Lightning rounds #22: Our drugs of choice

In this episode of Critical Care Scenarios, Brandon Odo and Brian Bowling discuss their go-to drug choices for common clinical scenarios encountered in the ICU. They emphasize that many drug decisions are based on habit, training, and local institutional culture rather than strict evidence-based guidelines, acknowledging that there are often multiple valid approaches in medicine. The hosts review their preferred drugs for stress ulcer prophylaxis (H2 blockers like Famotidine), DVT prophylaxis (subcutaneous heparin or low molecular weight enoxaparin), and IV fluids (avoiding maintenance fluids when possible, preferring boluses). They also discuss diuretics (Furosemide), hypertension management (Labetalol and Hydralazine), rapid A-fib rate control (Metoprolol), and empiric broad-spectrum antibiotics (Vancomycin and Piptezo). Additionally, they delve into strategies for sedation and analgesia in ventilated patients, including the use of Propofol and Dexmedetomidine, and methods for de-escalating sedative and opioid drips. They encourage listeners to share their own preferred drug choices and engage in a discussion on the Patreon site.