“If the gut works, use it!” but when it doesn’t…
✨ Check out this post to learn more!
💉 Total parenteral nutrition (TPN), also known as parenteral nutrition (PN) is a form of nutritional support given completely via the bloodstream, intravenously with an IV pump.
🍞 TPN administers proteins, carbohydrates, fats, vitamins, and minerals.
Total Parenteral Nutrition (TPN) Read More »
Aminoglycosides – ‘The 3 Amigos’
⭐ AMINOglycosides are antibiotics comprised of AMINO acid sugars that are linked together.
3️⃣ The three most commonly used are (mnemonic: TAG):
-Tobramycin
-Amikacin
-Gentamicin
Other agents include plazomicin, streptomycin, and neomycin.
⭐ They are used for serious infections caused by gram-negative bacteria such as complicated UTIs, sepsis, or intraabdominal infections. They can also be used in combination with other agents for infectious caused by gram-positive bacteria in endocarditis.
⭐ MOA: they kill bacteria by binding onto 30S ribosomal subunits inhibiting the bacteria’s ability to synthesize proteins, leading to cell death
⭐ Other key facts to know:
-Adverse effects include nephrotoxicity and ototoxicity
-They are approximately 70-95% excreted renally
-They are concentration-dependent bacterial killers, which means bacterial killing increases with rising drug concentrations
-Monitor serum drug levels (troughs and peaks), serum creatinine, BUN, urine output, and hearing.
Vasopressors and Inotropes
Vasopressors and inotropes OH NO! 🙇🏻♀️ These medications are commonly used in the critical care setting in patients with shock (or those with extremely low blood pressure) leading to end-organ damage (acute kidney injury, increased LFTs, etc.).
👉🏻 Vasopressors are drugs that cause vasoconstriction, therefore increasing mean arterial pressure (MAP). Vaso refers to blood vessels and pressor means to put pressure on or constrict making up the word – VASO-pressor. 🩸
Examples of vasopressors include:
⭐ Norepinephrine
⭐ Epinephrine
⭐ Vasopressin
⭐ Phenylephrine
👉🏻 Inotropes are drugs that affect cardiac contractility (or the force of muscular contractions). They can also be used as chronotropes (drugs that increase heart rate). THINK: Ino = strength; Chrono = time. Some vasopressors may also have effects on contractility and are called inopressors.
Examples of positive inotropic agents include:
⭐ Milrinone
⭐ Dobutamine
⭐ Dopamine
⭐ Isoproterenone
🧠 With the many different types of vasopressors and inotropes, it is important to understand how they work to use them effectively. Choosing the wrong agent or using it inappropriately, can harm the patient.
Vasopressors and Inotropes Read More »
Hyperkalemia, Signs and Symptoms of Read More »
Hypernatremia, Signs & Symptoms of Read More »