In this episode, I’ll discuss the impact of compounded oral vancomycin liquid on hospital readmission for C diff infection. Subscribe on iTunes, Android, or Stitcher The drug acquisition cost for oral vancomycin capsules is several orders of magnitude larger than for liquid vancomycin prepared from the IV formulation and given via the oral route. This […]
Episode 1000: Should Pharmacists Be paying Attention to This Bacteremia Metric?
In this episode, I’ll discuss time to positivity as a predictor of catheter-related bacteremia and mortality in adults with Pseudomonas aeruginosa bloodstream infection. Subscribe on iTunes, Android, or Stitcher Two metrics are emerging as predictors of catheter-related infection with Pseudomonas as well as mortality risk: 1. Time to positivity, which is the time from when […]
Episode 999: Is This Study a Breakthrough for Antimicrobial Stewardship?
In this episode, I’ll discuss whether delayed broad-spectrum antibiotics have an impact on clinical outcomes. Subscribe on iTunes, Android, or Stitcher From my experience with antimicrobial stewardship efforts, the biggest reason for overly broad antibiotic coverage is what I call the “what if” factor. What if it really is Pseudomonas even though risk factors might […]
Episode 998: Why the NKF Says Its OK to Use Race-Free eGFR to Make Renal Dose Adjustments
In this episode, I’ll discuss why the NKF says its OK to use race-free eGFR to make renal dose adjustments. Subscribe on iTunes, Android, or Stitcher A Consensus workgroup of the National Kidney Foundation has just published in the American Journal of Health-System Pharmacy a consensus document title Moving forward from Cockcroft-Gault creatinine clearance to […]
Episode 997: The use of methylene blue for the treatment of refractory anaphylaxis without hypotension
In this episode, I’ll discuss the use of methylene blue for the treatment of refractory anaphylaxis without hypotension. Subscribe on iTunes, Android, or Stitcher Methylene blue has some unique uses such as in the treatment of acquired methemoglobinemia and vasoplegia after cardiac surgery. It also appears to have a role in treating patients experiencing anaphylaxis […]
Episode 996: Tisdale Risk Score For Identifying ICU Patients at Risk of QTc Prolongation
In this episode, I’ll discuss whether the Tisdale Risk Score can be used to identify ICU patients at risk of QTc prolongation. Subscribe on iTunes, Android, or Stitcher The Tisdale Risk Score (TRS) was first published in 2013 as a way to identify hospitalized patients at risk for QT interval prolongation. The scoring system assigns […]
Episode 995: Expert Recommendations For Using Dialysis to Treat Ethylene Glycol Poisoning
In this episode, I’ll discuss when dialysis is recommended to be used to treat ethylene glycol poisoning. Subscribe on iTunes, Android, or Stitcher The metabolites of ethylene glycol (glycolate and oxalate) are responsible for the development of metabolic acidosis, neurotoxicity, acute kidney injury, and mortality. Fomepizole effectively blocks the development of these toxic metabolites and […]
Episode 994: When can you stop octreotide in patients with variceal bleeding?
In this episode, I’ll discuss when octreotide can be discontinued in patients with variceal bleeding. Subscribe on iTunes, Android, or Stitcher When given to patients with variceal bleeding, octreotide helps achieve hemostasis and prevent rebleeding. While it is a relatively inexpensive intervention at between $50 and $100 per day, octreotide does carry a high incidence […]
Episode 993: Ketamine vs Ketorolac for Pain Management in ED Patients with Chest Trauma
In this episode, I’ll discuss ketamine vs ketorolac for pain management in ED patients with chest trauma. Subscribe on iTunes, Android, or Stitcher Chest trauma is a frequent cause of hospitalization for trauma patients, and more than a third of such patients have rib fractures. Pain management is important in these patients to ensure they […]
Episode 992: Should A C Diff Test Be Auto-Canceled With Recent Laxative Use?
In this episode, I’ll discuss whether recent laxative use should preclude testing for C diff. Subscribe on iTunes, Android, or Stitcher The IDSA C Diff guidelines make the following recommendation regarding C Diff testing in a patient who recently received a laxative: Patients with unexplained and new-onset ≥3 unformed stools in 24 hours are the preferred […]
Episode 991: What Dose of Steroids Prevents Post-Extubation Stridor and Re-Intubation?
In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. Subscribe on iTunes, Android, or Stitcher Corticosteroid administration before elective extubation has been used to prevent post-extubation stridor and reintubation. Multiple steroid regimens have been studied to prevent post-extubation stridor and re-intubation. No one regimen has been proven superior. Three example regimens […]
Episode 990: Lowest Effective Dose of Haloperidol for Agitation in Elderly Patients
In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. Subscribe on iTunes, Android, or Stitcher Despite the black box warning that antipsychotics can increase mortality in elderly patients, medications like haloperidol are sometimes needed to control agitation from hospitalized elderly patients that have delirium […]
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