The Elective Rotation

Show notes at pharmacyjoe.com/episode193. In this episode I'll: 1. Discuss an article about allometric dosing of vancomycin. 2. Answer the drug information question "How long should steroids be given for severe alcoholic hepatitis?" 3. Share a resourc

Show notes at pharmacyjoe.com/episode 111 In this episode I'll: 1. Discuss an article about the risk and severity of Clostridium difficile Infection with PPIs. 2. Answer the drug information question "Will IV fat emulsion work for cardiac toxicity c

Show notes at pharmacyjoe.com/episode110 In this episode I'll discuss the treatment of coagulase-negative staphylococci infection.

Show notes at pharmacyjoe.com/episode109 In this episode I'll: 1. Discuss an article about using high dose heparin for VTE prophylaxis in obese patients. 2. Answer the drug information question "Do the new FDA quinolone warnings for mild infections

Show notes at pharmacyjoe.com/episode108 In this episode, I'll discuss the treatment of drug-induced Torsades. When responding to code blue, rapid response calls, and other medical emergencies, take the stairs instead of the elevator whenever possible

Show notes at pharmacyjoe.com/episode107 In this episode, I'll: 1. Discuss an article about the use of banana bags in ICU patients. 2. Answer the drug information question "If a pharmacist programs an IV pump for infusion, does that count as administrati

Show notes at pharmacyjoe.com/episode106 IIn this episode I'll discuss how pharmacists can improve their working relationships with physicians. Thank you so much for helping to make my book A Pharmacist's Guide to Inpatient Medical Emergencies the #1

Show notes at pharmacyjoe.com/episode105 In this episode I'll: 1. Discuss an article about therapeutic drug monitoring of voriconazole. 2. Answer the drug information question "When alteplase is given for massive PE in a patient undergoing cardiopulmonar

Show notes at pharmacyjoe.com/episode104 I've ordered the proof copy for my book, A Pharmacist's Guide to Inpatient Medical Emergencies and I look forward to hitting the final publish button very soon! To see the cover you can go to: clinicalpharmac

Show notes at pharmacyjoe.com/episode103 In this episode I'll: 1. Discuss an article about increased mortality from epinephrine in cardiogenic shock. 2. Answer the drug information question "Can phenytoin cause hypothermia" 3. Share two resources for st

Show notes at pharmacyjoe.com/episode102 In this episode I'll discuss how to transition from dexmedetomidine to clonidine. Dexmedetomidine is an IV alpha-2A adrenergic agonist. It has sedative effects and is used for the management of pain, agitation, a

Show notes at pharmacyjoe.com/episode101 In this episode I'll: 1. Discuss an article about using propofol for toxin-related seizures. 2. Answer the drug information question "Should SSRIs be stopped in a patient with GI bleeding?" 3. Share a resource fo

Show notes at pharmacyjoe.com/episode100 In this episode I'll discuss my ICU workflow as a critical care pharmacist. I'll also share how I orient PGY-1 pharmacy residents to my critical care pharmacy rotation. Workflow There is a basic workflow to t

Show notes at pharmacyjoe.com/episode99 In this episode I'll: 1. Discuss a new guideline on Acute kidney injury in ICU patients. 2. Answer the drug information question "What do you think about IV push antibiotics in sepsis?" 3. Share a resource for

Show notes at pharmacyjoe.com/episode98 In this episode I'll discuss whether there is a pro-ketamine bias in the #FOAMed community. Click here if you'd like to help me pick the title for my new book about inpatient medical emergencies for pharmacists.

show notes at pharmacyjoe.com/episode24 I'm excited to have my first guest here on The Elective Rotation Podcast. In this episode we'll be talking with the one of the most talented and patient focused respiratory therapists I know. He is also a treme

Show notes at pharmacyjoe.com/episode23 In this episode, I'll give real world patient care examples of how to remember and apply the concepts of sensitivity, specificity and predictive value as they relate to medical tests. I struggled with rememberin

Show notes at pharacyjoe.com/episode22 Methemoglobinemia is a potentially life-threatening form of functional anemia. There are two types of methemoglobinemia - congenital and acquired. In this episode I'll discuss the recognition and treatment of acqu

Show notes at pharmacyjoe.com/episode21 In episode 20, I discussed how I prepare for ICU rounds. In this episode I'll be talking about how ICU rounds are structured and how I participate in ICU rounds, including when and how I present my recommendations

Show notes at pharmacyjoe.com/episode20 Most of my pharmacy students are surprised that I look at medications last in my pre-rounding review of ICU patients. I am constantly tweaking and improving my method for pre-rounding on ICU patients. Here is my c

show notes at pharmacyjoe.com/episode19 In this episode I'll share the decision making process I use to decide when and how to write a pharmacy progress note. When to write a pharmacy progress note? Not all communication is appropriate for a progress

show notes at pharmacyjoe.com/episdoe18 The methods I am going to discuss in this episode are not first line or even second line therapies for controlling acute agitation. I use them rarely - as in a few times per year or less. But in some difficult si

