Dr.
Edgar R. Gonzalez is the President and Chief Executive Officer for Capital
Pharmacy Consultants. This multi disciplinary medical research and education
corporation provides clinical pharmacy services and medical research and
education support to private hospitals, teaching institutions and research
foundations nationally. Dr. Gonzalez is Professor of Clinical Pharmacy at the
Nevada College of Pharmacy Henderson Nevada. He coordinates the implementation
of the “Faculty in Residence” Program and lectures to Doctor of Pharmacy
candidates in the areas of Pharmacology and Clinical Pharmacy at the Nevada
College of Pharmacy.
Dr. Gonzalez has
devoted a substantial portion of his professional career to the advancement of
Critical Care as a subspecialty of Clinical Pharmacy Practice. He led the
efforts to develop and implement the American Society of Health-System
Pharmacists (ASHP) Specialty Practice Group (SPG) for Critical Care Pharmacy and
he was the first Chairman of this SPG. Dr. Gonzalez spearheaded the efforts to
write the ASHP Supplemental Standards and Learning Objectives for Residency
Training in Critical Care Pharmacy. Under his preceptorship, the Critical Care
Pharmacy Residency at the Medical College of Virginia Hospital was the first to
be accredited by ASHP. Dr. Gonzalez is the first recipient of the American
Society of Consultant Pharmacists Foundation Fellowship in Geriatric Long Term
Care.
Dr. Gonzalez is an
avid researcher and author. He has been awarded over 40 research grants. He has
published more than 115 articles and over 40 abstracts. He has authored 18 book
chapters, and published two textbooks: Drug Therapy in Emergency Medicine and
Field Drug Reference for Emergency Care Providers. He is a reviewer for numerous
scientific journals, research fellowship committees, and grant award committees.
He was the Pharmacology Section Editor for the 1992 and 1994 American Heart
Association Standards and Guidelines for Advanced Cardiac Life Support. In 1999
and 2000, he served on the Scientific Evidence Based Evaluation Sub-Committee
for the American Heart Association’s Emergency Cardiac Care Committee. He was
the first and only pharmacist, to date, to serve on the American Heart
Association’s National Advanced Cardiac Life Support Subcommittee. He is
currently a member of the Critical Care Advisory Board of the United States
Pharmacopeial Convention and a member of the National P& T Committee for
Pharmerica. Dr. Gonzalez’ research has led to the implementation of the
National Heart Attack Alert Program and the Practice Guidelines for the
Treatment of Acute Cardiac Care by the National Institutes of Health.
Furthermore, his work in pre-hospital emergency cardiac care is leading the way
for the implementation of intravenous amiodarone for use in refractory
ventricular fibrillation.
Dr. Gonzalez received
a Bachelor of Science in Pharmacy (cum laude) from the Philadelphia College of
Pharmacy and Science. Dr. Gonzalez holds a Doctor of Pharmacy degree and a
Graduate Certificate in Gerontology from the University of Utah. He completed a
two-year clinical pharmacy residency at the University of Utah Medical Center.
Agreements and Controversies in the New ACLS Guidelines
Everyday we treat 1,000 cardiac arrest victims, and
despite our most sophisticated efforts at advanced cardiac life support, less
than 1 in 10 victims of ventricular fibrillation that is refractory to
electrical therapy survives to leave to the hospital.
What new hope can we offer these victims?
Today’s discussion will focus on the emerging roles of vasopressin and
intravenous amiodarone for the treatment of refractory ventricular fibrillation.
Individually, these therapies have shown promising results.
Together, these drugs may offer the best approach to improving survival
in patients with ventricular fibrillation that is refractory to electrical
therapy.
Educational Goal
To review the epidemiology, pathophysiology, and
treatment options for ventricular electrical storm and sudden cardiac death in
accordance with current scientific evidence and the 2000 American Heart
Association Guidelines for Advanced Cardiac Life Support.
Learning Objectives:
At the conclusion of this program, participants will be
able to:
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Define the epidemiology of sudden cardiac death.
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State why rapid defibrillation is the strongest link in
the chain of survival following cardiac arrest.
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Describe the pathogenesis of the electrical storm that
culminates in refractory ventricular fibrillation.
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Discuss why the mechanisms of action of vasopressin
make it a more desirable pressor when compared with epinephrine in patients
with refractory ventricular fibrillation.
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Review the evidence-based process used in determining
role of lidocaine, bretylium, magnesium, procaine amide, and amiodarone in
the treatment of the electrically unstable ventricular myocardium.
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Discuss 2000 AHA ACLS Guidelines for treatment of
refractory ventricular fibrillation
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List potential adverse drug reactions and drug
interactions that can hinder the outcome of patients with refractory
ventricular fibrillation
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Review the techniques for rapid administration of
vasopressin and amiodarone in patients with refractory ventricular
fibrillation. |
