In this episode, I’ll discuss why moxifloxacin doesn’t cover urinary tract infections. Subscribe on iTunes, Android, or Stitcher Imagine the following scenario: You’re covering multidisciplinary rounds with the hospitalist team when they present a patient who appears to have two infections. 1. Community-acquired pneumonia, for which the patient was admitted for and had a positive […]

In this episode, I’ll discuss famotidine as a potential cause of delirium. Subscribe on iTunes, Android, or Stitcher Depending on which meta-analysis you read, famotidine is an option for stress ulcer prophylaxis in ICU patients. However, famotidine also has the potential to cause CNS related side effects and carries the warning: Central nervous system (CNS) […]

In this episode, I’ll discuss potential reasons for an unexpected positive urine barbiturate screen. Subscribe on iTunes, Android, or Stitcher When a urine drug screen comes up positive for barbiturates unexpectedly, healthcare practitioners often suspect the result is a false positive. Both ibuprofen and naproxen have been reported to cause a false positive urine barbiturate […]

In this episode, I’ll discuss potential reasons for a false heparin anti-Xa level. Subscribe on iTunes, Android, or Stitcher Time Sensitive Announcement: The price for the Hospital Pharmacy Academy will be increasing significantly this Friday, June 28 at 10 pm EST.  Current members and those that join before the deadline this Friday will lock in the […]

In this episode, I’ll discuss octreotide’s role in treating variceal bleeding. Subscribe on iTunes, Android, or Stitcher Octreotide is a long-acting analog of somatostatin. It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid.  Because glucagon is a vasodilator, octreotide indirectly decreases splanchic blood flow by […]

In this episode, I’ll discuss an article about using dexmedetomidine in critically ill patients.  This trial turned out to be a negative trial which can sometimes be as instructive as a positive one.  In this case, it turned out to be a study in how not to use dexmedetomidine. Subscribe on iTunes, Android, or Stitcher […]

In this episode, I’ll discuss the drug interaction between sugammadex and oral contraceptives. Subscribe on iTunes, Android, or Stitcher Sugammadex is a γ-cyclodextrin that was designed to bind rocuronium and vecuronium for the purpose of reversing paralysis from these neuromuscular blocking medications. It has been on the European market since 2008 and has been recently […]

In this episode, I’ll talk about how to use naloxone for opioid overdose in the inpatient setting. Subscribe on iTunes, Android, or Stitcher It has been over 370 episodes since we last talked about naloxone dosing for inpatients with opioid overdose! Naloxone is a pure opioid antagonist that competes with and displaces opioids at receptor […]

In this episode, I will discuss whether intermittent boluses of pantoprazole be used to treat acute GI bleeding rather than continuous infusions. Subscribe on iTunes, Android, or Stitcher The best evidence to support intermittent boluses of PPIs to treat GI bleeding comes from a 2014 meta-analysis. The study compared intermittent doses of PPIs and the […]

In this episode I’ll discuss giving alteplase for acute ischemic stroke during pregnancy. Subscribe on iTunes, Android, or Stitcher Although acute ischemic stroke is a rare occurrence during pregnancy, it is responsible for about 7% of maternal deaths in the US. Two case reports and a review article of giving alteplase during pregnancy were recently […]

In this episode, I’ll discuss the effect of beta-blocker therapy on dobutamine. Subscribe on iTunes, Android, or Stitcher Dobutamine is an inotropic agent useful in the treatment of decompensated heart failure. Part of dobutamine’s action is on beta 1 and beta 2 receptors and therefore concomitant beta-blocker therapy can be expected to blunt a patient’s […]

In this episode, I’ll discuss an article about when to draw a free phenytoin level. Subscribe on iTunes, Android, or Stitcher Article Predicting Unbound Phenytoin Concentrations: Effects of Albumin Concentration and Kidney Dysfunction Lead author: Margaret C. Montgomery Published in Pharmacotherapy May 2019 Background Phenytoin is highly protein bound, and both low albumin levels and […]