In this episode, I’ll discuss a novel metric for antibiotic stewardship. Subscribe on iTunes, Android, or Stitcher Days of Therapy (DOT) is probably the most common metric to track antimicrobial stewardship efforts related to antibiotic consumption. DOT is not a perfect metric as it is calculated by calendar day regardless of the number of doses […]

In this episode, I’ll discuss the consolidated CHEST guidelines on antithrombotic therapy for venous thromboembolism disease. Subscribe on iTunes, Android, or Stitcher The CHEST guidelines on venous thromboembolism disease are an invaluable resource, but one flaw that has persisted since 2016 has made referencing the guidelines awkward and inconvenient. When the 1st updated to the […]

In this episode, I’ll discuss what predicts critical care pharmacist intervention – patient acuity or medication regimen complexity? Subscribe on iTunes, Android, or Stitcher It makes intuitive sense that both scenarios of high patient acuity and high medication regimen complexity would be legitimate ways of identifying ICU patients who are more likely to need pharmacist […]

In this episode, I’ll discuss the mortality rate for critically ill patients when ketamine vs etomidate is used as an induction agent for intubation. Subscribe on iTunes, Android, or Stitcher Out of the available induction agents for intubation, ketamine is considered to have the best cardiovascular risk profile, as it typically has a neutral to […]

In this episode, I’ll discuss which antibiotic should be given first in sepsis – the beta-lactam or the vancomycin? Subscribe on iTunes, Android, or Stitcher Quickly administering appropriate empiric antibiotic therapy is essential in the treatment of severe infections. If multiple antibiotics are required for empiric therapy to treat a severe infection (such as for […]

In this episode, I’ll discuss whether patients taking beta-blockers require increased doses of epinephrine for anaphylaxis. Subscribe on iTunes, Android, or Stitcher Animal data suggests that patients taking beta-blockers have more severe anaphylaxis, possibly by decreasing the threshold for mast cell activation. With beta-blockers interfering with the same receptors epinephrine needs to activate in order […]

In this episode, I’ll discuss the association between number of learners trained per year and rates of burnout among inpatient pharmacists. Subscribe on iTunes, Android, or Stitcher Burnout is defined as a work-related stress syndrome resulting from chronic exposure to job stress that consists of 3 dimensions: emotional exhaustion, cynicism and depersonalization, and reduced professional […]

In this episode, I’ll discuss the analgesic ceiling dose of ibuprofen in ED patients. Subscribe on iTunes, Android, or Stitcher NSAIDs (including ibuprofen) have a ceiling dose beyond which, no additional analgesic effect is seen.  I must have missed that part of the lecture in pharmacy school because I don’t remember encountering this concept in […]

In this episode, I’ll discuss why I think ketamine and propofol don’t belong in the same syringe. Subscribe on iTunes, Android, or Stitcher Ketamine and propofol are compatible in the same syringe, and several published studies have specifically stated that the two medications were placed in the same syringe. But just because we can, doesn’t […]

In this episode, I’ll discuss why glucocorticoids have no role in reversing the acute symptoms of anaphylaxis. Subscribe on iTunes, Android, or Stitcher Despite epinephrine clearly being recommended as the first line of treatment for an acute episode of anaphylaxis, glucocorticoids continue to be given by many providers. The mechanism of action for glucocorticoids is […]

In this episode, I’ll discuss the impact of giving epinephrine before defibrillation to in-hospital cardiac arrest (IHCA) patients with shockable rhythms. Subscribe on iTunes, Android, or Stitcher Knowing when a medication is the first-line treatment for a condition should be easy for pharmacists, as this is exactly what we spend our time on during training […]