In this episode, I’ll discuss inhaled amikacin to prevent VAP. Subscribe on iTunes, Android, or Stitcher The prevention of ventilator associated pneumonia has been a focus of research for many decades. The peak incidence of VAP appears to occur after about 7 days of ventilator use and this has led researchers to focus on whether […]

In this episode, I’ll discuss predicting the success of dexmedetomidine as a sedative. Subscribe on iTunes, Android, or Stitcher Anecdotally, dexmedetomidine has always seemed like a hit-or-miss sedative, working wonderfully in many patients and barely or not at all in others. Researchers recently published in Pharmacotherapy a single-center, retrospective, cohort study of 158 critically ill […]

In this episode, I’ll discuss what happened to the “ISMP’s Do Not Crush List.” Subscribe on iTunes, Android, or Stitcher If you navigate to the page on the website for the Institute for Safe Medication Practices that once hosted the document titled “Oral Dosage Forms That Should Not Be Crushed” you will instead find a notice […]

In this episode, I’ll discuss an article about cefepime vs piperacillin-tazobactam in adults hospitalized with acute infection. Subscribe on iTunes, Android, or Stitcher Because piperacillin-tazobactam and cefepime have similar cost and coverage vs gram-negative bacteria, the choice of which agent to use in hospitalized patients with acute infection comes down to differences in adverse effect profiles. […]

In this episode, I’ll discuss why hypokalemia can result from digoxin immune fab fragment administration. Subscribe on iTunes, Android, or Stitcher In the setting of digoxin toxicity, the sodium-potassium ATPase pump is impaired and potassium shifts from the intracellular to extracellular space. With the administration of antidote therapy with digoxin immune fab fragments, the function of […]

In this episode, I’ll discuss a case report of seizures precipitated by esmolol in sterile water formulation. Subscribe on iTunes, Android, or Stitcher A case report recently published in American Journal of Health-System Pharmacy highlights the potential for a drug diluent to have significant adverse clinical consequences. The case is that of a 34-year-old male […]

In this episode, I’ll discuss the 4 factors that predict agitation in lightly sedated ventilated patients. Subscribe on iTunes, Android, or Stitcher Light sedation is encouraged in ventilated patients due to less delirium. However agitation is one of the risks of a light sedation strategy. If the agitation is not treated in time, a patient […]

In this episode, I’ll discuss the SCCM Rapid Sequence Intubation Guidelines. Subscribe on iTunes, Android, or Stitcher The SCCM recently published Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. While any pharmacist that works in a critical care setting should take the time to read these new guidelines, there are […]

In this episode, I’ll discuss the optimal dosing of levetiracetam for seizure prophylaxis in critically ill patients. Subscribe on iTunes, Android, or Stitcher When used for seizure prophylaxis following traumatic brain injury, intracerebral hemorrhage, spontaneous subarachnoid hemorrhage, or supratentorial neurosurgery levetiracetam doses used are often very low. However, critically ill patients typically have higher clearance […]

In this episode, I’ll discuss two doses of ketamine for analgesia in the ED. Subscribe on iTunes, Android, or Stitcher Low dose ketamine for analgesia is generally considered to be doses of 0.5 mg/kg IV or less. This dose is below the threshold that will cause dissociative anesthesia, and ketamine is considered to have a […]

In this episode, I’ll discuss the consensus statement published in CHEST on the Treatment of Community-Acquired Pneumonia in immunocompromised patients. Subscribe on iTunes, Android, or Stitcher Authors in the journal CHEST published a consensus statement on the Treatment of Community-Acquired Pneumonia in immunocompromised patients.  This patient population was left out of the updated IDSA CAP […]

In this episode, I’ll discuss the effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock. Subscribe on iTunes, Android, or Stitcher Push dose vasopressors as a temporizing measure for profound hypotension in critically ill patients is frequently used in many institutions. However the extent of the data for this strategy […]