In this episode, I’ll discuss an article comparing different methods of administering adenosine. Subscribe on iTunes, Android, or Stitcher Article Single Syringe Administration of Diluted Adenosine Lead author: Marc McDowell Published in Academic Emergency Medicine October 2019 Background Because the half-life of adenosine is measured in seconds, administration must be rapid and followed by a […]
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Episode 451: Should higher than normal doses of naloxone be considered for opioid overdose?
In this episode, I’ll discuss using higher than normal doses of naloxone for opioid overdose. Subscribe on iTunes, Android, or Stitcher A recent publication in the American Journal of Health-System Pharmacy described two case reports of opioid overdose where very high doses of naloxone were required to reverse respiratory depression. The first patient received 4 […]
Episode 450: Does aspiration pneumonia require different antibiotics than community acquired pneumonia?
In this episode, I’ll discuss why the new CAP guidelines do not recommend treating most cases of suspected aspiration pneumonia with broadening antibiotic therapy. Subscribe on iTunes, Android, or Stitcher Broadening therapy in community-acquired pneumonia to cover potential anaerobes in the case of suspected aspiration pneumonia is a common occurrence. This results in the use […]
Episode 449: The most exciting part about the new Community Acquired Pneumonia guidelines!
In this episode, I’ll discuss the most exciting part about the new Community Acquired Pneumonia guidelines! Subscribe on iTunes, Android, or Stitcher The CAP guidelines were updated in October 2019, having gone 12 years without changes. The most exciting part of the guidelines, and one that has the biggest implication for antibiotic stewardship is that […]
Episode 448: Rabies immune globulin
In this episode, I’ll discuss the use of rabies immune globulin. Subscribe on iTunes, Android, or Stitcher Rabies immune globulin (RIG) administration is part of successful rabies post-exposure prophylaxis. The rabies vaccine produces active immunity beginning about 7 to 10 days after the vaccine series is started. However, when RIG is given, passive immunity is […]
Episode 447: Does dexmedetomidine prolong the QTc interval?
In this episode, I’ll discuss whether dexmedetomidine prolongs the QTc interval. Subscribe on iTunes, Android, or Stitcher Dexmedetomidine appears to have been added to a list of drugs that possibly prolong the QTc based on a single case report where pediatric use of dexmedetomidine unmasked congenital long QT syndrome. However, there are no published reports […]
Episode 446: How well does a negative nasal MRSA screen rule out infection with MRSA?
In this episode, I’ll discuss how well a negative nasal MRSA screen rules out infection with MRSA. Subscribe on iTunes, Android, or Stitcher Many hospitalized patients are treated empirically with anti-MRSA antibiotics only to have cultures come back negative for MRSA after several days of anti-MRSA therapy. This represents an antibiotic stewardship opportunity if the […]
Episode 445: Can N-acetylcysteine be used in non-acetaminophen-induced acute liver failure?
In this episode, I’ll discuss whether N-acetylcysteine can be used in non-acetaminophen-induced acute liver failure. Subscribe on iTunes, Android, or Stitcher A prospective study of 80 patients of Kashmiri ethnicity with non-acetaminophen-induced acute liver failure was published in 2017 where half of the patients received a 72-hour infusion of IV N-acetylcysteine (NAC )and half served […]
Episode 444: Desmopressin (DDAVP) in patients with antiplatelet-associated intracranial hemorrhage
In this episode, I’ll discuss an article about desmopressin effectiveness and safety in patients with antiplatelet-associated intracranial hemorrhage. Subscribe on iTunes, Android, or Stitcher Article Retrospective Assessment of Desmopressin Effectiveness and Safety in Patients With Antiplatelet-Associated Intracranial Hemorrhage Lead author: Elizabeth Feldman Published ahead of print in Critical Care Medicine Background Back in episode 51 […]
Episode 443: What dose of steroids can prevent post-extubation stridor?
In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. Subscribe on iTunes, Android, or Stitcher Corticosteroid administration before elective extubation has been used to prevent post-extubation stridor and reintubation. Multiple steroid regimens have been studied to prevent post-extubation stridor and re-intubation. No one regimen has been proven superior. Three example regimens […]
Episode 442: Should recent laxative use preclude testing for C diff?
In this episode, I’ll discuss whether recent laxative use should preclude testing for C diff. Subscribe on iTunes, Android, or Stitcher The recently updated IDSA C Diff guidelines make the following recommendation: Patients with unexplained and new-onset ≥3 unformed stools in 24 hours are the preferred target population for testing for CDI (weak recommendation, very […]
Episode 441: A tip to predict pharmacotherapy needs in rapid response or emergent situations
In this episode, I’ll discuss a tip to predict pharmacotherapy needs in rapid response or emergent situations. Subscribe on iTunes, Android, or Stitcher At the beginning of any rapid response or emergent procedure such as rapid sequence intubation, make a note of your patient’s starting heart rate, rhythm, oxygen saturation, and blood pressure. Any significant […]
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