Critical Care Scenarios

Lightning rounds #22: Our drugs of choice

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Nov 23, 2022
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ADVICE

Stress Ulcer Prophylaxis Choices

  • For stress ulcer prophylaxis, famotidine is a good initial choice unless PPIs are specifically indicated.
  • PPIs may be used for high-risk patients or those with prior GI bleeding but have unclear outcome benefits over H2 blockers.
ADVICE

DVT Prophylaxis Preferences

  • Use subcutaneous heparin routinely for DVT prophylaxis, especially in neuro and surgical ICUs.
  • Consider low molecular weight heparin in surgical patients or those without renal issues for convenience and efficacy.
ADVICE

IV Fluid Maintenance Strategy

  • Prefer to avoid maintenance IV fluids routinely; use bolus fluids for volume indications.
  • Choose Lactated Ringer's for maintenance if needed, except in neuro ICU where normal saline is preferred.
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