IBL-ICU

Reviewed and revised 9 September 2019

See below for the daily questions for the Inquiry-Based Learning programme at the Alfred ICU (IBL-ICU). Click the links for the self-directed learning resources for each topic.

TERM 3, 2019

Week 7: Pharmacology and Toxicology

Q1. Thursday (12/09):
Review a patient’s drug chart with the ICU pharmacist. What are the potential drug interactions to be aware of? What are the common ICU drug interactions?

Q2. Friday (13/09):
Discuss the dosing and frequency of administration of important ICU medications with the ICU pharmacist. What factors affect the pharmacokinetics (absorption, distribution, metabolism and excretion) of these medications in critically ill patients?

Q3. Saturday (14/09):
Discuss a patient who may benefit from therapeutic drug monitoring (TDM). When should we perform TDM – which drugs and in which patients? What practical issues affect TDM?

Q4. Sunday (15/09):
Review a patient who has renal impairment (+/- renal replacement therapy). How does it affect the dosing and timing of their medications? How does renal replacement therapy alter this?

Q5. Monday (16/09):
Review a patient with complex analgesia needs. Discuss the advantages and disadvantages of different pharmacological therapies for this patient? (e.g. opioids, partial opioid agonists (such as buprenorphine, tramadol/ tapentadol), pracetamol, NSAIDS, ketamine, and lignocaine infusions)

Week 5: Infectious diseases and Microbiology

Q1. Thursday (29/08):
Review a patient who has had a fever in the last 24 hours. How do you define fever? What are the potential infectious and non-infectious causes of fever in ICU patients?

Q2. Friday (30/08):
Review a patient who is being treated for an infection. How will you determine when to stop antibiotics?

Q3. Saturday (31/08):
Review a patient who is being treated with antibiotics. How do you decide if the patient is failing to respond to treatment? What are the possible causes of failure to respond to antibiotic therapy?

Q4. Sunday (01/09):
Consider a patient who has been isolated for infection control. What are the different types of isolation and their indications?

Q5. Monday (02/09):
Attend an ICU Micro round. How does the ICU micro round help patients? What strategies help reduce the emergence of resistant organisms?