In this episode, I’ll discuss the dose of methylene blue for the treatment of acquired methemoglobinemia. Subscribe on iTunes, Android, or Stitcher Acquired methemoglobinemia is typically a reaction to medications. The ferric hemes of methemoglobin are unable to bind oxygen therefore causing a functional anemia. Suspect methemoglobinemia when the following occur: 1. Sudden cyanosis after […]

In this episode, I’ll discuss whether a pacemaker or implanted cardiac defibrillator (ICD) protects from medication-induced torsades. Subscribe on iTunes, Android, or Stitcher I’ve heard clinicians make this argument several times in my career – that because a patient has a pacemaker or ICD, a QTc prolonging drug interaction has no or little risk compared […]

In this episode, I’ll discuss a review article on the safety of peripheral vasopressors and hypertonic saline. Subscribe on iTunes, Android, or Stitcher When advances in medical knowledge are accompanied by aggressive marketing campaigns, the use of new information in patient care can occur rapidly. However not all new data is accompanied by a marketing […]

In this episode, I’ll discuss the pharmacist’s role if malignant hyperthermia is suspected outside of the operating room. Subscribe on iTunes, Android, or Stitcher Malignant hyperthermia is a rare event, occurring in about 1 out of 100,000 administrations of anesthesia. While MH is usually thought of as occurring in the operating room, it can occur […]

In this episode, I’ll discuss an article about timing of amiodarone for out-of-hospital, shock-refractory cardiac arrest. Subscribe on iTunes, Android, or Stitcher A group of authors has hypothesized that the lack of clinically significant difference between amioadrone and lidocaine for out-of-hospital shock-refractory cardiac arrest is due to delayed timing of the administration of study medications. […]

In this episode, I’ll discuss an article about IVP antibiotic safety. Subscribe on iTunes, Android, or Stitcher Article Safety of intravenous push administration of beta-lactams within a healthcare system Lead author: Kassandra Marsh, PharmD, BCIDP Published in American Journal of Health-System Pharmacy April 2020 Background In the aftermath of hurricane disruptions to IV solution supply […]

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 […]

In this episode, I’ll discuss the 6th edition of the European guideline on management of major bleeding and coagulopathy following trauma. Subscribe on iTunes, Android, or Stitcher The 6th edition of the European guideline on management of major bleeding and coagulopathy following trauma has recently been published in the Journal Critical Care. While the majority […]

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 […]

In this episode, I’ll discuss an article about using bivalirudin for anticoagulation during ECMO. Subscribe on iTunes, Android, or Stitcher In recent years some ECMO centers have decided to use bivalirudin over heparin to maintain systemic anticoagulation during ECMO as the literature to support this practice has grown. One center that made this switch in […]

In this episode, I’ll discuss empiric dosing of vancomycin for patients on CRRT. Subscribe on iTunes, Android, or Stitcher A lower dose of vancomycin is recommended for use in patients receiving CRRT in common 3rd party medication references such as Lexi-Comp. However there is little published data available to base such dosing recommendations on. A […]