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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

Subscribe on iTunes, Android, or Stitcher   Delays in starting antibiotics for bacteremia can be significant. One community teaching hospital implemented a protocol to notify a pharmacist whenever a blood culture turned positive so appropriate therapy could be started faster and infection-related mortality dropped from 25% to 11%. The protocol is called the rapid administration […]

In this episode I’ll: 1. Discuss an article about the duration of therapy in gram-negative bacteremia. 2. Answer the drug information question “Can cefazolin sensitivity be used to predict cephalexin sensitivity?” 3. Share a tip for responding to inpatient medical emergencies. Subscribe on iTunes, Android, or Stitcher Article Seven versus fourteen Days of Antibiotic Therapy […]