In this episode, I’ll discuss oral beta-lactams for complicated UTIs. Subscribe on iTunes, Android, or Stitcher Most oral beta-lactams (especially cephalosporins)have usually been avoided when treating complicated UTIs out of concern for reduced effectiveness. However, in light of increasing resistance and toxicity issues with fluoroquinolones and trimethoprim/sulfamethoxazole (TMP/SMX), researchers are re-examining oral beta-lactams to see […]

In this episode, I’ll discuss a novel metric for antibiotic stewardship. Subscribe on iTunes, Android, or Stitcher Days of Therapy (DOT) is probably the most common metric to track antimicrobial stewardship efforts related to antibiotic consumption. DOT is not a perfect metric as it is calculated by calendar day regardless of the number of doses […]

In this episode, I’ll discuss the effects of therapeutic plasma exchange on enoxaparin half-life. Subscribe on iTunes, Android, or Stitcher Therapeutic Plasma Exchange (TPE) or plasmapharaesis is a procedure that takes the patient’s blood and passes it through an apheresis machine, where the filtered plasma is removed and discarded with reinfusion of red blood cells […]

In this episode, I’ll discuss what predicts critical care pharmacist intervention – patient acuity or medication regimen complexity? Subscribe on iTunes, Android, or Stitcher It makes intuitive sense that both scenarios of high patient acuity and high medication regimen complexity would be legitimate ways of identifying ICU patients who are more likely to need pharmacist […]

In this episode, I’ll discuss the 2026 AHA Stroke Guideline changes to how contraindications to thrombolytics are presented. Subscribe on iTunes, Android, or Stitcher The data to support contraindications to thrombolytic therapy for acute ischemic stroke is limited to case reports and common sense concerning what patient characteristics might increase the risk of intracerebral hemorrhage […]

In this episode, I’ll discuss which antibiotic should be given first in sepsis – the beta-lactam or the vancomycin? Subscribe on iTunes, Android, or Stitcher Quickly administering appropriate empiric antibiotic therapy is essential in the treatment of severe infections. If multiple antibiotics are required for empiric therapy to treat a severe infection (such as for […]

In this episode, I’ll discuss whether patients taking beta-blockers require increased doses of epinephrine for anaphylaxis. Subscribe on iTunes, Android, or Stitcher Animal data suggests that patients taking beta-blockers have more severe anaphylaxis, possibly by decreasing the threshold for mast cell activation. Because beta-blockers interfere with the same receptors epinephrine needs to activate to effectively […]

In this episode, I’ll discuss the use of subcutaneous antibiotics. Subscribe on iTunes, Android, or Stitcher The subcutaneous route of administration is often underappreciated, but it can be a solution in a number of challenging clinical scenarios. Subcutaneous dexmedetomidine can be used for sedation , and fluid replacement, aka hypodermoclysis, can also be accomplished via […]

In this episode, I’ll discuss linezolid-associated serotonin toxicity in patients receiving linezolid and concomitant serotonergic agents. Subscribe on iTunes, Android, or Stitcher Concern that linezolid, when combined with serotonergic medications, could increase the chance of serotonin syndrome has been present since linezolid was first developed, since it has nonselective monoamine oxidase (MAO) type A and […]

In this episode, I’ll discuss the association between the number of learners trained per year and burnout rates among inpatient pharmacists. Subscribe on iTunes, Android, or Stitcher Burnout is defined as a work-related stress syndrome resulting from chronic exposure to job stress that consists of 3 dimensions: emotional exhaustion, cynicism and depersonalization, and reduced professional […]

In this episode, I’ll discuss the safety of tenecteplase in patients with stroke mimics. Subscribe on iTunes, Android, or Stitcher Acute ischemic stroke must be treated promptly when a patient presents within the thrombolytic treatment window, but invariably, some patients who present with stroke-like symptoms will be determined to have had a different condition after […]

In this episode, I’ll discuss why glucocorticoids have no role in reversing the acute symptoms of anaphylaxis. Subscribe on iTunes, Android, or Stitcher In medicine, it seems that old habits die hard. Despite epinephrine clearly being recommended as the first line of treatment for an acute episode of anaphylaxis, glucocorticoids continue to be given by […]