Blood Pressure Targets in Hypertensive Crisis Timeline: 1 hour: ↓ MAP by 25%, Maintain DBP ≥ 100 mmHg 2-6 hours: Titrate To Goal SBP 160 mmHg & DBP 100 mmHg 24 hours: Maintain SBP <160 mmHg & DBP <100 mmHg Ashley & Brooke Barlow PharmD @theABofPharmaC #Blood #Pressure #Targets #Hypertensive #Crisis #Emergency #Urgency #management

Status Epilepticus Pharmacotherapy Guide • Phenytoin and Fosphenytoin • Valproate Sodium • Levetiracetam • Lacosamide • Midazolam • Phenobarbital • Propofol • Ketamine Ashley & Brooke Barlow PharmD @theABofPharmaC #Status #Epilepticus #Pharmacology #neurology #management #epilepsy #seizure

Status Epilepticus Pharmacology Ashley & Brooke Barlow PharmD @theABofPharmaC #Status #Epilepticus #Pharmacology #neurology #management #seizure

High Dose Methotrexate - Toxicities and Pharmacology Ashley & Brooke Barlow PharmD @theABofPharmaC #High #Dose #Methotrexate #Pharmacology #oncology #leucovorin #Toxicities

Antithrombotic Regimens for Prosthetic Heart Valves Mechanical Heart Valves Bioprosthetic Heart Valves Transcatheter Aortic Valve Repair Ashley & Brooke Barlow PharmD @theABofPharmaC #anticoagulation #Prosthetic #Heart #Valves #replacement #mechanical #pharmacology #cardiology

Testicular Cancer - Treatment Related Toxicities Bleomycin, Cisplatin, Etoposide, lfosfamide Tinnitus & Hearing Loss Neurotoxicity Pulmonary Fibrosis Hypotension Nephrotoxicity Skin Hyperpigmentation Hemorrhagic Cystitis Myelosuppression Peripheral Neuropathy Ashley & Brooke Barlow PharmD @theABofPharmaC #Testicular #Cancer #chemotherapy #toxicity #toxicology #Toxicities #pharmacology #oncology

Antibiotic Tissue Penetration Blood Brain Barrier: Penicilins (IV), 3rd & 4th generation Cephalosporins (IV), Meropenem, TMP-SMX, Metronidazole, Linezolid, Fluoroquinolones Prostate: Fluoroquinolones Urine: Beta-lactams, Fluoroquinolones (NOT moxifloxacin), TMP-SMX, Aminoglycosides Lungs: Most antibiotics EXCEPT Daptomycin (inactivated by pulmonary surfactant), Aminoglycosides (hydrophilic, low Vd), Vancomycin (low Vd) Intrabdominal: Beta-lactams, Ceftriaxone Bone: Fluoroquinolones Poor Abscess Penetration: Aminoglycoside (inactivated by low pH) Ashley & Brooke Barlow PharmD @theABofPharmaC #Antibiotic #Tissue #Penetration #pharmacology

Pharmacologic Management of ARDS Acute Respiratory Distress Syndrome (ARDS) - Berlin Definition Mechanical Ventilation - Minimizing "Baro trauma" Fluid Management in ARDS - Liberal vs. Conservative Approach Corticosteroids in ARDS Neuromuscular Blockade Pulmonary Vasodilators - Prostacyclins Ashley & Brooke Barlow PharmD @theABofPharmaC #ARDS #pharmacology #medications #management #pulmonary

Rasburicase Pharmacology Summary Recombinant urate oxidase from saccharomyces Immediate onset of action Dosing: - Package insert: 0.2 mg/kg IV once daily up to 5 days - Clinical practice: 1.5-6mg x 1 dose depending on the level of uric acid Contraindications: G6PD deficiency due to hydrogen peroxide produced from conversion of uric acid to allantoin Monitoring: repeat uric acid every 8 hours for 1-2 days until no longer at risk of cell lysis Ashley & Brooke Barlow PharmD @theABofPharmaC #Rasburicase #Pharmacology #Elitek

Allopurinol Pharmacology Summary Xanthine oxidase inhibitor blocking the formation of new uric acid Initiate 1-2 days prior to chemotherapy Dosing: 100 mg/m2/dose every 8 hours (max 800mg/day) • Usual: 300 mg/day • Dose adjustments for CrCl <10mL/min Side effects: gastrointestinal irritation, rash, fever, hypersensitivity Drug interactions: 6-mercaptopurine and azathioprine Limitations: • Slow onset of action of 24-72 hours • No effect on excretion of pre-formed uric acid • Precipitation of xanthine metabolites in the kidney #Allopurinol #Pharmacology #pathophysiology #gout #uricacid