*Note
on course proficiencies*
YEAR 4
SEMESTER 1 - 2 - 3
Critical Care
PHAR 5685
Course Description:
Clinical pharmaceutical health care experience with patients in
a critical care unit.
Cr. 6. (0-18)
Prerequisite:
Fourth year standing in the College of Pharmacy or consent of
the instructor.
Course Proficiencies:
The student will be able to:
1. Describe the pathophysiology and therapy
(drug and non-drug) of the following complications in critical
care settings:
a. Pneumonia
b. Sepsis and septic shock syndrome
c. Acute respiratory distress syndrome
d. Acid-Base disorders
e. Nosocomial infections (catheter-related, ventilator-related)
f. Coagulopathies
g. Respiratory failure
h. Pneumothorax
i. Stress ulcer
j. Deep vein thrombosis/Pulmonary embolism
k. Malnutrition
2. Describe the pathophysiology and therapy (drug and non-drug)
of the following disease specific complications:
a. Hypo- and hyperthyroidism
b. Diabetic ketoacidosis
c. Meningitis
d. AIDS/Opportunistic infections
e. Hepatic failure
f. Acute poisonings/Drug overdose
g. Endocarditis
h. Acute gastrointestinal bleeding
i. Acute/Chronic renal failure
j. Cerebral vascular accidents
k. Acute coronary syndromes
l. Pulmonary embolism
3. Describe basic principals of ventilator management including:
a. Blood gas interpretation
b. Ventilator settings including mode, tidal volume, FiO2, rate,
PEEP, pressure support
c. Weaning protocol
d. Sedative agents
e. Pain management
f. Neuromuscular blocking agents
g. DVT prophylaxis
h. Stress Ulcer prophylaxis
i. Nutritional therapy
4. Describe the therapeutic use of the following medical devices:
a. Peripheral intravenous catheter
b. Central venous catheter
c. Arterial line
d. Central venous pressure catheter
e. Pulmonary artery catheter
f. Pacer
g. Chest tube
h. Feeding tubes
i. Urinary catheter
j. Shunts
5. Describe the therapeutic use of the following procedures:
a. Hemodialysis
b. Glucose accu-checks
c. Echocardiogram
d. Cardiac catheterization
e. Transesophageal echocardiogram
f. Bone marrow aspiration
g. Bronchoscopy
h. Lower extremity ultrasound
i. V/Q scan
j. CT scan
k. Chest X-ray
l. ERCP (endoscopic retrograde cholangiopancretography)
m. EGD (esophagogastroduodenoscopy)
6. Describe the clinical applications of the following laboratory
tests:
a. Chemistry panels
b. Liver function tests
c. CBC with differential
d. Urinalysis
e. Gram stain reports
f. Culture and sensitivity reports
g. Therapeutic drug monitoring reports
h. Albumin/pre-albumin
i. CSF
7. Retrieve and assess pertinent information from the patient’s
medical record including:
a. Physician orders
b. Physician progress notes
c. Laboratory results
d. Procedures
e. Nutritional assessments
f. Flow sheets: I/O, temperature, pulse, respirations, diet
g. Nurse’s notes
h. Medication administration
8. Assess a patient’s nutritional needs and develop a plan through
a multidisciplinary approach including assessment of patient’s
caloric, fluid, and protein needs.
9. Recommend adjust of a patient’s nutritional requirements based
on coexisting disease states such as diabetes, hepatic failure,
renal failure, and patients requiring ventilator management.
10. Describe the advantages, disadvantages, and complications
of enteral nutritional therapy.
11. Describe the advantages, disadvantages, and complications
of parenteral nutritional therapy.
12. Describe monitoring parameters for enteral nutritional therapy
including laboratory results such as chemistry panels, LFT, nutritional
indices, I/O, glucose, lipid profile, residual volumes.
13. Describe monitoring parameters for parenteral nutritional
therapy including laboratory results such as chemistry panels,
LFT, nutritional indices, I/O, glucose, lipid profile, residual
volumes.
14. Recommend the appropriate drug in a cardiac emergency, based
on advanced cardiac life support (ACLS) algorithms.
15. Describe dosing and monitoring parameters for the following
emergency drugs:
a. Dopamine
b. dobutamine,
c. norepinephrine,
d. epinephrine
e. nitroprusside
f. nitroglycerin
g. diltiazem
h. amiodarone
i. lidocaine
j. procainamide
k. insulin.
16. Provide a pharmacokinetic consult for the following drugs:
a. Aminoglycosides
b. Vancomycin
c. Phenytoin
d. Digoxin
e. Theophylline
f. Phenytoin
17. Demonstrate the ability to function as a productive member
of a multidiciplinary healthcare team including the intensivist/attending
physician/consulting physician, nurse, respiratory therapist,
dietician, social worker, case manager, and any other relevant
team member involved in patient care.
18. Formulate a therapeutic plan for each assigned patient, including
recommendations for the management and monitoring of all drug
therapy.
19. Demonstrate the ability to monitor the progression of disease
or effects of therapy by using clinical symptoms, laboratory data,
information generated by hemodynamic monitoring techniques, and
other relevant data.
20. Monitor the effects of drug therapy changes on quality of
patient care, patient outcome, and assessment of clinical pharmacy
services.
