Pharmacy pearls I’ve noticed in ICU COVID patients... 1) ⬆️ triglycerides (from HLH features of these patients) make using propofol sedation regimens difficult, have had to use BZDs to achieve apparopriate sedation for paralysis... 1/
2) look for Co-infections. These patients can be persistently febrile but don’t let that fool you into thinking it’s due to COVID alone. Co-infections DO happen. Viral or bacterial. Trust me.... 2/
3) the need to keep patients net negative/even with diuresis/ ultrafiltration makes pts more sensitive to hypotension from propofol (when you can use it). 4) the drug interactions with Kaletra/plaquenil and other drugs makes me want to 😭..... 2/
5) “no you cannot use Azithromycin to treat COVID” is going to be a common phrase you say at least ten times a day. 6) bundling medications is logistically very difficult but doable especially if the pumps are outside the room.... 3/
7) I anticipate we are going to see a lot of delirium. Being trapped in a room sedated with strangers in bunny suits and masks strapped to a bed and machines is horrifying. It’s what nightmares are made off. They are going to be delirious and frightened... 4/
8) once u get used to caring for these pts make a guidance document for nuances (how to use steroids, ID regimens, labs to monitor etc) for your other pharmacists who haven’t cared for these pts yet. Save references to a public place. #ShareTheLove ... 5/
9) when you get home from work, don’t think about COVID. Virtual happy hours are a must! #COVID19 #WereInThisTogether #CriticalCare
