In this episode, I’ll discuss the most common triggers for a rapid response call. Subscribe on iTunes, Android, or Stitcher A retrospective multisite cohort study published in Critical Care Medicine October 2019 examined this issue. The article is titled Characteristics of Rapid Response Calls in the United States: An Analysis of the First 402,023 Adult […]

In this episode, I’ll discuss whether DOACs ever require bridging. Subscribe on iTunes, Android, or Stitcher When the only oral anticoagulant available was warfarin, patients who experienced a thromboembolic event required a bridging period with unfractionated or low molecular weight heparin when starting warfarin therapy. The reasons for this bridging are two-fold: 1. In the […]

In this episode, I’ll discuss whether oral vancomycin use for C diff increases the risk of VRE. Subscribe on iTunes, Android, or Stitcher Recent changes to the C diff guidelines moved vancomycin up to first line treatment for C diff infection, regardless of the level of disease severity. Such a large increase in vancomycin use […]

In this episode, I’ll discuss an article about rebound hypertension from dexmedetomidine. Subscribe on iTunes, Android, or Stitcher Article Incidence of Rebound Hypertension after Discontinuation of Dexmedetomidine Lead author: Lauren A. Flieller Published in the journal Pharmacotherapy August 2019 Background Because the sedative dexmedetomidine shares receptor targets with the antihypertensive clonidine, a warning was placed […]

In this episode, I’ll discuss what antibiotic to use in a patient with severe appendicitis and severe penicillin allergy. Subscribe on iTunes, Android, or Stitcher In severe appendicitis, antibiotic coverage is typically broadened to cover: Pseudomonas aeruginosa Enterobacteriaceae Enteric streptococci Anaerobes A carbapenem such as meropenem is the usual choice of therapy to cover all […]

In this episode, I’ll discuss the types and causes of drug-induced liver injury. Subscribe on iTunes, Android, or Stitcher Drug-induced liver injury is a rare event but it accounts for more than half of the cases of acute liver injury. It is a diagnosis of exclusion, as there is no reliable diagnostic test. The fact […]

In this episode, I’ll discuss how often midodrine use continues after a patient leaves the ICU. Subscribe on iTunes, Android, or Stitcher Midodrine has been shown in several studies to aid in the discontinuation of vasopressors in otherwise medically stable ICU patients to facilitate discharge from the ICU. But what happens to the midodrine order […]

In this episode, I’ll discuss how long patients need to be monitored in the ICU after receiving alteplase for acute ischemic stroke. Subscribe on iTunes, Android, or Stitcher The typical length of stay for a patient in the ICU after receiving alteplase for acute ischemic stroke is 24 hours. This monitoring period is primarily to […]

In this episode, I’ll discuss when octreotide can be discontinued in patients with variceal bleeding. Subscribe on iTunes, Android, or Stitcher When given to patients with variceal bleeding, octreotide helps achieve hemostasis and prevent rebleeding. While it is a relatively inexpensive intervention at between $50 and $100 per day, octreotide does carry a high incidence […]

In this episode, I’ll discuss how to become a peer reviewer for a medical journal. Subscribe on iTunes, Android, or Stitcher One common reason for a pharmacist to wish to become a peer reviewer for a journal is to satisfy ASHP standards for preceptors in the area of ongoing professionalism. Additionally, being a peer reviewer […]

In this episode, I’ll discuss the treatment of fulminant C. diff. Subscribe on iTunes, Android, or Stitcher In older IDSA guidelines, the term “severe complicated” was used to describe the sickest group of patients with C. diff infection. In the most recent guidelines, patients with C. diff and hypotension, shock, or ileus are now said […]

In this episode, I’ll discuss the different types of statistical data. Subscribe on iTunes, Android, or Stitcher How to evaluate whether the correct statistical test is being used in a medical study is a necessary part of being able to properly evaluate a study. The application of biostatistics is a complicated field and in practice, […]