The Fundamentals of Critical Care Clinical Pharmacy Course 2024

• 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

• 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

• 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

• 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)

• 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

•  Describe the main functions of the liver

• Understand how to interpret Liver Function Tests (LFTs)

• Describe the signs and symptoms of chronic liver disease and the impact these have on drug handling and PKPD

•  Develop a systematic approach for screening prescription orders in patients with liver diseases considering patient factors, drug factors, extracorporeal factors and disease factors. 

•  Learn about the reference sources to support decision making with regard to dose adjustment in liver disease and the limitations of these

• Developing an understanding of the important factors to consider when reviewing:

-(i) Sedation

-(ii) Analgesia 

-(iii) Anticoagulation in patients with liver disease 

• 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