In this episode, I’ll discuss the biggest risk to using phenobarbital monotherapy for severe alcohol withdrawal. Subscribe on iTunes, Android, or Stitcher Phenobarbital is a very effective option for treating severe alcohol withdrawal.  A recent retrospective analysis of 3 protocols – one using diazepam alone, one using lorazepam and phenobarbital and one using phenobarbital alone […]

In this episode I’ll: 1. Discuss an article about the safety and efficacy of apixaban in patients at extremes of body weight. 2. Answer a drug information question about the diagnosis of adrenocortical insufficiency without using Cortosyn. Subscribe on iTunes, Android, or Stitcher Article Efficacy and Safety of Apixaban versus Warfarin in Patients with Atrial […]

In this episode, I’ll discuss the state of research for hydrocortisone, ascorbic acid, and thiamine (HAT Rx) for sepsis. Subscribe on iTunes, Android, or Stitcher It has been nearly 2 and a half years since the publication of Paul Marik’s retrospective before-after study of hydrocortisone, ascorbic acid, and thiamine to treat septic shock. According to […]

In this episode, I’ll discuss the use of methylene blue for the treatment of refractory anaphylaxis without hypotension. Subscribe on iTunes, Android, or Stitcher Methylene blue has some unique uses such as in the treatment of acquired methemoglobinemia and vasoplegia after cardiac surgery.  It also appears to have a role in treating patients experiencing anaphylaxis […]

In this episode, I’ll discuss PGY-1 Learning Activities and the 6 levels of Bloom’s Learning Taxonomy. Subscribe on iTunes, Android, or Stitcher ASHP accreditation standards mandate that : Learning activities are developed at the cognitive learning level (Bloom’s Taxonomy) associated with the objective. The 6 levels of cognitive learning according to Bloom’s are: Level 1: […]

In this episode I’ll: 1. Discuss an article about the use of ketamine for agitation in patients with schizophrenia 2. Answer the drug information question “Can oral and IV vancomycin be given at the same time to the same patient?” Subscribe on iTunes, Android, or Stitcher   Article Psychiatric Outcomes of Patients With Severe Agitation […]

Subscribe on iTunes, Android, or Stitcher Why is IV dextrose given to patients with DKA? When the serum glucose reaches 200 mg/dL in a patient with diabetic ketoacidosis (DKA), IV dextrose is added to avoid the development of cerebral edema. In addition, the rate of insulin infusion may need to be slowed down to between […]

In this episode, I’ll discuss how to remember antibiotic spectrum of activity. Subscribe on iTunes, Android, or Stitcher Knowing the antibiotic spectrum of activity Early in my career, I asked an ID physician how he kept track of the spectrum of activity for all the antibiotics (Shout out to “Infectious Disease Phil”).  He told me […]

In this episode, I’ll discuss whether 100 mg of micafungin is enough for critically ill obese patients. Subscribe on iTunes, Android, or Stitcher The recommended dose of micafungin for candidemia is 100mg, but is this enough to achieve adequate levels in obese patients? A meta-analysis published in the journal Critical Care attempts to answer this […]

In this episode, I’ll discuss the role for tranexamic acid in the treatment of epistaxis. Subscribe on iTunes, Android, or Stitcher Tranexamic acid is an antifibrinolytic agent. It works by forming a reversible complex that displaces plasminogen from fibrin. This results in the inhibition of fibrinolysis. Tranexamic acid has been used in oral or topical […]

In this episode, I’ll discuss whether to use phentolamine to treat dobutamine extravasation. Subscribe on iTunes, Android, or Stitcher Extravasation of vasopressors is of great concern due to vasoconstriction and tissue necrosis at the site of extravasation. Since the vasoconstriction is due to alpha1-adrenergic agonism, phentolamine works as a direct antidote to extravasation by blocking […]

In this episode, I’ll discuss an article about enhanced renal clearance in patients with hemorrhagic stroke. Subscribe on iTunes, Android, or Stitcher Article Enhanced Renal Clearance in Patients With Hemorrhagic Stroke Lead author: Kathryn Morbitzer Published in Critical Care Medicine March 2019 Background Augmented or enhanced renal clearance is a phenomenon in some critically ill […]