In this episode, I’ll discuss antibiotic exposure and the emergence of multidrug-resistant bacteria in patients with liver cirrhosis. Subscribe on iTunes, Android, or Stitcher Patients with advanced chronic liver disease and acute-on-chronic liver failure often have indications for antibiotic use, however this increases the risk of developing an infection with a multi-drug resistant organism (MDRO). […]

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 the effect of ondansetron on respiratory drive in patients with acute respiratory distress syndrome. Subscribe on iTunes, Android, or Stitcher One of the complicating issues of treating patients with acute respiratory distress syndrome is when they have excessive respiratory effort, which leads to further lung injury. Excessive sedative and paralytic […]

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 the performance of lidocaine vs. amiodarone for refractory ventricular fibrillation or tachycardia in in-hospital cardiac arrest. Subscribe on iTunes, Android, or Stitcher Current resuscitation guidelines recommend the use of either amiodarone or lidocaine for refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). To date, this recommendation has been primarily […]

In this episode, I’ll discuss a systematic review and meta-analysis on the ability of linezolid and clindamycin to inhibit bacterial toxin production in critically ill adults. Subscribe on iTunes, Android, or Stitcher In episode 1162, I discussed a review article where the authors concluded that linezolid inhibits bacterial toxin production just as well as clindamycin. […]

In this episode, I’ll discuss the use of NSAIDs in patients with traumatic brain injury. Subscribe on iTunes, Android, or Stitcher Whether it is OK to use nonsteroidal anti-inflammatory drugs (NSAIDs) after a traumatic brain injury (TBI) is controversial. On one hand, non-opioid pain management is important to use whenever feasible; on the other hand, […]

In this episode, I’ll discuss the use of succinylcholine vs rocuronium for tracheal intubation in emergency department patients. Subscribe on iTunes, Android, or Stitcher Few topics are as hotly debated in emergency medicine circles as the use of succinylcholine vs rocuronium for tracheal intubation. In brief, the “pro succinylcholine” group emphasizes its rapid onset and […]

In this episode, I’ll discuss the performance evaluation of a large language model for medication management tasks. Subscribe on iTunes, Android, or Stitcher With the growth of artificial intelligence (AI) tools based on large language models, there is uncertainty on how well they perform clinical tasks such as medication management. A group of researchers published […]

In this episode, I’ll discuss catheter-directed thrombolytics for patients with intermediate-high-risk pulmonary embolism. Subscribe on iTunes, Android, or Stitcher How to use catheter-directed thrombolytics to benefit patients with intermediate-high-risk pulmonary embolism has been the subject of considerable research over the last decade. Researchers recently published a major study in this area in the New England […]

In this episode, I’ll discuss phenobarbital vs. benzodiazepine-based pathways for alcohol withdrawal syndrome in the ICU. Subscribe on iTunes, Android, or Stitcher Considerable research has been done comparing phenobarbital with benzodiazepines for alcohol withdrawal syndrome in critically ill adult patients. A group of authors have synthesized this research in a systematic review and meta-analysis published […]

In this episode, I’ll discuss the antibiotics that inhibit bacterial toxin production. Subscribe on iTunes, Android, or Stitcher Some bacteria produce microbial toxins that significantly contribute to infection severity. Notable examples include Clostridioides difficile, Staphylococcus aureus, and Streptococcus pyogenes. During infection with these organisms, it is possible that therapies that suppress toxin production may lessen […]