Therapeutics - Acid/Base 2

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Author:
kyleannkelsey
ID:
260888
Filename:
Therapeutics - Acid/Base 2
Updated:
2014-02-08 14:27:10
Tags:
Therapeutics Acid Base
Folders:
Therapeutics - Acid/Base 2
Description:
Therapeutics - Acid/Base 2
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  1. Acetazolamide
    • Metabolic alkalosis treatment– Saline Responsive
    • Urine Cl- < 10 mMol/L
    • Use when can’t tolerate high Na (CHF, renal failure)
    • 1 or 2 doses is enough
    • 250 mg IV q6 -12h
  2. Remove excess mineralcorticoid
    • Metabolic alkalosis treatment- Saline resistant
    • Urine Cl>20 mMol/L
  3. Spironolactone
    • Metabolic alkalosis treatment- Saline resistant
    • Urine Cl>20 mMol/L
  4. Replace Potassium deficit
    • Metabolic alkalosis treatment- Saline resistant
    • Urine Cl>20 mMol/L
  5. What causes Saline responsive metabolic acidosis?
    • Loss of Cl-
    • Usually from Gastric acid loss or Excessive dieresis
    • What cases Saline resistant metabolic acidosis?
    • K depletion
    • Hypercalcemia
    • Mineralocorticoid excess (hyperaldosteronism, black licorice)
  6. What are the treatments for Saline resistant metabolic alkalosis?
    • Remove mineralcorticoid source
    • Replace K
    • Spirolactone
  7. What are the treatments for Saline responsive metabolic alkalosis?
    • Acetazolamide (if can’t tolerate Na)
    • NS
  8. What lab result would indicate Saline-responsive metabolic alkalosis?
    • Saline responsive: Cl < 10 mmol/L
    • Metabolic alkalosis: >7.45 pH and >45 mm Hg pC02
  9. What lab result would indicate Saline-resistant metabolic alkalosis?
    • Saline responsive: Cl > 20 mmol/L
    • Metabolic alkalosis: >7.45 pH and >45 mm Hg pC02
  10. What are the causes of Respiratory Acidosis?
    • Alveolar Hypoventilation
    • e.g.
    • COPD, BB, Sleep apnea,
  11. Is Sodium Bicarbonate commonly used for Respiratory acidosis?
    No, could cause pulmonary edema
  12. What are the treatments for Respiratory acidosis?
    • Mechanical ventilation/CPAP
    • Correct underlying issues
    • Respiratory stilmulants:
    • Medroxyprogesterone acetate
    • Theophylline
    • Doxapram
  13. Mechanical ventilation/CPAP
    Respiratory acidosis
  14. Respiratory stilmulants
    Respiratory acidosis
  15. Medroxyprogesterone acetate
    Respiratory acidosis
  16. Theophylline
    Respiratory acidosis
  17. Doxapram
    • Respiratory acidosis
    • Reserve for unresponsive patients
  18. Should you aggressively treat chronic low pH in Respiratory Acidosis?
    No
  19. What are the signs of Respiratory Alkalosis?
    • Increased rate and depth of breaths
    • Tachycardia
    • pH: >7.45
    • pC02: <35
  20. What are the treatment options for Respiratory Alkalosis?
    • Treat underlying cause
    • Let resolve on its own
    • Breathing exercises
    • Sedatives
  21. What are the causes of respiratory alkalosis?
    • CHAMPS
    • CNS disease
    • Hypoxia
    • Anxiety
    • Mechanical ventilators
    • Progesterone
    • Salicylates/sepsis
  22. Pulmonary embolus causes what acid/base disorder?
    Respiratory Alkalosis
  23. Hypotension causes what acid/base disorder?
    Metabolic Acidosis
  24. Vomiting causes what acid/base disorder?
    Metabolic Alkalosis
  25. Diarrhea causes what acid/base disorder?
    Metabolic Acidosis
  26. Cirrhosis causes what acid/base disorder?
    Respiratory Alkalosis
  27. Renal Failure causes what acid/base disorder?
    Metabolic Acidosis
  28. Sepsis causes what acid/base disorder?
    Respiratory alkalosis/Metabolic Acidosis
  29. Pregnancy causes what acid/base disorder?
    Respiratory Alkalosis
  30. Diuretics cause what acid/base disorder?
    Metabolic Alkalosis
  31. COPD causes what acid/base disorder?
    Respiratory Acidosis

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