In this episode, I’ll discuss an article comparing different methods of administering adenosine. Subscribe on iTunes, Android, or Stitcher Because the half-life of adenosine is measured in seconds, administration must be rapid and followed by a 20 mL saline flush for enough of the medication to reach the site of action before it is metabolized. […]

In this episode, I’ll discuss persistent MRSA bacteremia after vancomycin therapy. Subscribe on iTunes, Android, or Stitcher The usual course of treatment for MRSA bacteremia is a minimum of 14 days, and the median time to bacterial clearance is about 7 days. For this reason, IDSA guidelines recommend an assessment to determine whether a change […]

In this episode, I’ll discuss 6 ways to develop a clinical pharmacist’s mindset. Subscribe on iTunes, Android, or Stitcher When it comes to having a positive impact on patient care, how a pharmacist thinks can be as important as their knowledge base. This episode is a collection of 6 mindset techniques that I have found […]

In this episode, I’ll discuss the effect of a sepsis huddle on identifying sepsis and compliance with the sepsis bundle in an Emergency Department setting. Subscribe on iTunes, Android, or Stitcher The Sepsis huddle has been described as a method of improving sepsis bundle compliance. The concept is that a group of clinicians convene (often […]

In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. Subscribe on iTunes, Android, or Stitcher Despite the black box warning that antipsychotics can increase mortality in elderly patients, medications like haloperidol are sometimes needed to control agitation from hospitalized elderly patients that have delirium […]

In this episode, I’ll discuss the dose–response of intravenous calcium in surgical ICU patients. Subscribe on iTunes, Android, or Stitcher How much does the ionized calcium value of a patient with hypocalcemia change when given a replacement dose of IV calcium? A group of authors published a retrospective cohort study in the International Journal of […]

In this episode, I’ll discuss why the administration of glucose without thiamine might precipitate or worsen Wernicke’s encephalopathy. Subscribe on iTunes, Android, or Stitcher Wernicke-Korsakoff syndrome is actually a combination of 2 different syndromes, both the result of severe thiamine deficiency. Wernicke’s encephalopathy is an acute disorder that has significant mortality and neurologic morbidity associated with […]

In this episode, I will discuss how I would treat Wernicke’s Encephalopathy if I were completely out of IV thiamine. Subscribe on iTunes, Android, or Stitcher Wernicke’s encephalopathy is an acute disorder that has significant mortality and neurologic morbidity associated with it.  Usual treatment for Wernicke’s involves high doses IV thiamine. At the time of […]

In this episode, I’ll discuss an article about clinical outcomes when dexmedetomidine is given to patients who have agitation from drug overdose or withdrawal. Subscribe on iTunes, Android, or Stitcher Dexmedetomidine fills a crucial role in the management of agitated patients given that it usually provides sedation without interfering with respiratory function. It is frequently […]

In this episode, I’ll discuss delayed QTc prolongation in overdose patients. Subscribe on iTunes, Android, or Stitcher   Patients who present to the ED with acute drug overdose and a QTc above 500 msec are known to have an increased risk of adverse cardiac event and are therefore proactively monitored for this development. However some […]

In this episode, I’ll discuss when to use octreotide for upper GI bleeding. Subscribe on iTunes, Android, or Stitcher Octreotide is a long-acting analog of somatostatin. It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid.  Because glucagon is a vasodilator, octreotide indirectly decreases […]

In this episode, I’ll discuss an article about the storage and safety of hypertonic saline. Subscribe on iTunes, Android, or Stitcher One of the oldest systems-based efforts to improve patient safety in hospitals has been to control the storage and administration of concentrated electrolytes. The greatest focus since the 1980s was on removing concentrated potassium […]