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TEXAS CHILDREN'S PHARMACY DEPARTMENT
Cardiology: Pediatric Cardiology/CV ICU Rotation

   
 

 

Preceptor
 Brady S. Moffett, Pharm.D.

Rotation Site Description
The CV ICU is ~ 15 bed critical care unit comprised of primarily post-operative cardiac surgical patients. Other admissions come from the catheterization laboratory or are directly admitted to the unit. A significant number of patients are placed on mechanical circulatory support (LVAD, Berlin Heart, and ECMO).

Rotation Responsibilities
Provide clinical pharmacy services to pediatric cardiac intensive care patients, which includes:

  • Understanding the basic pathophysiology of the disease states.
  • Knowing the pharmacology of each drug used.
  • Knowing the indication for each drug used.
  • Ensuring appropriate dosing for each drug used. based on height, weight, and renal function.
  • Aminoglycoside pharmacokinetic consultation and serum level analysis.
  • Vancomycin pharmacokinetic consultation and serum level analysis.
  • Pharmacokinetic consultation on any medications monitored by serum levels.
  • Calculation and recommendation of total parenteral nutrition (TPN) formulations.
  • Reporting of adverse drug events and medication incident reports.
  • Interact effectively with members of the multidisciplinary CV ICU team.
  • Attend lecture and teaching sessions with members of the CV ICU team, as applicable.
Activities
Rounds: 0700 – 0900, Monday – Friday. Rounds start later on Monday due to surgical case conference.

Required Meetings:
Meetings as scheduled with preceptor.
Cardiology SCOPE conference, 19th floor conference room,
                 last Monday of the month at noon.
Fellows lectures as necessary
Feigin Rounds (Tuesdays 1030)
Grand Rounds (Friday 0830)

Topics to be discussed
  • Congenital Heart Defects
    • PDA, Tetralogy of Fallot, ASD/VSD, HLHS, Tricuspid atresia, TGA, Aortic stenosis, Pulmonary atresia, Aortic Coarctation
  • Surgical procedures
    • PDA ligation, ASD/VSD closure, Norwood, Bidirectional Glenn, Fontan, Arterial Switch, Heart Transplantation, End to End repair of Coarctation, Patch closure of Coarctation, Blalock-Taussig shunt
  • Post-operative care
    • Stress ulcer prophylaxis, pain control, infectious prophylaxis, DVT prophylaxis
  • Management of low cardiac output syndrome
  • Arrhythmia and antiarrhythmic medications
  • Anticoagulation
  • Mechanical Circulatory Support
    • ECMO, LVAD, Berlin Heart
  • Renal Dysfunction and associated therapies
    • Hemodialysis, CVVHD, Peritoneal dialysis
  • Heart transplantation