In this episode, I’ll discuss whether to use actual, ideal, or adjusted body weight when dosing gentamicin in pregnant patients. Subscribe on iTunes, Android, or Stitcher Aminoglycosides such as gentamicin are very rarely used in pregnancy to treat infections. Gentamicin crosses the placenta, and is pregnancy category D. Case reports of congenital deafness following maternal […]

In this episode, I’ll discuss whether patiromer can be used for acute hyperkalemia. Subscribe on iTunes, Android, or Stitcher In the treatment of acute hyperkalemia, IV calcium provides immediate cardioprotection and allows time for insulin to move potassium into the intracellular space and away from the heart. This is only a short term solution however, […]

In this episode, I’ll discuss why dexamethasone is given for acute headache in the ED. Subscribe on iTunes, Android, or Stitcher While not given as monotherapy, dexamethasone is often added to standard treatment of acute headache in patients presenting to the emergency department. This is done because dexamethasone has been shown to reduce migraine recurrence […]

In this episode, I’ll discuss an article about relative hypoglycemia in the ICU. Subscribe on iTunes, Android, or Stitcher Article Relative Hypoglycemia in Diabetic Patients With Critical Illness Lead author: Timothy Kwan Published in Critical Care Medicine online January 2020 Background Relative hypoglycemia is most commonly a term used in outpatient care of diabetic patients. […]

In this episode, I’ll discuss why vaccines shouldn’t be given in the 14 days immediately post-splenectomy. Subscribe on iTunes, Android, or Stitcher This recommendation is based on a small study of 59 splenectomy patients where vaccine response at 1, 7, and 14 days post-splenectomy were compared. Better functional antibody responses against the serogroup and serotypes […]

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 use of alteplase for suspected Impella device thrombosis Subscribe on iTunes, Android, or Stitcher An Impella device provides mechanical circulatory support, and device thrombosis is a potential complication. The purge solution for an Impella device is heparinized but despite this, thrombosis may still occur. A combination of low purge […]

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 whether levetiracetam, fosphenytoin, or valproate is better for status epilepticus unresponsive to benzodiazepines. Subscribe on iTunes, Android, or Stitcher A recent randomized, blinded, adaptive trial was published in New England Journal of Medicine comparing levetiracetam, fosphenytoin, or valproate in pediatric and adult patients for status epilepticus unresponsive to benzodiazepines. The […]

In this episode, I’ll discuss an article about using thrombolysis during resuscitation for out-of-hospital cardiac arrest caused by pulmonary embolism. Subscribe on iTunes, Android, or Stitcher   Article Thrombolysis During Resuscitation for Out-of-Hospital Cardiac Arrest Caused by Pulmonary Embolism Increases 30-Day Survival Lead author: François Javaudin Published in the journal CHEST December 2019 Background Pulmonary […]

In this episode, I’ll discuss why beta-blockers should be tapered before clonidine. Subscribe on iTunes, Android, or Stitcher For patients taking concomitant beta-blocker and clonidine therapy who require tapering, the recommendation is to taper the beta-blocker first, followed by the clonidine.  The concern if this taper order is not followed is the development of severe […]

In this episode, I’ll discuss cefazolin and ertapenem combination therapy for refractory MSSA bacteremia. Subscribe on iTunes, Android, or Stitcher A recent case series published in Clinical Infectious Diseases describes the successful treatment of 11 patients with persistent methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. The authors had an index case where they discovered apparent synergy against […]