Critical Care Pharmacology Flashcards
6 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Critical Care Pharmacology flashcards as text
Which medication used for stress ulcer prophylaxis in ICU patients is associated with the highest risk of Clostridioides difficile infection?
Answer: Proton pump inhibitors (PPIs)
PPIs carry the highest risk of C. difficile-associated diarrhea among stress ulcer prophylaxis agents due to their profound suppression of gastric acid, which normally inhibits spore germination.
A patient receiving phenytoin IV for seizure management develops bradycardia and hypotension during infusion. What is the most appropriate intervention?
Answer: Slow the infusion rate to no faster than 50 mg/min
Phenytoin IV must not be infused faster than 50 mg/min due to its propylene glycol vehicle, which causes cardiac depression and hypotension with rapid administration.
Which drug is used as a continuous infusion for refractory status epilepticus and requires monitoring for propylene glycol toxicity with prolonged use?
Answer: Midazolam
Continuous midazolam infusion is used for refractory status epilepticus; prolonged use can cause propylene glycol accumulation, leading to metabolic acidosis and renal failure.
A critically ill patient requires vasopressin. What is the primary mechanism of action of vasopressin in septic shock?
Answer: V1 receptor-mediated vasoconstriction of vascular smooth muscle
Vasopressin acts on V1 receptors on vascular smooth muscle to cause vasoconstriction and restore vascular tone in septic shock, independent of adrenergic pathways.
Which corticosteroid is recommended by current Surviving Sepsis guidelines for refractory septic shock (vasopressor-dependent)?
Answer: Hydrocortisone 200 mg/day (continuous or divided doses)
IV hydrocortisone 200 mg/day is recommended for adult septic shock patients who remain hemodynamically unstable despite adequate fluid resuscitation and vasopressor therapy.
A patient is receiving a nicardipine infusion for hypertensive emergency. Which parameter should the nurse monitor most closely?
Answer: Blood pressure every 5–15 minutes during titration
Nicardipine is a titratable IV calcium channel blocker; blood pressure must be monitored every 5–15 minutes during titration to avoid overshoot hypotension.