Aneurysmal Subarachnoid Hemorrhage
06/03/20 • 97 min
Aneurysmal Subarachnoid Hemorrhage
Special Guest: Casey May, PharmD, BCCCP
Show Notes: https://pharmacytodose.files.wordpress.com/2020/06/asah-show-notes.pdf
Reference List: https://pharmacytodose.files.wordpress.com/2020/06/asah-references.pdf
02:51 – Types of intracerebral bleeds; 06:19 – Types of subarachnoid hemorrhage; 08:25 – Pathophysiology of aSAH; 10:45 – Risk factors; 12:48 – Classic aSAH presentation; 16:36 – Classificiation systems; 22:25 – Prioritizating acute management of aSAH; 25:15 – Blood pressure goals; 26:21 – Preferred anti-HTN agent?; 28:25 – Biggest concerns with anti-HTN agents; 31:08 – ICP management; 35:40 – Surgical clipping v. Endovascular coiling; 42:51 – Cerebral vasospasms and delayed cerebral ischemia; 55:07 – Nimodipine in aSAH; 68:20 – DVT prophylaxis; 73:48 – Seizure prophylaxis; 76:30 – Augmented renal clearance; 83:56 – Take-home points
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Aneurysmal Subarachnoid Hemorrhage
Special Guest: Casey May, PharmD, BCCCP
Show Notes: https://pharmacytodose.files.wordpress.com/2020/06/asah-show-notes.pdf
Reference List: https://pharmacytodose.files.wordpress.com/2020/06/asah-references.pdf
02:51 – Types of intracerebral bleeds; 06:19 – Types of subarachnoid hemorrhage; 08:25 – Pathophysiology of aSAH; 10:45 – Risk factors; 12:48 – Classic aSAH presentation; 16:36 – Classificiation systems; 22:25 – Prioritizating acute management of aSAH; 25:15 – Blood pressure goals; 26:21 – Preferred anti-HTN agent?; 28:25 – Biggest concerns with anti-HTN agents; 31:08 – ICP management; 35:40 – Surgical clipping v. Endovascular coiling; 42:51 – Cerebral vasospasms and delayed cerebral ischemia; 55:07 – Nimodipine in aSAH; 68:20 – DVT prophylaxis; 73:48 – Seizure prophylaxis; 76:30 – Augmented renal clearance; 83:56 – Take-home points
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Previous Episode
Acute Liver Failure
Acute Liver Failure
Special Guest: Stephanie Bass, PharmD, BCPS, BCCCP
Show Notes: https://pharmacytodose.files.wordpress.com/2020/05/acute-liver-failure-show-notes.pdf
Reference List: https://pharmacytodose.files.wordpress.com/2020/05/acute-liver-failure-references.pdf
03:05 – Stephanie’s interest in the liver; 05:54 – Diagnosing ALF; 07:20 – Does having liver disease increase ALF risk?; 09:00 – Ultimate goal when treating ALF; 10:07 – Patient presentation; 11:58 – Common causes of ALF; 13:30 – ICP and cerebral edema management in ALF; 15:50 – PAD management in ALF; 18:55 – Acute hepatic encephalopathy management; 21:00 – Trending ammonia levels?; 22:25 – NAC for APAP overdose ALF; 27:11 – NAC for non-APAP overdose ALF; 30:23 – Albumin for ALF fluid resuscitation; 34:33 – Vasopressor use; 36:53 – Blood pressure goals; 40:00 – TEG for bleeding risk assessment; 43:45 – Hemostatic agents for coagulopathy; 46:18 – Anticoagulant of choice; 47:59 – Hepatic dose adjustments; 52:12 – Medication dosing with MARS/RRT; 54:00 – Medications to avoid; 56:02 – Transplant considerations; 58:24 – Take-home points
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Next Episode
Medication Dosing in CRRT
CRRT Medication Dosing
Special Guest: Bruce Mueller, PharmD, FCCP, FASN, FNKF
Show Notes: https://pharmacytodose.files.wordpress.com/2020/06/medication-dosing-in-crrt-show-notes.pdf
Reference List: https://pharmacytodose.files.wordpress.com/2020/06/medication-dosing-in-crrt-references.pdf
04:05 – Effect of AKI on patient outcomes; 08:40 – Different RRT modalities; 13:56 – How long has CRRT been used?; 17:35 – CRRT for all ICU patients?; 22:06 – When to avoid CRRT; 23:28 – CRRT definitions; 43:20 – Medication underdosing on CRRT; 51:27 – Older CRRT dosing studies v. newer studies; 54:29 – Drug properties that increase CRRT clearance; 58:36 – Does CRRT modality affect medication clearance?; 60:02 – Antibiotic retiming; 61:20 – Drug reference dosing recommendations; 64:20 – Dosing when patient is on CRRT and not in AKI; 66:40 – Anticoagulation for CRRT; 75:13 – Hybrid CRRT modalities; 81:45 – General dosing considerations; 83:23 – CRRT dosing drug references
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