Sepsis

Question 1

what alterations occur in sepsis to the pharmacokinetics and pharmacodynamics of antibiotics?

Answer 1

because of increased cardiac output, there is an increase in the clearance of these drugs

because of leaky capillaries and altered protein binding, there is increased volume of distribution

both of these contribute to low plasma concentrations

Question 2

what is the first line pressor/inotrope for critical care (based on current data)?

Answer 2

first line is norad

dobutamine has been associated with worse outcomes in sepsis and cardiogenic shock

adrenaline was associated with higher lactate levels and need for insulin infusion