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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.

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  1. Which vasopressor is considered first-line for septic shock according to Surviving Sepsis Campaign guidelines?

    Answer: Norepinephrine

    Norepinephrine is the first-line vasopressor for septic shock due to its predominant alpha-1 agonist activity with minimal beta effects, increasing MAP effectively.

  2. A patient receiving amiodarone develops blue-gray skin discoloration and thyroid dysfunction. These are examples of which type of adverse effects?

    Answer: Long-term toxicity effects

    Blue-gray skin discoloration and thyroid dysfunction (hypo- or hyperthyroidism) are well-known long-term toxicities of amiodarone due to its iodine content and tissue accumulation.

  3. Which anticoagulant requires monitoring with anti-Xa levels rather than aPTT for accurate dosing assessment?

    Answer: Low-molecular-weight heparin (LMWH)

    LMWH (e.g., enoxaparin) does not reliably prolong aPTT and requires anti-Xa level monitoring, especially in patients with renal impairment, obesity, or pregnancy.

  4. A patient in the ICU is receiving IV vancomycin. The AUC/MIC ratio target for optimal vancomycin efficacy against MRSA is:

    Answer: 400–600

    Current ASHP/IDSA/SIDP guidelines recommend an AUC/MIC target of 400–600 mg·h/L for vancomycin to optimize efficacy and minimize nephrotoxicity.

  5. Which medication used in ICU patients is a direct thrombin inhibitor and is the anticoagulant of choice in heparin-induced thrombocytopenia (HIT)?

    Answer: Argatroban

    Argatroban is a direct thrombin inhibitor approved for anticoagulation in HIT; it is monitored by aPTT and does not require anti-Xa levels.

  6. Sodium bicarbonate infusion should NOT be used to treat metabolic acidosis caused by which condition?

    Answer: Diabetic ketoacidosis (DKA)

    In DKA, sodium bicarbonate is generally not recommended because it does not improve outcomes and may worsen hypokalemia, paradoxical CSF acidosis, and delay ketone clearance.