Month January 2019
CCC Critical Care compendium 340

Flumazenil

Flumazenil: benzodiazepine antagonist; competitive antagonist that act on the benzodiazepine receptor

CCC Critical Care compendium 340

GI Drug Absorption in Critical Illness

GI Drug Absorption in Critical Illness; multi-factorial determinants influence the bioavailability of drugs; governed by factors altering transport of substances across cell membranes (diffusion, active transport, ultrafiltration)

CCC Critical Care compendium 340

Gentamicin

Gentamicin; aminoglycoside; irreversible binding to bacterial ribosomal proteins -> inhibits protein synthesis; Antimicrobial cover: gram negative rods (including Pseudomonas)

CCC Critical Care compendium 340

Heparin

Heparin: anticoagulant; unfractionated heparin (UFH) is a sulfated polysaccharide with a molecular weight range of 3 to 30 kDa

CCC Critical Care compendium 340

Imipenem

carbapenem (imipenem + cilastatin); inhibition of bacterial cell wall synthesis; cilastatin reduces renal metabolism -> increases effective concentration and decreases nephrotoxicity

CCC Critical Care compendium 340

Ketamine

Ketamine: phencyclidine derivative hypnotic and analgesic. NMDA receptor antagonist resulting in dissociative anaesthesia (profound analgesia with superficial sleep); interacts with opioid receptors - mu, delta and kappa

CCC Critical Care compendium 340

Levosimendan vs Dobutamine

COMPARISON EVIDENCE Mebazza, (2007) SURVIVE – Levosimendan vs Dobutamine in patients with acute decompensated heart failure, JAMA References and Links

CCC Critical Care compendium 340

Levosimendan

Levosimendan: Calcium sensitizer (novel inotrope, also considered an inodilator like milrinone)

CCC Critical Care compendium 340

Lignocaine

Lignocaine: local anaesthetic and membrane stabilising anti-arrhythmic; binds selectively to refractory Na+ channels -> preferentially when cells are depolarised (ie. in ischaemia)