In this episode, I’ll discuss when the acute ischemic stroke guidelines recommend stopping alteplase mid-infusion. Subscribe on iTunes, Android, or Stitcher There are three circumstances where AHA acute ischemic stroke guidelines recommend stopping alteplase mid-infusion. 1. Abnormal pre-alteplase coagulation test results become available Coagulation studies are no longer necessary to decide whether or not to […]

In this episode, I’ll discuss an article about the adverse effects of medications given for acute agitation in the ED. Subscribe on iTunes, Android, or Stitcher Article Risk Factors for Sedation‐Related Events During Acute Agitation Management in The Emergency Department Lead author: Celene Y.L. Yap Published in Academic Emergency Medicine July 2019 Background Sedation for […]

In this episode, I’ll discuss why you don’t need to know the cause of severe, symptomatic hyponatremia before treating it. Subscribe on iTunes, Android, or Stitcher Severe, symptomatic hyponatremia is characterized by a serum sodium < 125 mEq/L and symptoms such as seizure, mental status changes, respiratory depression, coma or obtundation. Without immediate treatment, this […]

In this episode, I’ll discuss the final 4 questions of a recent survey of intensive care professionals about clinically relevant pharmacokinetic knowledge on antibiotic dosing. This is part 3 of a 3 part series that began with episode 414. Subscribe on iTunes, Android, or Stitcher The survey was published in May 2019 in the journal […]

In this episode, I’ll discuss questions 6, 7 and 8 of a recent survey of intensive care professionals about clinically relevant pharmacokinetic knowledge on antibiotic dosing. This is part 2 of a 3 part series that began with episode 414. Subscribe on iTunes, Android, or Stitcher The survey was published in May 2019 in the […]

In this episode, I’ll discuss a recent survey of intensive care professionals about clinically relevant pharmacokinetic knowledge on antibiotic dosing. Subscribe on iTunes, Android, or Stitcher Article Clinically relevant pharmacokinetic knowledge on antibiotic dosing among intensive care professionals is insufficient: a cross-sectional study Lead author: Lucas M. Fleuren Published May 2019 in the journal Critical Care […]

In this episode, I’ll discuss why moxifloxacin doesn’t cover urinary tract infections. Subscribe on iTunes, Android, or Stitcher Imagine the following scenario: You’re covering multidisciplinary rounds with the hospitalist team when they present a patient who appears to have two infections. 1. Community-acquired pneumonia, for which the patient was admitted for and had a positive […]

In this episode, I’ll discuss famotidine as a potential cause of delirium. Subscribe on iTunes, Android, or Stitcher Depending on which meta-analysis you read, famotidine is an option for stress ulcer prophylaxis in ICU patients. However, famotidine also has the potential to cause CNS related side effects and carries the warning: Central nervous system (CNS) […]

In this episode, I’ll discuss potential reasons for an unexpected positive urine barbiturate screen. Subscribe on iTunes, Android, or Stitcher When a urine drug screen comes up positive for barbiturates unexpectedly, healthcare practitioners often suspect the result is a false positive. Both ibuprofen and naproxen have been reported to cause a false positive urine barbiturate […]

In this episode, I’ll discuss potential reasons for a false heparin anti-Xa level. Subscribe on iTunes, Android, or Stitcher Time Sensitive Announcement: The price for the Hospital Pharmacy Academy will be increasing significantly this Friday, June 28 at 10 pm EST.  Current members and those that join before the deadline this Friday will lock in the […]

In this episode, I’ll discuss octreotide’s role in treating variceal bleeding. Subscribe on iTunes, Android, or Stitcher Octreotide is a long-acting analog of somatostatin. It inhibits the release of many endocrine peptides including insulin and glucagon. In addition, it inhibits the release of gastric acid.  Because glucagon is a vasodilator, octreotide indirectly decreases splanchic blood flow by […]

In this episode, I’ll discuss an article about using dexmedetomidine in critically ill patients.  This trial turned out to be a negative trial which can sometimes be as instructive as a positive one.  In this case, it turned out to be a study in how not to use dexmedetomidine. Subscribe on iTunes, Android, or Stitcher […]