The Fundamentals of Critical Care Clinical Pharmacy Course 2023

What the course will involve

Q&A

How to access/use google classroom 

What is critical care and what it involves

Patient journey in critical care

A standardised approach to screening ICU patients

ICU standard prescriptions, including

Nutrition talk by ICU dietician

Patient length of stay and experience

Know the differences between classes of commonly used analgesic and paralysis agents in critical care

Describe the basic pharmacology and pharmacokinetics of analgesic and paralysis agents used in critical care

Describe the key  monitoring parameters for the use of analgesic paralysis agents in critical care

Discuss possible options for analgosedation and which combinations of sedatives may be used (including dexmedatomidine–Understand side effects associated with analgosedatives

Understand the effects of weaning on sedation and the possible treatments that may be used

Identify delirium risk factors (predisposing and precipitating)

Understand how to identify and score delirium 

Understand drug causes and how these can be minimized

Understand pharmacological and non-pharmacological management of delirium to the different types of delirium

Be familiar with side effects of drugs used to treat delirium

How to improve sleep ‘hygiene’? Role of medicines to help with sleep

Be familiar with the Sepsis 3 definitions and revised Surviving Sepsis Guidelines and rationale behind treatments

Sepsis care bundle 

Understand pathophysiology and definitions of sepsis and the difference between sepsis and septic shock

Understand the use of different inotropes and vasoconstrictors and their modes of action within sepsis/septic shock

Discuss place in therapy of steroids

Understand which antibiotics may be used for different infections and which should be first line choices

Treating infection in sepsis

The kidney anatomy and functions

AKI/CKD

When a filter would be indicated 

How the filter works and calculating renal function

Drug dosing on filter

Anticoagulation for filters

Features and causes of hypovolaemia 

Fluid replacement and choices

Fluid balance 

How to give a fluid challenge 

Discuss when a fluid challenge would be indicated and how response would be monitored

Know difference in principle between fluid challenge and maintenance fluid

Know the difference and discuss the advantages/disadvantages between colloids and crystalloids

Know the commonly used fluids on ICU and when they are indicated

Know what to monitor when patients are on fluids (bloods, i/o)

Understand and differentiate between Type 1 respiratory failure, Type 2 respiratory failure and acute respiratory distress syndrome (ARDS)

Discuss basic interpretation of arterial blood gases (ABG)

Describe the pharmacological management of T1RF, T2RF and ARDS

Describe the basics of mechanical ventilation

Understand the weaning process from mechanical ventilation onto non-invasive support

Describe a tracheostomy and when it is indicated

Secretion Management in Critically ill adult  patients

Understand the indications for inotropes and vasopressors

Describe the differences between inotropes and vasopressors

Discuss monitoring parameters appropriate in patients on vasoactive drugs

Discuss the use of other vasoactive agents used in Critical Care e.g. levosimendan, milronone

Discuss options for central vs peripheral vasopressors

What is pharmacokinetics and pharmacodynamics?

Concepts in pharmacokinetics 

ICU approach to prescribing antibiotics ie max doses, loading doses for 24 hours before dose reduction in renal failure, international perspective

Dosing in haemofiltration

Pharmacodynamic properties correlating with efficacy 

TDM principles 

Role of anti-infectives in ICU and antimicrobial stewardship

Be familiar with the management on SAH

Be aware of complications of neurosurgical patients

Understand how swallow can be affected by neurological conditions

Understand the management of acute seizures

Understand the management of autoimmune conditions