Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss whether patients with liver disease and prolonged PT/INR levels still need VTE prophylaxis. Patients with liver disease and prolonged PT/INR levels appear to be teetering between the risk of bleeding and the risk of clotting. In a patient with cirrhosis, simply having a prolonged […]
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Episode 374: Musculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy and the benefit of de-escalating ceftriaxone to cefazolin
In this episode I’ll: 1. Discuss a review article about musculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy 2. Answer the drug information question “Is there any benefit in de-escalating ceftriaxone to cefazolin?” Subscribe on iTunes, Android, or Stitcher Article Musculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy Lead author: Kazuhiko […]
Episode 373: Can linezolid be used to inhibit bacterial toxin production in necrotizing fasciitis?
Subscribe on iTunes, Android, or Stitcher Clindamycin is usually thought of as the antibiotic to use in necrotizing fasciitis to reduce toxin production. But linezolid and clindamycin both bind to the 50S subunit of bacterial ribosomes to inhibit protein synthesis. Linezolid is a particularly interesting choice in infections with group A strep as the drug […]
Episode 372: Fentanyl-induced chest wall rigidity
In this episode, I’ll discuss fentanyl-induced chest wall rigidity. Subscribe on iTunes, Android, or Stitcher Fentanyl is an ideal opioid to use in critically ill patients due to its relatively quick onset and offset. Fentanyl also has minimal histamine release and resulting effects on hemodynamics when compared with other opioids. A known but rare complication […]
Episode 371: Can patients with an iodine allergy receive amiodarone?
Can patients with an iodine allergy receive amiodarone? Subscribe on iTunes, Android, or Stitcher This question was best addressed in a 2012 retrospective medical record review in the journal Pharmacotherapy. Records of 234 sequential hospitalized patients in 2 academic medical centers with a listed iodine and/or iodinated radiocontrast agent allergy who received oral or intravenous […]
Episode 370: The impact of an emergency medicine pharmacist during trauma resuscitation, probiotics via NG tube in the ICU, and a tip for responding to inpatient medical emergencies
In this episode I’ll: 1. Discuss an article about the presence of an emergency medicine pharmacist during critical care trauma patient resuscitation. 2. Answer the drug information question “Should probiotics be given via NG tube to ICU patients?” 3. Share a tip for responding to inpatient medical emergencies. Subscribe on iTunes, Android, or Stitcher Article […]
Episode 369: Does IV acetaminophen cause hypotension?
Subscribe on iTunes, Android, or Stitcher The formulary status of IV acetaminophen can be controversial, given that it is an expensive medication without consistent evidence of benefit on clinically meaningful patient outcomes such as reducing the length of hospital stay or ileus. One argument for keeping IV acetaminophen on formulary is for use in critically […]
Episode 368: Can 3% (hypertonic) sodium chloride be given through a peripheral IV?
In this episode, I’ll discuss peripheral IV administration of 3% sodium chloride solution. Subscribe on iTunes, Android, or Stitcher Infusions of 3% sodium chloride are routinely recommended to be given through central, not peripheral IV lines. This recommendation is based on the theory that since the osmolarity of 3% sodium chloride exceeds 900 mOsm/L, it […]
Episode 367: How much insulin should be used to treat hyperkalemia?
Subscribe on iTunes, Android, or Stitcher How much insulin should be used to treat hyperkalemia? I think of insulin like a key that unlocks a door in cell membranes to allow glucose, potassium, and water to walk through. Putting the potassium in the intracellular space hides it from the heart temporarily and is a critical […]
Episode 366: Metronidazole in mild Clostridium difficile infection, captisol-based amiodarone, and a tip for responding to inpatient medical emergencies
Subscribe on iTunes, Android, or Stitcher In this episode I’ll: 1. Discuss an article about using metronidazole in mild Clostridium difficile infection. 2. Answer the drug information question “What is captisol-based amiodarone?” 3. Share a tip for responding to inpatient medical emergencies. Article What is the role for metronidazole in the treatment of Clostridium difficile […]
Episode 365: How many mcg of push-dose norepinephrine is needed to prevent hypotension?
Subscribe on iTunes, Android, or Stitcher How many mcg of push-dose norepinephrine is needed to prevent hypotension? Despite the popularity of push-dose vasopressors in emergency medicine and critical care scenarios, nearly all of the data supporting their use comes from women undergoing elective cesarean delivery under spinal anesthesia. Push-dose vasopressors are used in that setting […]
Episode 364: The 2018 ACLS Antiarrhythmic Drug Update
In this episode, I’ll discuss the 2018 ACLS antiarrhythmic drug update. Subscribe on iTunes, Android, or Stitcher In 2015 the ACLS guidelines transitioned from a 5-year cycle of periodic revisions and updates to a web-based format that is continuously updated. Late 2018 we saw a change to the guidelines with a Focused Update on Advanced Cardiovascular […]
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