In this episode, I’ll discuss an article comparing half-dose to full-dose alteplase for pulmonary embolism. Subscribe on iTunes, Android, or Stitcher The risk of hemorrhage is the major drawback to therapy with alteplase for any indication. When used for pulmonary embolism, a long-standing research question has been whether 50 mg of alteplase can treat PE […]

In this episode, I’ll discuss when to use a cold or warm compress to treat extravasation. Subscribe on iTunes, Android, or Stitcher Extravasation is a complication of IV therapy that refers to the infiltration of tissues with a medication that is an irritant or vesicant. The only difference between infiltration and extravasation is that the […]

In this episode, I’ll discuss iatrogenic hyperchloremia. Subscribe on iTunes, Android, or Stitcher Iatrogenic hyperchloremia occurs when excessive chloride levels occur during the treatment of another condition. While loss of hypotonic fluids via excessive carbonic anhydrase inhibitor use is probably the first thing a pharmacist thinks of for iatrogenic causes of hyperchloremia, this is a […]

In this episode, I’ll discuss potential reasons for an unexpected positive urine barbiturate screen. Subscribe on iTunes, Android, or Stitcher When a urine drug screen comes up positive for barbiturates unexpectedly, healthcare practitioners often suspect the result is a false positive. Both ibuprofen and naproxen have been reported to cause a false positive urine barbiturate […]

In this episode, I’ll discuss a study that addresses the controversy over giving patients with viral infections antibiotics in the Community Acquired Pneumonia guidelines. Subscribe on iTunes, Android, or Stitcher As discussed in episode 1088, new guidelines for treating patients with community-acquired pneumonia were published earlier in 2025 by the American Thoracic Society, but unlike […]

In this episode, I’ll discuss the recent conflict between ATS and IDSA over the Community Acquired Pneumonia guidelines. Subscribe on iTunes, Android, or Stitcher New guidelines for treating patients with community-acquired pneumonia were published earlier in 2025 by the American Thoracic Society, but unlike previous versions, these were not endorsed by the Infectious Disease Society […]

In this episode, I’ll discuss the efficacy of IV push levetiracetam over slow IV infusions. Subscribe on iTunes, Android, or Stitcher IV levetiracetam is FDA labeled to be infused slowly, over 15 min. Rapid IV push administration has gained popularity with several studies supporting its safety, and some of these have been discussed recently in episode1056. […]

In this episode, I’ll discuss whether the reversal of anticoagulants is necessary for neurologically intact patients with traumatic intracranial hemorrhage. Subscribe on iTunes, Android, or Stitcher While intracranial hemorrhage (ICH) has the potential to lead to a catastrophic outcome in patients with traumatic injury who are also taking oral anticoagulants, the reversal of anticoagulation is […]

In this episode, I’ll discuss what phenotype of patients are most affected by delays in antibiotic therapy. Subscribe on iTunes, Android, or Stitcher For patients with sepsis, the link between a delay in antibiotic therapy and increased risk of mortality is well-established. However, it is possible that not all patients are affected the same way […]

In this episode, I’ll discuss best practices in airway management in critically ill adults. Subscribe on iTunes, Android, or Stitcher Pharmacists who work in critical care areas have tremendous opportunities to help the care team and patient whenever tracheal intubation takes place, from preventing awareness with paralysis to managing post-intubation cardiovascular complications as has been […]

In this episode, I’ll discuss the dose of insulin to treat hyperkalemia. Subscribe on iTunes, Android, or Stitcher Back in episodes 653 and 612 I discussed using a lower dose of insulin (5 units instead of 10) to treat hyperkalemia, and this practice has become more common because it seems to offer equivalent reduction in […]