Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss how to predict the risk of cardiac arrest after intubation. A retrospective analysis of 64 ICUs in France determined the prevalence of and risk factors for cardiac arrest during intubation in ICU. A total of 1,847 intubation procedures were included in the analysis. The […]

Subscribe on iTunes, Android, or Stitcher Most third-party drug interaction services or references don’t help with determining the clinical significance of a given drug interaction. But the book Top 100 Drug Interactions by Hansten and Horn helps me determine whether an interaction is real vs theoretical, so I can guide patients and physicians safely through […]

Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss whether patients with liver disease and prolonged PT/INR levels still need VTE prophylaxis. Patients with liver disease and prolonged PT/INR levels appear to be teetering between the risk of bleeding and the risk of clotting. In a patient with cirrhosis, simply having a prolonged […]

In this episode I’ll: 1. Discuss a review article about musculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy 2. Answer the drug information question “Is there any benefit in de-escalating ceftriaxone to cefazolin?” Subscribe on iTunes, Android, or Stitcher Article Musculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy Lead author: Kazuhiko […]

Subscribe on iTunes, Android, or Stitcher Clindamycin is usually thought of as the antibiotic to use in necrotizing fasciitis to reduce toxin production. But linezolid and clindamycin both bind to the 50S subunit of bacterial ribosomes to inhibit protein synthesis. Linezolid is a particularly interesting choice in infections with group A strep as the drug […]

In this episode, I’ll discuss fentanyl-induced chest wall rigidity. Subscribe on iTunes, Android, or Stitcher Fentanyl is an ideal opioid to use in critically ill patients due to its relatively quick onset and offset. Fentanyl also has minimal histamine release and resulting effects on hemodynamics when compared with other opioids. A known but rare complication […]

Can patients with an iodine allergy receive amiodarone? Subscribe on iTunes, Android, or Stitcher This question was best addressed in a 2012 retrospective medical record review in the journal Pharmacotherapy. Records of 234 sequential hospitalized patients in 2 academic medical centers with a listed iodine and/or iodinated radiocontrast agent allergy who received oral or intravenous […]

In this episode I’ll: 1. Discuss an article about the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation. 2. Answer the drug information question “Should probiotics be given via NG tube to ICU patients?” 3. Share a tip for responding to inpatient medical emergencies. Subscribe on iTunes, Android, or Stitcher Article […]

Subscribe on iTunes, Android, or Stitcher The formulary status of IV acetaminophen can be controversial, given that it is an expensive medication without consistent evidence of benefit on clinically meaningful patient outcomes such as reducing the length of hospital stay or ileus. One argument for keeping IV acetaminophen on formulary is for use in critically […]

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 […]

Subscribe on iTunes, Android, or Stitcher How much insulin should be used to treat hyperkalemia? I think of insulin like a key that unlocks a door in cell membranes to allow glucose, potassium, and water to walk through. Putting the potassium in the intracellular space hides it from the heart temporarily and is a critical […]

Subscribe on iTunes, Android, or Stitcher In this episode I’ll: 1. Discuss an article about using metronidazole in mild Clostridium difficile infection. 2. Answer the drug information question “What is captisol-based amiodarone?” 3. Share a tip for responding to inpatient medical emergencies. Article What is the role for metronidazole in the treatment of Clostridium difficile […]