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 […]
Episode 10: The Pharmacist and the ECG Should Be Friends
As the expert in drug therapy, you need to know how different drugs exert their effects on the electrical system of the heart. Subscribe on iTunes, Android, or Stitcher Pharmacist review of the ECG is relatively straight forward compared to other professions. We should be able to identify the rhythm, look for signs of drug […]
Episode 9: How To Talk Like A Physician And Get A Physician To Listen Like A Pharmacist
Today I’m going to pull the curtain back and show you how I trained myself to have successful verbal communications with physicians and get my interventions accepted. I’ll go over: Expected acceptance rates First impressions of your conversation Planning out your conversation What to do when the physician comes to you with a question Subscribe on […]
Episode 8: Empiric Antibiotic Selection in the ICU
So much of antibiotic selection has to do with local resistance patterns and it cannot be protocolized or generalized without that knowledge. Subscribe on iTunes, Android, or Stitcher That said I believe there are some principles of antibiotic selection in the ICU that are worth discussing in general terms. A big shout out to Pharmacist […]
Episode 7: Seven tips on How to stay current with medical literature
Here are my 7 tips for how to stay current with medical literature: Subscribe on iTunes, Android, or Stitcher Pharmacist’s Letter / Prescriber’s Letter I’ve been a subscriber to Pharmacist’s Letter for over 12 years. They are an unbiased source of current information about new medications and new uses for old medications. Their monthly newsletter is concise […]