In this episode, I’ll discuss the efficacy of IV push levetiracetam over slow IV infusions. Subscribe on iTunes, Android, or Stitcher IV levetiracetam is FDA labeled to be infused slowly, over 15 min. Rapid IV push administration has gained popularity with several studies supporting its safety, and some of these have been discussed recently in episode1056. […]

In this episode, I’ll discuss whether the reversal of anticoagulants is necessary for neurologically intact patients with traumatic intracranial hemorrhage. Subscribe on iTunes, Android, or Stitcher While intracranial hemorrhage (ICH) has the potential to lead to a catastrophic outcome in patients with traumatic injury who are also taking oral anticoagulants, the reversal of anticoagulation is […]

In this episode, I’ll discuss what phenotype of patients are most affected by delays in antibiotic therapy. Subscribe on iTunes, Android, or Stitcher For patients with sepsis, the link between a delay in antibiotic therapy and increased risk of mortality is well-established. However, it is possible that not all patients are affected the same way […]

In this episode, I’ll discuss best practices in airway management in critically ill adults. Subscribe on iTunes, Android, or Stitcher Pharmacists who work in critical care areas have tremendous opportunities to help the care team and patient whenever tracheal intubation takes place, from preventing awareness with paralysis to managing post-intubation cardiovascular complications as has been […]

In this episode, I’ll discuss the dose of insulin to treat hyperkalemia. Subscribe on iTunes, Android, or Stitcher Back in episodes 653 and 612 I discussed using a lower dose of insulin (5 units instead of 10) to treat hyperkalemia, and this practice has become more common because it seems to offer equivalent reduction in […]

In this episode, I’ll discuss anti-Xa monitoring of enoxaparin in VTE prophylaxis. Subscribe on iTunes, Android, or Stitcher An advantage of using enoxaparin for VTE prophylaxis is that it has predictable pharmacokinetics and pharmacodyamics which allow for either fixed dosing of 40 mg subQ once daily or 0.5 mg/kg in the case of obese patients. […]

In this episode, I’ll discuss using gabapentin to reduce benzodiazepine use in patients hospitalized with alcohol withdrawal. Subscribe on iTunes, Android, or Stitcher Because gabapentin’s mechanism of action fits the pathophysiology of alcohol withdrawal, many investigators have sought to test gabapentin for this condition. Chronic ethanol use affects receptors in the brain in two ways: […]

In this episode, I’ll discuss the bioavailability of methadone. Subscribe on iTunes, Android, or Stitcher Popular tertiary references suggest a conversion ratio of oral to IV methadone of 2:1, meaning 10 mg of oral methadone is equivalent to 5 mg of IV methadone. But a team of researchers published a scoping review on the bioavailability […]

In this episode, I’ll discuss the prediction of hypotension from propofol when used as an ICU sedative. Subscribe on iTunes, Android, or Stitcher Hypotension from ICU sedatives like propofol and dexmedetomidine can complicate patient management.  I discussed predicting hypotension from dexmedetomidine back in Episode 853. Hypotension from propofol in the ICU can also be reasonably […]

In this episode, I’ll discuss the AHA/NCS scientific statement on critical care management of patients after cardiac arrest. Subscribe on iTunes, Android, or Stitcher There is a lack of high-quality published research to support the critical care management of patients after cardiac arrest, and as a result there are few guideline recommendations in this area. […]

In this episode, I’ll discuss 5 changes to the ACLS guidelines that hospital pharmacists should know about. Subscribe on iTunes, Android, or Stitcher The ACLS guidelines have been updated for 2025 and published at cpr.heart.org, and updated algorithms can be found at this link. Some notable changes are: 1. Vasopressin has been downgraded from a […]

In this episode, I’ll discuss whether diuretics are safe for reducing fluid balance in critically ill patients. Subscribe on iTunes, Android, or Stitcher Interest in fluid balance and the associated adverse effects in ICU patients has grown considerably over the last decade. The general practice of reducing fluid balance, sometimes referred to as deresuscitation, is […]