Methemoglobinemia is a potentially life-threatening form of functional anemia. There are two types of methemoglobinemia – congenital and acquired. In this episode I’ll discuss the recognition and treatment of acquired methemoglobinemia. Subscribe on iTunes, Android, or Stitcher Background Methemoglobin is formed when the ferrous irons of heme are oxidized to the ferric state. The ferric […]
Episode 21: How to participate and give pharmacy recommendations on ICU rounds
In episode 20, I discussed how I prepare for ICU rounds. In this episode I’ll be talking about how ICU rounds are structured and how I participate in ICU rounds, including when and how I present my recommendations. Subscribe on iTunes, Android, or Stitcher For context, know that I am in a 20-bed community hospital […]
Episode 20: Preparation for ICU rounds on a critical care pharmacy rotation
In this episode, I’ll discuss how to prepare for ICU rounds on a critical care pharmacy rotation. Subscribe on iTunes, Android, or Stitcher Most of my pharmacy students are surprised that I look at medications last in my pre-rounding review of ICU patients. I am constantly tweaking and improving my method for pre-rounding on ICU […]
Episode 19: When and how to write a pharmacy progress note
In this episode I’ll share the decision making process I use to decide when and how to write a pharmacy progress note. Subscribe on iTunes, Android, or Stitcher When to write a pharmacy progress note? Not all communication is appropriate for a progress note. There are 3 main ways that I communicate with other members […]
Episode 18: Sedation of the acutely agitated patient when intubation is prohibited
In this episode the methods I am going to discuss in this episode are not first line or even second line therapies for controlling acute agitation. I use them rarely – as in a few times per year or less. But in some difficult situations they are like having an Ace up your sleeve! Subscribe on […]
Episode 17: When to IV push alteplase for massive PE
In this episode, I’ll cover when, why, and how to give alteplase for massive pulmonary embolism (PE). I’ll also touch on bleeding risk and whether to stop or continue the heparin infusion while you give the alteplase. Subscribe on iTunes, Android, or Stitcher First, let’s define massive PE. Massive pulmonary embolism is present when a […]
Episode 16: How to use ketamine in the critical care setting
In this episode, I’ll highlight the key points that set ketamine apart from other sedatives & analgesics and discuss how to use ketamine in the critical care setting. Subscribe on iTunes, Android, or Stitcher There is a lot of buzz around the use of ketamine in the critical care setting, and for good reason. But […]
Episode 15: Pharmacist assisted intubation
If one of us is not already at the bedside, pharmacists at my institution are frequently called by critical care providers to assist with intubation procedures in critically ill patients. In this episode I’ll review the pharmacists’ role and expectations during intubation of critically ill patients. Subscribe on iTunes, Android, or Stitcher We’ll cover the […]
Episode 14: Sux vs Roc AND Roc Doesn’t Rock Unless A Pharmacist is in the House
In this episode, I’ll first review how Sux and Roc stack up in terms of onset, duration, efficacy, and safety. Then, I’ll explain the reason why Roc only rocks when you, Pharmacy Nation, are around. This discussion will be framed around the urgent need to establish an airway in a critical care setting. Elective and preoperative airway […]
Episode 13: Antibiotic Dosing in CRRT
In this episode, I will discuss three topics regarding antibiotic dosing in CRRT (continuous renal replacement therapy). 1. Review CRRT antibiotic dosing rules 2. Review CRRT antibiotic dosing exceptions 3. Discuss the prevalence of antibiotic underdosing in CRRT Subscribe on iTunes, Android, or Stitcher The CRRT variant this episode will refer to is CVVHDF, or continuous veno-venous […]
Episode 12: How to Evaluate QTc Drug Interactions
Prolonged QTc interval leading to torsades. It is the adverse medication event that keeps pharmacists awake at night. In this episode I will explain how, as a hospital-based pharmacist, I evaluate drug interactions that carry the risk of QT prolongation. Subscribe on iTunes, Android, or Stitcher Evaluating QTc drug interactions This is an area of […]
Episode 11: Making Patient Focused Risk:Benefit Assessments
The topic for today’s show is PharmacyJoe-ism #7: Making patient focused risk benefit assessments. Subscribe on iTunes, Android, or Stitcher Why Is My Patient In the ICU and How Sick Are They? My ability to do this greatly improved when I started to explicitly and on a basic level think about why is a patient […]