In this episode, I’ll discuss a case report of enoxaparin overdose. Subscribe on iTunes, Android, or Stitcher A group of authors recently published their experience treating an overdose of 900 mg enoxaparin with a protamine bolus and infusion in the American Journal of Health System Pharmacy. There is little data available on managing large enoxaparin […]
Episode 845: How aggressively should extremely high blood pressure be managed in patients with ICH?
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 […]
Episode 844: Why A Pharmacist Should Learn to Predict the Need for Intubation
In this episode, I’ll discuss the pharmacist’s role in predicting the need for intubation. Subscribe on iTunes, Android, or Stitcher Because of how drug delivery systems are set up in most US hospitals with medications stored in automated dispensing cabinets, there can be a considerable delay between the time a physician makes a decision to […]
Episode 843: What are the risk factors for not attaining target beta-lactam levels in ICU patients?
In this episode, I’ll discuss the risk factors for not attaining target beta-lactam levels in ICU patients. Subscribe on iTunes, Android, or Stitcher For beta-lactam antibiotics, an adequate time above the MIC is essential to achieve clinical success. However, critically ill patients undergo physiologic changes that may make achieving adequate time above MIC difficult. This […]
Episode 842: Antibiotic Stewardship Before Discharge?
In this episode, I’ll discuss opportunities for antibiotic stewardship before hospital discharge. Subscribe on iTunes, Android, or Stitcher A primary focus of antibiotic stewardship programs is to reduce unnecessary antibiotic use among hospital inpatients. Reducing unnecessary antibiotic use upon hospital discharge is not a popular focus among the majority of stewardship programs. However, a significant […]
Episode 841: Should Lithium Be Resumed in Critically Ill Patients While Still in the ICU?
In this episode, I’ll discuss 3 reasons to consider holding lithium in critically ill patients. Subscribe on iTunes, Android, or Stitcher Chronic medications, especially neuro-active ones, are often resumed in the ICU as soon as critically ill patients can tolerate them. Lithium, however, has a particularly narrow therapeutic range and the potential for toxicity to […]
Episode 840: A Rare Disease Resource Every Hospital Pharmacist Should Know About
In this episode, I’ll discuss a resource for taking care of patients with a rare disease. Subscribe on iTunes, Android, or Stitcher There exists a large number of rare diseases that any given hospital pharmacist might encounter once in their practice, if at all. Many of these diseases are exacerbated by certain medications but because of […]
Episode 839: A Rare Case of Propofol Dependence and How it Was Managed
In this episode, I’ll discuss the management of suspected propofol dependence with phenobarbital in an adult patient with COVID-19. Subscribe on iTunes, Android, or Stitcher There is limited published information on propofol withdrawal syndrome. Authors recently published a case report of their experience treating a patient with suspected propofol dependence with phenobarbital in the American […]
Episode 838: Hypotension After Intubation – Is It the Sedative Dose That Matters?
In this episode, I’ll discuss whether there is an association between the sedative dose and postintubation hypotension and rapid sequence intubation. Subscribe on iTunes, Android, or Stitcher When a patient who requires sedation for intubation also has hemodynamic instability, a common recommendation is to lower the dose of sedative given in hopes of preventing further […]
Episode 837: Don’t Let IV Medications Shift A Patient Out of Ketosis
In this episode, I’ll discuss parenteral medication considerations for the ketogenic diet. Subscribe on iTunes, Android, or Stitcher A high-fat, low-carbohydrate diet may be prescribed to induce ketosis and help patients with epilepsy that is refractory to medical treatment. While dietary carbohydrate intake is tightly controlled in these patients, small amounts of carbohydrate from non-dietary sources […]
Episode 836: Should Meropenem Be Given Routinely as a Continuous Infusion in the Critically Ill?
In this episode, I’ll discuss whether meropenem should be given by continuous infusion in critically ill patients. Subscribe on iTunes, Android, or Stitcher A continuous infusion of meropenem helps to ensure 100% time above MIC and is often employed for resistant infections. This has led some to question whether it is better to routinely give meropenem […]
Episode 835: Results of a Pilot Trial of Sodium Bicarbonate for Metabolic Acidosis in the ICU
In this episode, I’ll discuss the results of a pilot trial of sodium bicarbonate for metabolic acidosis in the ICU. Subscribe on iTunes, Android, or Stitcher Sodium Bicarbonate is frequently given to ICU patients to correct metabolic acidosis however evidence to support this indication is lacking and sodium bicarb is not a benign intervention without risk […]
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