BCPS
- Cardiovascular
- Endocrine
- Gastrointestinal disorder
- Infectious disease
- Men’s and women’s health
- Neurology
- Oncology
- Ophthalmic and otics
- Pain management
- Psychiatric
- Renal disease / fluids & electrolytes
- Respiratory
- Skin conditions
- Special populations
- Pharmacokinetics pharmacodynamics
- Biostatistics and pharmacoeconomics
- Pharmacy policy, procedure and regulations
The questions in this section are intended to test your knowledge and skills on pharmacotherapy including biostatistics for practicing pharmacists and pharmacist preparing for BCPS (Board Certified Pharmacotherapy Specialist)
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BCPS | Respiratory
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Question 1 |
JP is a 40yr old male who was found lying on the floor with several empty liquor bottles by his friend. After being brought to the ER his serum alcohol level was found to be 475 mg/dl. Toxicology report negative except for high alcohol level. 2 hours after admission in the ER he was intubated and then transferred to ICU . His liver enzymes and renal function are normal. PT/INR within normal limit. No past medical history. Upon transfer medications includes Propofol, MVI daily, Lorazepam prn and Piperacillin/Tazobactam. What measures can one take to prevent ventilator associated Pneumonia (VAP)?
Twice daily oral decontamination with Chlorhexidine | |
Give Pipercillin/Tazobactam 3.375gm IV q6hr prophylaxis | |
Elevate the head of the bed by 30-45 | |
A and C are appropriate measures to prevent VAP |
Question 1 Explanation:
The following 5 elements are part of the Institute of Healthcare Improvement VAP bundle: oral care with Chlorhexidine, head of bed elevation, DVT prophylaxis, SUP, and daily sedation assessment and spontaneous breathing trials. Other suggested measures for VAP prophylaxis are small bowel feeding instead of gastric feeding, prophylactic probiotics, alcohol based hand washing policy, early discontinuation of invasive devices, early tracheostomy, and reducing reintubation rates. Giving prophylaxis antibiotic is not recommended.
Reference:
Kalanuria AA, Zai W, Mirski M. Ventilator-associated pneumonia in the ICU. Critical Care. 2014;18(2):208. doi:10.1186/cc13775.
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