In this episode, I’ll discuss adjunctive inhaled antibiotics for ICU patients with pneumonia and invasive ventilation. Subscribe on iTunes, Android, or Stitcher A theoretical benefit of using adjunctive inhaled antibiotics to treat ICU patients with pneumonia and invasive ventilation is that it allows for high concentrations at the site of the infection and the potential […]

In this episode, I’ll discuss why the CAP guidelines do not recommend treating most cases of suspected aspiration pneumonia with broadening antibiotic therapy. Subscribe on iTunes, Android, or Stitcher Broadening therapy in community-acquired pneumonia to cover potential anaerobes in the case of suspected aspiration pneumonia is a common occurrence. This results in the use of […]

In this episode, I’ll discuss the 4 clinical teaching roles for residency preceptors. Subscribe on iTunes, Android, or Stitcher The 4 teaching roles that ASHP wants PGY-1 residency preceptors to use are: 1. Instructing 2. Modeling 3. Coaching 4. Facilitating ASHP expects that PGY-1 residency preceptors have a working knowledge of these roles. During a […]

In this episode, I’ll discuss whether milrinone can be used in patients on CRRT. Subscribe on iTunes, Android, or Stitcher Occasionally ICU patients undergoing continuous renal replacement therapy (CRRT) will also require inotropic support for conditions like heart failure with reduced ejection fraction in the setting of decreased cardiac contractility. Dobutamine and milrinone are the […]

In this episode, I’ll discuss peripheral IV administration of 3% sodium chloride solution. Subscribe on iTunes, Android, or Stitcher Infusions of 3% sodium chloride are routinely recommended to be given through central, not peripheral IV lines. This recommendation is based on the theory that since the osmolarity of 3% sodium chloride exceeds 900 mOsm/L, it […]

In this episode, I’ll discuss how to become a peer reviewer for a medical journal. Subscribe on iTunes, Android, or Stitcher One common reason for a pharmacist to wish to become a peer reviewer for a journal is to satisfy ASHP standards for preceptors in the area of ongoing professionalism. Additionally, being a peer reviewer […]

In this episode, I’ll discuss diffuse alveolar hemorrhage due to bupropion nasal inhalation. Subscribe on iTunes, Android, or Stitcher Sympathomimetic agents like cocaine are known to cause diffuse alveolar hemorrhage when inhaled. While not considered a sympathomimetic, bupropion does have a sympathomimetic amine structure. Authors in the journal Chest have published a case study describing […]

In this episode, I’ll discuss a tip to predict pharmacotherapy needs in rapid response or emergent situations. Subscribe on iTunes, Android, or Stitcher At the beginning of any rapid response or emergent procedure such as rapid sequence intubation, make a note of your patient’s starting heart rate, rhythm, oxygen saturation, and blood pressure. Any significant […]

In this episode, I’ll discuss an article comparing IV acetaminophen with IV hydromorphone for acute pain in elderly ED patients. Subscribe on iTunes, Android, or Stitcher IV acetaminophen has been a tremendous disappointment when compared to opioids in terms of both efficacy and reducing opioid-related side effects. I have not yet seen a study demonstrating […]

In this episode, I’ll discuss whether a quinolone is really superior to a macrolide for legionella pneumonia. Subscribe on iTunes, Android, or Stitcher Traditionally it is thought that a bacteriocidal antibiotic is preferable to a bacteriostatic one, especially in severe infections such as legionella pneumonia. This leads many clinicians to assume that a quinolone such […]

In this episode, I’ll discuss paralytic first vs sedative first RSI and the chance of first attempt success. Subscribe on iTunes, Android, or Stitcher One of the most significant contributors to a positive outcome for a patient undergoing emergency tracheal intubation is that the first attempt at placing the airway is a success. The purpose […]

In this episode, I’ll discuss how a pharmacist can ensure the best possible outcomes for status epilepticus. Subscribe on iTunes, Android, or Stitcher Whenever I encounter a hospital inpatient with an acute seizure, I make sure that I have IV lorazepam available. Most seizures stop after about 2 minutes. In reality, this means that by […]