In this episode, I’ll discuss what antibiotic to use in a patient with severe appendicitis and severe penicillin allergy. Subscribe on iTunes, Android, or Stitcher In severe appendicitis, antibiotic coverage is typically broadened to cover: Pseudomonas aeruginosa Enterobacteriaceae Enteric streptococci Anaerobes A carbapenem such as meropenem is the usual choice of therapy to cover all […]

In this episode, I’ll discuss the types and causes of drug-induced liver injury. Subscribe on iTunes, Android, or Stitcher Drug-induced liver injury is a rare event but it accounts for more than half of the cases of acute liver injury. It is a diagnosis of exclusion, as there is no reliable diagnostic test. The fact […]

In this episode, I’ll discuss how often midodrine use continues after a patient leaves the ICU. Subscribe on iTunes, Android, or Stitcher Midodrine has been shown in several studies to aid in the discontinuation of vasopressors in otherwise medically stable ICU patients to facilitate discharge from the ICU. But what happens to the midodrine order […]

In this episode, I’ll discuss how long patients need to be monitored in the ICU after receiving alteplase for acute ischemic stroke. Subscribe on iTunes, Android, or Stitcher The typical length of stay for a patient in the ICU after receiving alteplase for acute ischemic stroke is 24 hours. This monitoring period is primarily to […]

In this episode, I’ll discuss when octreotide can be discontinued in patients with variceal bleeding. Subscribe on iTunes, Android, or Stitcher When given to patients with variceal bleeding, octreotide helps achieve hemostasis and prevent rebleeding. While it is a relatively inexpensive intervention at between $50 and $100 per day, octreotide does carry a high incidence […]

In this episode, I’ll discuss how to become a peer reviewer for a medical journal. Subscribe on iTunes, Android, or Stitcher One common reason for a pharmacist to wish to become a peer reviewer for a journal is to satisfy ASHP standards for preceptors in the area of ongoing professionalism. Additionally, being a peer reviewer […]

In this episode, I’ll discuss the treatment of fulminant C. diff. Subscribe on iTunes, Android, or Stitcher In older IDSA guidelines, the term “severe complicated” was used to describe the sickest group of patients with C. diff infection. In the most recent guidelines, patients with C. diff and hypotension, shock, or ileus are now said […]

In this episode, I’ll discuss the different types of statistical data. Subscribe on iTunes, Android, or Stitcher How to evaluate whether the correct statistical test is being used in a medical study is a necessary part of being able to properly evaluate a study. The application of biostatistics is a complicated field and in practice, […]

In this episode, I’ll discuss topical lidocaine for wound vac dressing changes. Subscribe on iTunes, Android, or Stitcher Wound VAC dressing changes can be particularly painful for patients. The wound VAC dressing is a sponge that is placed on top of the wound. During the healing process, the granulation tissue and regenerating nerve endings can […]

In this episode, I’ll discuss an article about the impact of total body weight on rate of acute kidney injury in patients treated with piperacillin–tazobactam and vancomycin Subscribe on iTunes, Android, or Stitcher Article Impact of total body weight on rate of acute kidney injury in patients treated with piperacillin–tazobactam and vancomycin Lead author: W. […]

In this episode, I’ll discuss why hypotonic or dextrose-based solutions are avoided in patients with acute ischemic stroke. Subscribe on iTunes, Android, or Stitcher A common cause of in-hospital death from acute ischemic stroke is brain edema and elevated intracranial pressure. This is often a result of occlusion of the major intracranial arteries or multi-lobar […]

In this episode, I’ll discuss deresuscitation of patients in the ICU. Subscribe on iTunes, Android, or Stitcher Since the first Surviving Sepsis Campaign, guidelines have contained a strong emphasis on early and aggressive fluid resuscitation for patients in septic shock. While this focus on fluid resuscitation is widely regarded as a cornerstone of the treatment […]