ICU Primary PrepCast #009- Respiratory Pharmacology
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Sep 16, 2018 Explore the fascinating world of respiratory pharmacology! Learn why oxygen is considered the most vital drug in the ICU and the risks of hyperoxia. Discover the differences between bronchodilators like Salbutamol and Salmeterol, and dive into the classifications of medications for acute severe asthma. Maddy shares insights on dosing, effects, and side effects of various drugs, providing valuable clinical implications. The conversation is wrapped up with a fun quiz that lightens the mood. Tune in for an engaging discussion on essential critical care pharmacology!
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Oxygen Is A Pharmacologic Agent
- Oxygen is a drug with systemic effects, not an inert gas, and most indications lack strong evidence.
- Hyperoxia causes ROS-mediated cellular injury and multiple organ adverse effects including V/Q mismatch and worsened hypercapnia.
Avoid Routine Hyperoxia
- Avoid routine hyperoxia; target appropriate saturations and avoid FiO2 >60% when possible due to pulmonary and cardiovascular harms.
- Recognize risks like increased myocardial infarct size, retinopathy in neonates, and impaired mucociliary clearance with high FiO2.
Three Therapeutic Targets In Severe Asthma
- Acute severe asthma therapy targets bronchodilation, inflammation reduction, and decreased work of breathing.
- Treatments span beta-2 agonists, antimuscarinics, methylxanthines, magnesium, ketamine, volatile agents, steroids, and sometimes heliox.