Subscribe on iTunes, Android, or Stitcher How many mcg of push-dose norepinephrine is needed to prevent hypotension? Despite the popularity of push-dose vasopressors in emergency medicine and critical care scenarios, nearly all of the data supporting their use comes from women undergoing elective cesarean delivery under spinal anesthesia. Push-dose vasopressors are used in that setting […]

In this episode, I’ll discuss the 2018 ACLS antiarrhythmic drug update. Subscribe on iTunes, Android, or Stitcher In 2015 the ACLS guidelines transitioned from a 5-year cycle of periodic revisions and updates to a web-based format that is continuously updated. Late 2018 we saw a change to the guidelines with a Focused Update on Advanced Cardiovascular […]

Subscribe on iTunes, Android, or Stitcher   Delays in starting antibiotics for bacteremia can be significant. One community teaching hospital implemented a protocol to notify a pharmacist whenever a blood culture turned positive so appropriate therapy could be started faster and infection-related mortality dropped from 25% to 11%. The protocol is called the rapid administration […]

In this episode I’ll: 1. Discuss an article about the duration of therapy in gram-negative bacteremia. 2. Answer the drug information question “Can cefazolin sensitivity be used to predict cephalexin sensitivity?” 3. Share a tip for responding to inpatient medical emergencies. Subscribe on iTunes, Android, or Stitcher Article Seven versus fourteen Days of Antibiotic Therapy […]

Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss the 4 steps I consider for every medication overdose case. Those steps are: #1 Supportive care #2 Antidote therapy #3 Decontamination #4 Enhance elimination As pharmacists, it is easy to think of antidotes as the first step to consider in medication overdose. However, it […]

In this episode, I’ll discuss a gram stain-based algorithm for antibiotic selection in patients with suspected VAP. Subscribe on iTunes, Android, or Stitcher The way the IDSA 2016 VAP guidelines are written, every patient with suspected VAP ends up receiving MRSA coverage plus one to two antipseudomonal agents. These are presented as strong recommendations based […]

In this episode, I’ll discuss how lactated ringers solution can play a role in managing a sodium bicarbonate shortage. Subscribe on iTunes, Android, or Stitcher For patients not affected by septic shock or reduced perfusion, the lactate in lactated ringers will be converted to bicarbonate shortly after being infused. Each liter of lactated ringers contains […]

In this episode I’ll: 1. Discuss an article about exposure to antibiotics and development of new resistance. 2. Answer the drug information question “Can naloxone reverse oversedation from clonidine toxicity?” 3. Share a tip for responding to medical emergencies. Subscribe on iTunes, Android, or Stitcher Article Duration of Exposure to Antipseudomonal β‐Lactam Antibiotics in the […]

In this episode, I’ll discuss Monte Carlo simulations. . Subscribe on iTunes, Android, or Stitcher A Monte Carlo Simulation in the context of healthcare uses software to simulate thousands of patients from smaller sample sizes to provide a more robust prediction of an event. The term Monte Carlo is taken from a casino in Monaco […]

In this episode, I’ll discuss vancomycin dosing by AUC:MIC instead of trough level. Subscribe on iTunes, Android, or Stitcher The consensus vancomycin guidelines from 2009 are being revised. One prediction that many are making is that the new guidelines will recommend a big change to how we adjust vancomycin doses. Instead of dosing by trough […]

In this episode, I’ll discuss whether giving an antibiotic IV push affects the pharmacodynamic exposure. Subscribe on iTunes, Android, or Stitcher Does giving an antibiotic IV push affect the pharmacodynamic exposure? This question was examined for meropenem, cefepime, and aztreonam in a study published in American Journal of Health-System Pharmacy May 2017. In this study, […]