In this episode, I will discuss whether intermittent boluses of pantoprazole be used to treat acute GI bleeding rather than continuous infusions. Subscribe on iTunes, Android, or Stitcher The best evidence to support intermittent boluses of PPIs to treat GI bleeding comes from a 2014 meta-analysis. The study compared intermittent doses of PPIs and the […]

In this episode I’ll discuss giving alteplase for acute ischemic stroke during pregnancy. Subscribe on iTunes, Android, or Stitcher Although acute ischemic stroke is a rare occurrence during pregnancy, it is responsible for about 7% of maternal deaths in the US. Two case reports and a review article of giving alteplase during pregnancy were recently […]

In this episode, I’ll discuss the effect of beta-blocker therapy on dobutamine. Subscribe on iTunes, Android, or Stitcher Dobutamine is an inotropic agent useful in the treatment of decompensated heart failure. Part of dobutamine’s action is on beta 1 and beta 2 receptors and therefore concomitant beta-blocker therapy can be expected to blunt a patient’s […]

In this episode, I’ll discuss an article about when to draw a free phenytoin level. Subscribe on iTunes, Android, or Stitcher Article Predicting Unbound Phenytoin Concentrations: Effects of Albumin Concentration and Kidney Dysfunction Lead author: Margaret C. Montgomery Published in Pharmacotherapy May 2019 Background Phenytoin is highly protein bound, and both low albumin levels and […]

In this episode, I’ll discuss predictors of oversedation in hospitalized patients. Subscribe on iTunes, Android, or Stitcher Opioid-induced respiratory depression (OIRD) and oversedation are significant risks to patient safety in the hospital. The ability to predict patients at risk for these consequences of opioid use could allow for monitoring to be increased and potentially less […]

In this episode, I’ll discuss the biggest risk to using phenobarbital monotherapy for severe alcohol withdrawal. Subscribe on iTunes, Android, or Stitcher Phenobarbital is a very effective option for treating severe alcohol withdrawal.  A recent retrospective analysis of 3 protocols – one using diazepam alone, one using lorazepam and phenobarbital and one using phenobarbital alone […]

In this episode I’ll: 1. Discuss an article about the safety and efficacy of apixaban in patients at extremes of body weight. 2. Answer a drug information question about the diagnosis of adrenocortical insufficiency without using Cortosyn. Subscribe on iTunes, Android, or Stitcher Article Efficacy and Safety of Apixaban versus Warfarin in Patients with Atrial […]

In this episode, I’ll discuss the state of research for hydrocortisone, ascorbic acid, and thiamine (HAT Rx) for sepsis. Subscribe on iTunes, Android, or Stitcher It has been nearly 2 and a half years since the publication of Paul Marik’s retrospective before-after study of hydrocortisone, ascorbic acid, and thiamine to treat septic shock. According to […]

In this episode, I’ll discuss the use of methylene blue for the treatment of refractory anaphylaxis without hypotension. Subscribe on iTunes, Android, or Stitcher Methylene blue has some unique uses such as in the treatment of acquired methemoglobinemia and vasoplegia after cardiac surgery.  It also appears to have a role in treating patients experiencing anaphylaxis […]

In this episode, I’ll discuss PGY-1 Learning Activities and the 6 levels of Bloom’s Learning Taxonomy. Subscribe on iTunes, Android, or Stitcher ASHP accreditation standards mandate that : Learning activities are developed at the cognitive learning level (Bloom’s Taxonomy) associated with the objective. The 6 levels of cognitive learning according to Bloom’s are: Level 1: […]

In this episode I’ll: 1. Discuss an article about the use of ketamine for agitation in patients with schizophrenia 2. Answer the drug information question “Can oral and IV vancomycin be given at the same time to the same patient?” Subscribe on iTunes, Android, or Stitcher   Article Psychiatric Outcomes of Patients With Severe Agitation […]