Laura Di Taranti, MD
PRESSORS! This post was originally submitted as a summary of many different pressors. It is great to think about them all together, but maybe not digestible in a single bite. If you want to learn about them all at once, watch Dr. Di Taranti's lecture from conference last month. Instead, we will break them down one by one, focusing on a different pressor each week, with the summary table re-presented each week to help compare. Use this as spaced repetition. Each week, remind yourself what the different receptors do. Ask yourself how one medication is different from the last. Ask yourself what dose you would start with and which patients you would use it for. Review all the pressors, but do it slowly, one bite at a time, and ease yourself in.
Most patients who undergo intubation will receive some sort of post-intubation sedative. In the ICU, over-sedation is common, and early deep sedation is associated with worse outcomes in mechanically ventilated patients – specifically, higher mortality. Does the choice of sedative affect mortality?
A 55 year old patient presents via EMS reporting a large ingestion of his home oral phenytoin. As you go to evaluate the patient, you consider the clinical manifestations and possible complications of a phenytoin overdose. Is this a serious overdose? Is there a high potential for decompensation and the dreaded tox "seizure/coma/death" triad? Are there effective antidotes? Good thing you read this article!