In this episode, I’ll discuss recent guidelines about complicated UTI treatment. Subscribe on iTunes, Android, or Stitcher For the first time ever, the IDSA has published a set of guidelines specific to the treatment of complicated UTIs. A complicated UTI is now defined as any UTI that is not confined to the bladder. This could […]

In this episode, I’ll discuss empiric posaconazole to prevent influenza-associated pulmonary aspergillosis. Subscribe on iTunes, Android, or Stitcher Critically ill patients who develop influenza-induced acute respiratory distress syndrome (ARDS) sometimes go on to experience secondary fungal infections such as influenza-associated pulmonary aspergillosis (IAPA). To evaluate the impact of empiric antifungal therapy on the development of […]

In this episode, I’ll discuss inhaled antibiotics to prevent VAP. Subscribe on iTunes, Android, or Stitcher The prevention of ventilator-associated pneumonia has been a focus of research for many decades. The peak incidence of VAP appears to occur after about 7 days of ventilator use and this has led researchers to focus on whether there […]

In this episode, I’ll discuss “Do Not Crush” medication lists. Subscribe on iTunes, Android, or Stitcher If you navigate to the page on the website for the Institute for Safe Medication Practices that once hosted the document titled “Oral Dosage Forms That Should Not Be Crushed” you will instead find a notice that the list has […]

In this episode, I’ll discuss the risk of hypotension when giving IV furosemide for acute decompensated heart failure. Subscribe on iTunes, Android, or Stitcher Patients who present with acute decompensated heart failure often also have hypotension, and clinicians are often concerned that treatment with furosemide, while it will address fluid overload might also result in […]

In this episode, I’ll discuss hemodynamic changes after using a dexmedetomidine loading dose in ED patients. Subscribe on iTunes, Android, or Stitcher Dexmedetomidine has many properties that make it an ideal sedative, such as not causing respiratory depression, having an analgesic sparing effect, and having a reduced risk of delirium. One drawback, however, is the […]

In this episode, I’ll discuss a case report of seizures precipitated by esmolol in sterile water formulation. Subscribe on iTunes, Android, or Stitcher A case report recently published in American Journal of Health-System Pharmacy highlights the potential for a drug diluent to have significant adverse clinical consequences. The case is that of a 34-year-old male […]

In this episode, I’ll discuss aiming for high-normal potassium to reduce sustained ventricular tachycardia in patients with an ICD. Subscribe on iTunes, Android, or Stitcher Both hypokalemia and hyperkalemia are associated with ventricular arrhythmias and sudden death. This is sometimes referred to as a U-shaped association due to the graphical representation of mortality risk vs […]

In this episode, I’ll discuss the SCCM Rapid Sequence Intubation Guidelines. Subscribe on iTunes, Android, or Stitcher The SCCM recently published Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. While any pharmacist that works in a critical care setting should take the time to read these new guidelines, there are […]

In this episode, I’ll discuss recent guidelines about fluid removal in critically ill patients. Subscribe on iTunes, Android, or Stitcher The European Society of Intensive Care Medicine Clinical has published part 3 of its Practice Guideline on fluid therapy in adult critically ill patients, which addresses fluid removal during the de-escalation phase. The title chosen […]

In this episode, I’ll discuss two doses of ketamine for analgesia in the ED. Subscribe on iTunes, Android, or Stitcher Low dose ketamine for analgesia is generally considered to be doses of 0.5 mg/kg IV or less. This dose is below the threshold that will cause dissociative anesthesia, and ketamine is considered to have a […]

In this episode, I’ll discuss the rapid administration of antiseizure medications. Subscribe on iTunes, Android, or Stitcher While the antiseizure medications lacosamide, levetiracetam, and valproate were initially labeled to be given via slow IV minibag infusion, evidence has continually been published supporting IV push administration over a few minutes for these medications. However, old habits […]