BCCCP study guide
BCCCP · Work through your exam, one topic at a time.
The Board Certified Critical Care Pharmacist (BCCCP) credential is a specialty certification for pharmacists who practice in intensive care units, cardiac care units, neuro-ICUs, burn units, and other high-acuity settings. It signals that a pharmacist can independently manage drug therapy for critically ill patients - patients whose physiology changes hour to hour and whose medication decisions carry immediate, life-threatening consequences. The BCCCP study guide has 10 sections and about 3,408 words.
01Cardiovascular Disorders
Cardiovascular items in critical care test a small set of repeated decisions: is this patient perfusing, which vasoactive drug and dose, and which timing or reversal rule applies. Build everything around shock physiology (preload, contractility, afterload) and the four rhythms that kill - VF/pVT, unstable VT with a pulse, symptomatic bradycardia, and unstable tachyarrhythmia.
347 words, about 2 min02Pulmonary Disorders and Mechanical Ventilation
Almost every ventilator question reduces to two ideas: protect the lung with small tidal volumes based on predicted body weight, and match the mode/settings to the underlying physiology (obstructive versus restrictive). ARDS: 6 mL/kg predicted body weight, plateau pressure ≤30 cmH2O, driving pressure under 15, PEEP titrated to oxygenation, permissive hypercapnia, prone positioning 12–16 hours/day when P/F is under 150, conservative fluid strategy.
307 words, about 2 min03Neurologic and Neurosurgical Disorders
Neurocritical care questions hinge on cerebral perfusion, seizure control, and time-critical stroke decisions. ICP/CPP: CPP = MAP − ICP; target roughly 60–70 mmHg.
300 words, about 2 min04Infectious Diseases and Sepsis
Sepsis questions test the sequence and the exceptions. Measure lactate, obtain cultures before antibiotics when it does not delay therapy, give broad-spectrum antibiotics within one hour for septic shock, give 30 mL/kg crystalloid for sepsis-induced hypoperfusion or shock, then start norepinephrine to keep MAP ≥65 mmHg.
303 words, about 2 min05Gastrointestinal, Hepatic, and Nutrition Support
Three topic clusters dominate: upper GI bleeding, cirrhosis complications, and nutrition timing. Nonvariceal GI bleed: resuscitate, IV proton pump inhibitor (80 mg bolus then 8 mg/h for 72 hours), transfuse to a restrictive hemoglobin threshold (about 7 g/dL), endoscopy after stabilization.
322 words, about 2 min06Renal Disorders, Fluids, Electrolytes, and Acid-Base
Acute kidney injury is staged by KDIGO using creatinine rise and urine output (under 0.5 mL/kg/h for 6 hours is stage 1). Serum creatinine lags 24–48 hours behind injury, so a rising creatinine means the insult already happened and a normal creatinine does not exclude injury in a patient with low muscle mass.
626 words, about 3 min07Endocrine and Metabolic Disorders
DKA and HHS share treatment principles but differ in detail. DKA: ketotic, acidemic, variable glucose.
308 words, about 2 min08Hematologic, Oncologic, and Coagulation Disorders
Restrictive transfusion (hemoglobin under 7 g/dL, under 8 in cardiac surgery or active ischemia) with single-unit dosing and reassessment is standard. Platelets are given for counts under 10,000/µL prophylactically, under 20,000 before procedures, or with active bleeding.
274 words, about 1 min09Trauma, Burns, Shock, and Resuscitation
Primary survey first (airway, breathing, circulation, disability, exposure) with simultaneous hemorrhage control. In hemorrhagic shock, activate the massive transfusion protocol early with a balanced ratio near 1:1:1 of plasma, platelets, and red cells, give tranexamic acid within 3 hours of injury, keep the patient warm, and correct calcium and acidosis.
325 words, about 2 min10Sedation, Analgesia, Delirium, and Toxicology
Analgesia-first sedation with a light target (RASS −2 to 0) shortens ventilation. Assess pain with a behavioral scale (CPOT or BPS) in patients who cannot self-report.
296 words, about 1 min