In this episode, I’ll discuss whether a urine dipstick test can identify patients with clinically significant amounts of plasma DOAC levels. Subscribe on iTunes, Android, or Stitcher Direct Acting Oral Anticoagulants such as apixaban, rivaroxaban, edoxaban, and dabigatran do not have readily available assays, yet there is often a clinical need to determine the presence […]

In this episode, I’ll discuss the benefits of a pharmacy-driven medication history. Subscribe on iTunes, Android, or Stitcher The concept of specialization in medicine to achieve superior results has been prevalent for more than 100 years and is rarely subjected to scrutiny. However with a modern focus on evidence-based medicine, to change the way a […]

In this episode, I’ll discuss strategies to reduce the cost of using vasopressin. Subscribe on iTunes, Android, or Stitcher After a period of unstable supply, IV vasopressin was given approval by the FDA in 2014 to be sold under the brand name Vasostrict by a single manufacturer. While this change went a long way to […]

In this episode, I’ll discuss the feasibility of peripheral vasopressors. Subscribe on iTunes, Android, or Stitcher Vasopressors are traditionally administered via central line only due to concerns about extravasation and tissue damage when they are given via a peripheral line. However central lines can be time consuming to place and have a risk of complication […]

In this episode, I’ll discuss the continuation of newly prescribed gabapentin for acute pain management after hospital discharge. Subscribe on iTunes, Android, or Stitcher The frequency of gabapentin use for the treatment of inpatient postoperative pain has increased due to the promotion of multimodal analgesia with the goal of reducing the use of opioids. A […]

In this episode, I’ll discuss the case for continuing statins for patients admitted to the ICU. Subscribe on iTunes, Android, or Stitcher Nonpharmacologic therapy remains the mainstay for the prevention of delirium in ICU patients. Statins are among the many medications that have been studied for the treatment and prevention of ICU delirium, and they […]

In this episode, I’ll discuss whether the duration of treatment for pseudomonas VAP can be shortened to 8 days. Subscribe on iTunes, Android, or Stitcher For most patients with ventilator associated pneumonia, an 8 day course of therapy is adequate. However, for patients with VAP caused by non-fermenting gram negative bacteria – especially pseudomonas – a […]

In this episode, I’ll discuss 4 alternative routes of administration for dexmedetomidine. Subscribe on iTunes, Android, or Stitcher Dexmedetomidine is an alpha2 adrenergic agonist sedative agent commonly used in the ICU as a continuous IV infusion. However, alternative routes of administration for dexmedetomidine have been studied. In a study of 120 adult patients, surgical patients […]

In this episode, I’ll discuss a titrated morphine algorithm that worked well in ED patients. Subscribe on iTunes, Android, or Stitcher A recent randomized trial in Academic Emergency Medicine showed that IV acetaminophen use didn’t alter morphine requirements vs placebo in ED patients with acute pain. This is another in a long line of studies […]

In this episode, I’ll discuss whether there is a benefit from switching to dexmedetomidine when sedation is started with midazolam. Subscribe on iTunes, Android, or Stitcher Sedation guidelines recommend light sedation with a non-benzodiazepine agent such as dexmedetomidine or propofol. However, many ICU patients are started on midazolam-based sedation regimens either due to a compelling […]

In this episode, I’ll discuss differences in heart rate in patients with sepsis and AFib between phenylephrine and norepineprhine. Subscribe on iTunes, Android, or Stitcher Phenylephrine, unlike norepinephrine, does not stimulate beta receptors and therefore should not raise a patient’s heart rate. This is often used as a reason to administer phenylephrine to patients with […]