Vasoactives in Septic Shock

Pharmacy to Dose: The Critical Care Podcast

Vasoactives in Septic Shock with Special Guest: Alex Flannery, PharmD, BCCCP, BCPS

3:35 – Why is Alex interested in sepsis?...5:49 – How do you teach sepsis with the recent changes?...8:35 – When to start vasopressors in a hypotensive patient?...11:58 – What do you consider high-dose norepinephrine?...13:40 – How do you add vasopressin and corticosteroids for patients in refractory septic shock?...15:15 – Do you use fludricortisone in combination with hydrocortisone?...16:49 – Utility of cortisol levels or ACTH stimulation testing...18:27 – Cost:benefit analysis of vasopressin...19:21 – Role of epinephrine in septic shock...21:15 – Dobutamine or Epinephrine?...22:57 – HAT cocktail...24:55 – Thiamine supplementation in sepsis and septic shock...28:35 – Use of Angiotensin II and its place in therapy...32:30 – Approach to using methylene blue...34:05 – Modify hemodynamic goals to assist with vasopressor weaning...36:07 – Managing adverse effects due to vasopressors...39:27 – Order of operations in weaning vasopressors and corticosteroids...44:35 – The use of midodrine to wean off IV vasopressors...49:25 – Take-away points for vasoactives and their use in septic shock...51:11– Future areas for research

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