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 ketamine vs etomidate for RSI. Subscribe on iTunes, Android, or Stitcher Countless journal articles, podcast episodes, blog posts, and social media posts have been filled up comparing and contrasting the pros and cons of ketamine vs etomidate for sedation prior to rapid sequence intubation (RSI). While there are differences between […]

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 how to answer a question like an experienced pharmacist, even if you’re brand new. Subscribe on iTunes, Android, or Stitcher The ED physician calls you on the phone and asks “What is the half-life of methadone?” How should you answer this question? This question is an example of an obscure […]

In this episode, I’ll discuss a recent article about vancomycin monitoring. Subscribe on iTunes, Android, or Stitcher Shout out to “Pharmacy David,” “Pharmacy Lisa,” and “Pharmacy Kathryn” at the Department of Pharmacy Practice & Science, University of Arizona for inspiring this episode! I can’t remember ever being as excited about a journal article as I […]

In this episode, I’ll discuss whether oral valganciclovir is really as good as IV ganciclovir for the treatment of CMV infection. Subscribe on iTunes, Android, or Stitcher Shout out to “Pulmonary Ashley” for inspiring this episode! When considering therapy to treat a CMV infection, multiple references suggest that oral therapy with valganciclovir is noninferior or […]

In this episode, I’ll discuss the compatibility of nebulized formoterol with other common nebulized medications. Subscribe on iTunes, Android, or Stitcher In 2008, an article was published that found admixtures of formoterol with budesonide, ipratropium, cromolyn, or acetylcysteine to be physically and chemically compatible. The study was thorough and used appropriate methods to determine compatibility. […]

In this episode, I’ll discuss what happens if you accidentally get rocuronium in your eye. Subscribe on iTunes, Android, or Stitcher While the Material Safety Data Sheet for rocuronium states “…inadvertent eye contact with this product may produce irritation with redness and discomfort,” there were no reports of accidental ocular exposure to rocuronium until recently. […]

In this episode, I’ll discuss when using IV bicarb in the ICU is actually helpful. Subscribe on iTunes, Android, or Stitcher If used to attempt to normalize pH without correcting the underlying problem, sodium bicarbonate use is essentially pointless as its effects will be short-lived.  In addition, indiscriminate bicarb use should be avoided due to potential adverse […]

In this episode, I’ll discuss the effects of ED length of stay when using either midazolam+haloperidol or lorazepam+haloperidol for acute agitation. Subscribe on iTunes, Android, or Stitcher Midazolam has a faster onset and shorter time to awakening than lorazepam. ED treatment of acute agitation often includes haloperidol given in combination with a benzodiazepine, and it is […]

In this episode, I’ll discuss the effects of morbid obesity on filgrastim pharmacokinetics. Subscribe on iTunes, Android, or Stitcher The prescribing information for filgrastim recommends dosing based on actual body weight, but this results in large doses for morbidly obese patients. The original data for filgrastim only used patients who were at an ideal body weight, […]

In this episode, I’ll discuss one hospital’s evolution of the U-500 insulin use process. Subscribe on iTunes, Android, or Stitcher Medication errors with U-500 insulin can be serious, and ensuring the safe use of this medication in a hospital setting has presented hospital pharmacies with considerable challenges. Recently, more tools have become available to facilitate the […]