VIVA: Pharmacology - Fluids Flashcards
Give an example of a preparation of calcium that is taken orally
1 needed to pass:
- Calcium carbonate
- Calcium acetate
- Calcium citrate
- Calcium glubionate
- Calcium gluconate
- Calcium lactate
- Calcium phosphate
What are the possible uses of oral calcium preparations?
Treatment of hypocalcaemia* (e.g. in patients with primary hypoparathyroidism, vitamin D deficiency, chronic renal disease or malabsorption
As an antacid
- needed to pass
What are the potential adverse effects of giving calcium intravenously?
Irritation of the veins (chemical phlebitis*)
Cardiac arrhythmias with rapid administration
Hypercalcaemia
- needed to pass
How does Hartmann’s solution differ from normal saline?
Addition of sodium lactate, potassium chloride, and calcium chloride*
pH adjustment
Na 130, K 5.4, Cl 112, Ca 1.8, lactate/bicarb 28mmol
Compared with normal saline which is Na 154 Cl 154*
- needed to pass
What are the potential advantages of Hartmann’s solution in resuscitation?
Closer to physiologic values for sodium potassium, calcium
Less hyperchloraemia*
Effective bicarbonate - some (slow) good effect on acidosis* (proof of superiority lacking)
- needed to pass
What are the potential complications of IV fluid therapy?
Overload or under resuscitation
Hypothermia
Extravasation
Acidosis
Electrolyte abnormalities
Osmolality changes
Air embolism
Infection
Cerebral oedema
Haemodilution
What are the different classes of IV fluids? Give an example of each
3 examples and 2 classes needed to pass:
1. Colloid (substance evenly dispersed throughout another solution in which it is insoluble)
- Albumin (naturally occurring)
- Dextran (synthetic)
- Gelatin (synthetic)
2. Crystalloid
- Isotonic: 0.9% sodium chloride, Hartmann’s, Plasmalyte
- Hypertonic: 3% or 7.5% sodium chloride
- Hypotonic: 0.45% sodium chloride, dextrose (5% or 10%)
3. Blood and blood products
What are the complications of crystalloid fluid therapy?
3 needed to pass:
- Acute pulmonary oedema
- Cerebral oedema (particularly with correction of hypernatraemia)
- Tissue oedema, limb and abdominal compartment syndromes
- Under-resuscitation
- Hypothermia
- Dilutional coagulopathy
- Acidosis
- Electrolyte abnormalities and osmolality changes
- Haemodilution
- Extravasation
- Air embolism
- Infection
What are the indications for the use of magnesium in pregnancy?
Indicated in pre-eclampsia* and eclampsia* for the prevention and treatment of life-threatening seizures*
- needed to pass
What are the other uses of magnesium in emergency medicine (besides for pre-eclampsia and eclampsia)?
Anti-convulsant effect*
Possible anti-arrhythmic effect*
Bronchodilator effect*
Influences Na+/K+ ATPase, Na+ channels, and certain K+ and Ca2+ channels
- 2/3 needed to pass
What are the toxic effects of magnesium?
Signs and symptoms of hypermagnesaemia include (3 needed to pass):
- Nausea and vomiting
- Flushing
- Hypotension
- Muscle weakness and paralysis
- Loss of reflexes
- CNS depression
- Blurred or double vision
- Respiratory depression
- Renal failure
- Cardiac arrhythmia
