In this episode, I’ll discuss an alternative to a dextrose-based purge solution for patients with an Impella ventricular assist device that also need a PET scan. Subscribe on iTunes, Android, or Stitcher Positron emission tomography (PET) scanning uses a tracer such as fluoro-deoxyglucose which gets picked up by cells in place of regular glucose for […]

In this episode, I’ll discuss how obesity affects SC and IM medication administration. Subscribe on iTunes, Android, or Stitcher The thickness of the subcutaneous layer increases with obesity and this has potential implications for both subcutaneous and intramuscular medication administration. The AJHP recently published a review article on the implications of obesity for drug administration […]

In this episode, I’ll discuss the incidence of torsades from low-dose ondansetron in peri-operative patients. Subscribe on iTunes, Android, or Stitcher Ondansetron prescribing information has a warning that Electrocardiogram (ECG) changes including QT interval prolongation have been seen in patients receiving ondansetron. Some references list this as a concern, but many clinicians believe that a […]

In this episode, I’ll discuss what vasopressor to use in post-resuscitation shock. Subscribe on iTunes, Android, or Stitcher The ideal choice of vasopressor for post resuscitative shock is unknown, and researchers from the Paris Cardiovascular Research Center conducted an observational multicenter study to determine whether epinephrine or norepinephrine was the superior vasopressor to use in […]

In this episode, I’ll discuss the use of tetanus immune globulin. Subscribe on iTunes, Android, or Stitcher Tetanus Immune Globulin can be part of successful tetanus post-exposure prophylaxis for certain patients as well as tetanus treatment. In post-exposure prophylaxis scenarios, tetanus immune globulin provides immediate but temporary passive immunity to tetanus. The immunity is conferred because […]

In this episode, I’ll discuss an article about nebulized vs IV ketamine for analgesia in the ED. Subscribe on iTunes, Android, or Stitcher To access my free download area with 20 different resources to help you in your practice, go to pharmacyjoe.com/free. Subdissociative-dose ketamine can be used for its analgesic effect in acute pain in patients […]

In this episode, I’ll discuss an article about risk factors for serious and general opioid-related adverse drug events. Subscribe on iTunes, Android, or Stitcher Opioid-related adverse effects in hospital inpatients can be a significant cause of morbidity and resource expenditure in the form of rapid response calls, transfers to higher levels of care, and extended […]

In this episode, I’ll discuss if antibiotic exposure intensity affects the risk of clostridioides difficile infection. Subscribe on iTunes, Android, or Stitcher The antibiotic spectrum index (ASI) was developed to classify commonly used antibiotics based on activity against relevant pathogens. In the ASI antibiotics are given points based on the number of unique pathogens they […]

In this episode, I’ll discuss if phentolamine is the only thing you can use for vasopressor extravasation. Subscribe on iTunes, Android, or Stitcher Extravasation is a complication of IV therapy that refers to the infiltration of tissues with a medication that is an irritant or vesicant. Infiltration can be done purposefully with therapeutic intent, such […]

In this episode, I’ll discuss assessing the risk of bias in a review of nonrandomized studies. Subscribe on iTunes, Android, or Stitcher According to training by Cochrane, bias in a meta-analysis is a systematic error or deviation from the truth. A risk of bias assessment of studies included in a meta-analysis is essential because the […]

In this episode, I’ll discuss what if it is not the sedative class that causes delirium – just the depth of sedation? Subscribe on iTunes, Android, or Stitcher Both the 2013 and 2018 SCCM guidelines for sedation in the ICU recommend avoiding benzodiazepine infusions for sedation in the ICU. The reason for this is in […]

In this episode, I’ll discuss what blood gas parameters can make you suspect methemoglobinemia. Subscribe on iTunes, Android, or Stitcher Methemoglobin is formed when the ferrous irons of heme are oxidized to the ferric state. The ferric hemes of methemoglobin are unable to bind oxygen, therefore, causing a functional anemia. Acquired methemoglobinemia is typically a reaction […]