In this episode, I’ll discuss the treatment of norepinephrine extravasation. Subscribe on iTunes, Android, or Stitcher Central line access is often preferred for vasopressor administration due to the risk of extravasation. Extravasation of a vasopressor such as norepinephrine can cause tissue necrosis and ultimately, the loss of a limb due to local vasoconstriction. The terms […]

In this episode, I’ll discuss stress ulcer prophylaxis recommendations from the AHA’s recent statement on Prevention of Complications in the Cardiac Intensive Care Unit. Subscribe on iTunes, Android, or Stitcher Stress ulcer prophylaxis guidelines are over 20 years old, and there is no sign anymore of an update of the 1999 ASHP guidelines on the horizon. […]

In this episode, I’ll discuss a yet-to-be-published study of chlorhexidine for oral hygiene in ICU patients. Subscribe on iTunes, Android, or Stitcher In recent years, the journal Intensive Care Medicine has published a cohort study and editorial that call into question the safety and efficacy of oral mouth care with chlorhexidine in ventilated ICU patients. Concerns […]

In this episode, I’ll discuss a study of the treatment of dyspepsia in patients who present to the emergency department. Subscribe on iTunes, Android, or Stitcher The use of a “GI Cocktail” with varying ingredients is popular in emergency departments both to treat dyspepsia and to attempt to distinguish nonischemic from ischemic chest pain. This is […]

In this episode, I’ll discuss why remdesivir is not indicated in patients with an eGFR below 30 mL/min. Subscribe on iTunes, Android, or Stitcher Remdesivir has recently been approved for the treatment of COVID-19 in hospitalized patients. The prescribing information states that it is not recommended in patients with eGFR less than 30 mL per minute. […]

In this episode, I’ll discuss a clinical prediction model for augmented renal clearance in adult mixed critically ill patients. Subscribe on iTunes, Android, or Stitcher Augmented or enhanced renal clearance is a phenomenon in some critically ill patients whereby their kidney function becomes supranormal. Awareness of clinicians to the possibility of augmented renal clearance in critically […]

In this episode, I’ll discuss a recent trial on surgery vs antibiotics for appendicitis. Subscribe on iTunes, Android, or Stitcher The question of whether some patients with appendicitis can be treated with antibiotics alone as an alternative to surgery is controversial. In an effort to bring clarity to this subject, a Randomized Trial Comparing Antibiotics with […]

In this episode, I’ll discuss what medications should be stocked on a malignant hyperthermia cart. Subscribe on iTunes, Android, or Stitcher Malignant hyperthermia is a rare event, occurring in about 1 out of 100,000 administrations of anesthesia. MH is usually thought of as occurring in the operating room, but it can occur an hour after anesthesia or […]

In this episode, I’ll discuss why the quadrivalent meningococcal vaccine was used as a control for a COVID-19 vaccine. Subscribe on iTunes, Android, or Stitcher Earlier this year a phase 1 and 2, randomized controlled trial of a COVID-19 vaccine was published in the Lancet and the quadrivalent meningococcal vaccine was used as a control […]

In this episode, I’ll discuss how to predict the pharmacotherapy needs of your patient and team during an inpatient medical emergency. Subscribe on iTunes, Android, or Stitcher I consider there to be 3 skill levels that pharmacists progress through as they learn how to respond to inpatient medical emergencies such as code blue and rapid […]

In this episode, I’ll discuss how top-performing resuscitation teams are more likely to include pharmacists. Subscribe on iTunes, Android, or Stitcher Exactly how many hospitals have pharmacists on their resuscitation teams is unclear, as it has been over a decade since the last US-based survey I can find in the medical literature. At that time, […]

In this episode, I’ll discuss how aggressively extremely high blood pressure should be managed in patients with ICH. Subscribe on iTunes, Android, or Stitcher AHA guidelines for the management of spontaneous intracerebral hemorrhage (ICH) split hypertension management recommendations into two groups based on the strength of available evidence.  The first group is those with a blood […]