In this episode, I’ll discuss how the use of drug-specific factor Xa inhibitor levels can reduce major bleeding. Subscribe on iTunes, Android, or Stitcher Factor Xa inhibitors such as rivaroxaban and apixaban gained popularity over warfarin in part because of the lack of monitoring needed to provide reliable therapeutic anticoagulation. Because routine monitoring is not […]

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 whether adding acetazolamide to loop diuretics improves the chance of successful decongestion in ADHF. Subscribe on iTunes, Android, or Stitcher Monotherapy with carbonic anhydrase inhibitors in acute decompensated heart failure has not been studied in decades since the advent of loop diuretics supplanted carbonic anhydrase inhibitors as first-line treatment. Since […]

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 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 safety of early antibiotic discontinuation in hematology patients with fever of unknown origin during chemotherapy-induced neutropenia. Subscribe on iTunes, Android, or Stitcher The occurrence of fever is very common in patients undergoing intensive chemotherapy treatment for malignant hematological disease. Because these patients are also prone to severe bacterial infection, […]

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 an article about using buprenorphine as an antidote in methadone overdose. Subscribe on iTunes, Android, or Stitcher While naloxone is the standard treatment for opioid overdose, it does have two significant limitations when treating respiratory depression from methadone overdose. First, naloxone will precipitate opioid withdrawal in opioid-dependent patients and patients […]

In this episode, I’ll discuss nebulized tobramycin for bronchiectasis from pseuduomonas. Subscribe on iTunes, Android, or Stitcher Bronchiectasis is a chronic airway infection with exacerbations that can cause increases in sputum production/purulence, cough, hemoptysis, respiratory distress, and fatigue. The focus of treatment for an exacerbation is usually on the reduction of bacterial load which then […]

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