hair coat
MM slightly dry, tongue moist

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9
Q

7-8% dehydration

A

Delay in return to skin to normal
Dry tongue and MM
Eyes soft and sunken
Slight prolongation of CRT

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10
Q

9-11% dehydration

A

Tented skin doesn’t return to normal
Prolonged CRT, sunken eyes, all mm dry
Tachycardia, cool extremities, rapid and weak pulses

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11
Q

12-15% dehydration

A

Definite signs of shock, circulatory collapse
Death imminent

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12
Q

Crystalloids

A

Water-based
Osmotically active small molecules permeable through the capillary
Isotonic and hypertonic solutions

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13
Q

Crystalloid administration

A

Moves into interstitial and intracellular space within 45 mins of IV admin

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14
Q

Colloids

A

Large molecules that don’t cross the capillary membrane
Natural (plasma/albumin) or synthetic (hydroxyethyl starch)

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15
Q

Aims of fluid replacement

A

Correct existing deficits
Satisfy maintenance needs
Replace ongoing losses

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16
Q

Step 1 of fluid therapy (correct hypovolemia)

A

Shock dose: 80-90 in dogs, 45-60 ml/kg in cats
25% given in first 15 min
Reassess condition (don’t over hydrate)- titrate to effect
Isotonic crystalloids and synthetic colloids

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17
Q

Step 2 of fluid therapy (Rehydration)

A

Administered over 24 hrs
Isotonic crystalloid solution

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18
Q

Calculating fluid deficit

A

L= (kg) x % dehydration / 100

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19
Q

Step 3 of fluid therapy (maintenance)

A

Asses water or fluid intake by patient
60 in dogs, 45 in cats over 24 hrs
Can ↑ rates for diuresis benefits
Isotonic crystalloids

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20
Q

Step 4 (ongoing fluid loss)

A

Estimate the loss in specific time periods
Addition to ongoing fluid admin

21
Q

Oral or nasogastric route

A

Least dangerous (don’t worry about tonicity vol and asepsis)
Combos of electrolyte salts and dextrose
Beneficial for epithelial lining of GI tract

22
Q

SQ route

A

Young or small animals
Absorbed more slowly than by IV
Use only isotonic fluids (LRS)

23
Q

IV fluids

A

Isotonic formulations
Maintaining asepsis during catheter placement or injection (catheters, clotting, hematomas)
Large vol too rapidly = overload circulatory system (pulmonary edema)

24
Q

Balanced (isotonic) electrolyte solutions - Crystalloids uses

A

Pre and post sx support
V/D
Renal Dz
Trauma and shock

25
Q

Balance electrolyte solutions

A

Resemble ECF
High Na+ and low K+

26
Q

Replacement fluids

A

Plasma like composition
High Na, Low K+
LRS, Plasmalyte, Normosol R

27
Q

Maintenace fluids

A

More free water
Low Na, High K
Normosol M

28
Q

How to give balanced (isotonic) electrolyte solutions - Crystalloids

A

Large vol. because they have a short lifespan in intravascular space
Once given, diffuse out of vasculature and into ECF

29
Q

Normal Saline and LRS

A

Acidifying solution
Used to tx patients with metabolic alkalosis
High in Cl- (promotes renal excretion of bicarb)

30
Q

Normal Saline

A

Used to tx hyperkalemia and hypercalcemia

31
Q

Crystalloid hypertonic solutions (HSS)

A

↑ COP due to ↑ preload
Peak occurs within 1 hr

32
Q

Crystalloid hypertonic solutions (HSS) uses

A

Shock associated with hemorrhage
Trauma and GDV

33
Q

Crystalloid hypertonic solutions (HSS) MOA

A

High circulating Na+ attracts water into vasculature from interstitial and intracellular spaces
Restore capillary flow and tissue perfusion

34
Q

Crystalloid hypertonic solutions (HSS) dose

A

3-5 ml/kg IV over 5-10 mins

35
Q

Crystalloid hypertonic solutions (HSS) contraindications

A

Hypernatremic patients
Patients with ↑ plasma osmolality
Don’t use alone in dehydrated patients

36
Q

Colloids MOA

A

Balances the force that draws water into the capillaries with the hydrostatic pressure pushing water out into the tissues

37
Q

__________ is the major plasma protein that maintains COP

A

Albumin

38
Q

Colloids indication

A

Perfusion deficits
Blood component deficiencies

39
Q

Adverse effects of colloids

A

Acute renal failure
↑ bleeding tendencies

40
Q

Which of the following do you need to administer if you want to replenish both intravascular and interstitial volume quickly?

A

Both crystalloids and colloids

41
Q

Whole blood

A

Anemia (acute and immune mediated)
Blood loss (hemorrhage)

42
Q

Plasma

A

Clotting deficiencies
Hypoproteinemia (V/D, sepsis)

43
Q

RBCs

A

To ↑ amount of RBCs after trauma or sx
Tx anemia
42d in fridge or 10y in freezer

44
Q

Fresh frozen plasma

A

Correct deficiency in coagulation factors
Tx shock due to plasma loss from burns or massive bleeding
1y in freezer

45
Q

Concentrate of platelets

A

Tx or prevent bleeding due to low platelet levels
Correct functional platelet problems
5d @ room temp

46
Q

Cryoprecipitate

A

Tx fibrinogen deficiencies
1 yr in the freezer

47
Q

Blood substitutes oxyglobin

A

For blood loss and anemia
Contain purified Hb removed from RBC and suspended in solution

48
Q

Oxyglobin

A

Only approved product in vet patients
Derived from bovine Hb

.pharmocology (21 decks)

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