The way of patient care process for #clinical_pharmacy

All Antibiotics according to the mechanism of action

متى نفضل إعطاء مضاد حيوي واسع الطيف ؟
في الحقيقه يفضل إعطاء مضاد واسع الطيف في حالتين وليس أي انفكشن يعطى
الحاله الأولى عندما يكون هناك
mixed infections where multiple organisms are likely to be present.
مثل
intra-abdominal and female pelvic infections
في هذه الحاله قد يصاب ب
aerobic and anaerobic bacteria
في هذه الحاله ي أما نجيب دواء واسع الطيف يغطي النوعين او نضيف دوائين.
الحالة الثانيه في
critically ill patients with presumed healthcare-associated infections
وهذا بسبب انة غالبا يصاب ب
multi-drug resistant.

Septic shock definition and fluid resuscitation

Vassopressors drugs in septic shock

Assessment of Tissue perfusion in septic shocks patient

Antimicrobial in Septic shock

Corticosteroid and sodium bicarbonate in septic shock

🔹PCT appears to be a more specific marker for bacterial infections than either CRP or ESR, and it can be a valuable tool for the clinician to help assess mortality risks of patients with infections and also can help determine when to initiate antibacterial

nutrition in septic shock
اخر موضوع

✅خلصت اجازة العيد والحمدلله اني اقدرت احضر وسجل موضوعين وهو Community-acquired pneumonia و Septic shock اخذت مني جهد ووقت واكتشفت انه الجانب الأكاديمي متعب😅 اتمنى بانة قد اوصلت الموضوعين بشكل جيد ، وغدا نعود لدوام العمل 😁 ونلتقي في الإجازات في مواضيع ثانية ان شاءالله،أسأل الله أن يكون هذا العمل خالص لوجهه الكريم 👏👏

🔺PCT levels may help determine whether to discontinue empiric antibiotics in possibly infected patients as well as to determine when antibiotics can be discontinued in patients recovering from infections.

🔹PCT levels below 0.25 ng/mL (mcg/L) are associated with low risk of infection and can help justify the discontinuation of antibiotics, while levels >0.5 ng/mL (mcg/L) may indicate that antibiotics should be continued

🛑Approach for shock management

✅Point of care ultrasound to differentiate cause of shock

✅Is there evidence of overt fluid/blood loss e.g. GIT bleeding ➡️blood and fluid resuscitation

✅In absence of evidence of overt blood loss➡️ Fluid responsiveness

✅Titrate norepinephrine to reach MAP ≥ 65 mmHg

✅After reaching the target of MAP ➡️assess tissue perfusion using lactate and/or capillary rfill time

✅If tissue perfusion is adequate→start weaning of vasopressor

✅If tissue perfusion is inadequate consider higher MAP (70-75 mmHg)

✅If tissue perfusion remains inadequate after achieving high MAP→ consider inotropic support in patients with poor contractility.

#Evidence-Based Critical Care Protocols 2022

🛑ادويه anticoagulants المستخدمه في معالجة مريض Acute coronary syndrome هي
✅heparin
✅enoxaparin
✅fondaparinux
✅bivalirudin
السؤال متى نستخدم كل واحد ؟؟