In this episode, I’ll discuss the evidence supporting using cefazolin for MSSA bacteremia. Subscribe on iTunes, Android, or Stitcher The strongest data on what to use to treat MSSA bacteremia has always been for the penicillinase-resistant penicillins like nafcillin and cloxacillin. But these antibiotics have high rates of adverse events. Cefazolin has a much more […]

In this episode, I’ll discuss 5 steps an ED or ICU pharmacist can take to prevent awareness with paralysis. Subscribe on iTunes, Android, or Stitcher Awareness with paralysis occurs when a patient receives a paralytic for rapid sequence intubation but does not receive ongoing sedation before the induction agent wears off. In the context of […]

In this episode, I’ll discuss the balance between the risk of cerebral edema from severe hyponatremia vs osmotic demyelination from overly rapid sodium correction. Subscribe on iTunes, Android, or Stitcher The risk of irreversible neurologic damage from osmotic demyelination after overly rapid correction of severe hyponatremia is significant. Over the years the maximum recommended increase […]

In this episode, I’ll discuss whether a nasal MRSA screen is useful for choosing antibiotics in critically ill patients with an intra-abdominal infection. Subscribe on iTunes, Android, or Stitcher A recent multicenter, retrospective, cohort study looking at the performance of a nasal MRSA screen in predicting intraabdominal infection with MRSA was published in the journal Pharmacotherapy. […]

In this episode, I’ll discuss respiratory depression from phenobarbital when used for alcohol withdrawal syndrome. Subscribe on iTunes, Android, or Stitcher Phenobarbital is increasing in popularity among clinicians for use in the treatment of alcohol withdrawal syndrome. Even though there is less data available on patient outcomes using phenobarbital over benzodiazepines for severe alcohol withdrawal, […]

In this episode, I’ll discuss a pharmacist-driven deprescribing protocol for negative urine and sexually transmitted infection cultures in the emergency department. Subscribe on iTunes, Android, or Stitcher When pharmacists begin to provide in-person services to the Emergency Department, one of the first areas to achieve an impact that everyone is satisfied with is the ED […]

In this episode, I’ll discuss using one vs two bag protocols for the treatment of diabetic ketoacidosis. Subscribe on iTunes, Android, or Stitcher In the management of diabetic ketoacidosis, it is essential to deliver isotonic IV fluids with additional electrolytes as well as dextrose. To accomplish this, one of two methods is generally used – […]

In this episode, I’ll discuss recent guidelines about complicated UTI treatment. Subscribe on iTunes, Android, or Stitcher For the first time ever, the IDSA has published a set of guidelines specific to the treatment of complicated UTIs. A complicated UTI is now defined as any UTI that is not confined to the bladder. This could […]

In this episode, I’ll discuss empiric posaconazole to prevent influenza-associated pulmonary aspergillosis. Subscribe on iTunes, Android, or Stitcher Critically ill patients who develop influenza-induced acute respiratory distress syndrome (ARDS) sometimes go on to experience secondary fungal infections such as influenza-associated pulmonary aspergillosis (IAPA). To evaluate the impact of empiric antifungal therapy on the development of […]

In this episode, I’ll discuss inhaled antibiotics to prevent VAP. Subscribe on iTunes, Android, or Stitcher The prevention of ventilator-associated pneumonia has been a focus of research for many decades. The peak incidence of VAP appears to occur after about 7 days of ventilator use and this has led researchers to focus on whether there […]

In this episode, I’ll discuss “Do Not Crush” medication lists. Subscribe on iTunes, Android, or Stitcher If you navigate to the page on the website for the Institute for Safe Medication Practices that once hosted the document titled “Oral Dosage Forms That Should Not Be Crushed” you will instead find a notice that the list has […]

In this episode, I’ll discuss the risk of hypotension when giving IV furosemide for acute decompensated heart failure. Subscribe on iTunes, Android, or Stitcher Patients who present with acute decompensated heart failure often also have hypotension, and clinicians are often concerned that treatment with furosemide, while it will address fluid overload might also result in […]