Show notes at pharmacyjoe.com/episode17 Have you already joined the Pharmacy Nation slack group to collaborate and communicate with other pharmacists in real time? If not, send yourself an invite at pharmacynation.org! In this episode I'll cover when

Show notes at http://www.pharmacyjoe.com/episode16 There is a lot of buzz around the use of ketamine in the critical care setting, and for good reason. But a lot of providers are unfamiliar with and hesitant to use the drug. In this episode I'll high

Show notes at pharmacyjoe.com/episode15 If one of us is not already at the bedside, pharmacists at my institution are frequently called by critical care providers to assist with intubation procedures in critically ill patients. This episode will provide

Show notes at pharmacyjoe.com/episode14 The Debate For over a decade there has been a debate on whether it is better to use succinylcholine (Sux) or rocuronium (Roc) for rapid sequence intubation (RSI) in emergency settings. I'm surprised when reading

In today's episode we will discuss three topics regarding antibiotic dosing in CRRT (continuous renal replacement therapy). 1. Review CRRT antibiotic dosing rules 2. Review CRRT antibiotic dosing exceptions 3. Discuss the prevelance of antibiotic underdo

Evaluating QTc drug interactions Prolonged QTc interval leading to torsades. It is the adverse medication event that keeps pharmacists awake at night. In this episode I will explain how, as a hospital-based pharmacist, I evaluate drug interactions that c

Why Is My Patient In the ICU and How Sick Are They? The topic for today's show is PharmacyJoe-ism #7: making patient focused risk benefit assessments. My ability to do this greatly improved when I started to explicitly and on a basic level think about

As the expert in drug therapy, you need to know how different drugs exert their effects on the electrical system of the heart. Pharmacist review of the ECG is relatively straight forward compared to other professions. We should be able to identify the rh

Today I'm going to pull the curtain back and show you how I trained myself to have successful verbal communications with physicians, and get my interventions accepted. We'll go over: Expected acceptance rates First impressions of your conversation

Show notes at pharmacyjoe.com/episode97 In this episode I'll: 1. Discuss an article about sedation choice and infection risk. 2. Answer the drug information question "Is phentolamine superior to terbutaline for treatment of extravasation?" 3. Share a re

Show notes at pharmacyjoe.com/episode96 In this episode I'll discuss the use of magnesium sulfate in critical care. Shout out to listener "Pharmacy Alex" for suggesting this topic! When I think of magnesium in critical care, 3 uses come to mind:

Show notes at pharmacyjoe.com/episode95 In this episode I'll: 1. Discuss evidence on the efficacy of ketamine IM for acute behavioral emergencies. 2. Answer the drug information question "Can a patient with an allergy to contrast media receive amiodaron

Show notes at pharmacyjoe.com/episode92 In this episode I'll discuss how I provide analgesia & sedation to critically ill patients who have taken buprenorphine. Buprenorphine is an opioid partial agonist. It is used to treat acute & chronic pain, op

Show notes at pharmacyjoe.com/episode93 In this episode I'll: 1. Discuss an article about high dose heparin for VTE prophylaxis in obese patients. 2. Answer a drug information question about vitamin K. 3. Share a resource for lab assay interference by n

So much of antibiotic selection has to do with local resistance patterns, and it cannot be protocolized or generalized without that knowledge. That said I believe there are some principles of antibiotic selection in the ICU that are worth discussing in g

Here are my 7 tips for how to stay current with medical literature: Pharmacist Letter / Subscriber's Letter Pubmed Alerts on saved searches Electronic delivery of journal table of contents Utilize your medical librarian Listen to a podcast Discuss new ar

Phentolamine is no longer manufactured. Phentolamine has now made ASHP's list of drugs no longer available. This information is critical to communicate to emergency medicine and critical care practitioners, as the risk:benefit of peripheral vasopressor

Shock is the syndrome that results when the cardiovascular system fails to maintain adequate tissue perfusion. The goal is to maintain hemodynamics while the cause of shock can be addressed. Fluids, vasopressors, and inotropes are the essential parts of

Push Dose Pressors, They're Not Just For Anesthesia Anymore! I like preventing the complications of profound hypotension as much as anyone. Really, I do. It's why I suggest you focus so much on anticipating patient and provider needs during an emergenc

Show notes at pharmacyjoe.com/episode92 In this episode I'll discuss how I provide analgesia & sedation to critically ill patients who have taken buprenorphine. Buprenorphine is an opioid partial agonist. It is used to treat acute & chronic pain, op

Show notes at pharmacyjoe.com/episode91 In this episode I'll: 1. Review an article about using imatinib for bleomycin interstitial pneumonitis. 2. Answer the drug information question "Should daptomycin or linezolid be used for VRE bacteremia?" 3. Share

Show notes at pharmacyjoe.com/episode90 In this episode I'll discuss 6 tips for pharmacists responding to medical emergencies. After years of working in the central pharmacy, an opportunity arose to go to the floors for code blue and rapid response ca

Show notes at pharmacyjoe.com/episode89 In this episode I'll: 1. Discuss an article about bloodless treatment of anemia. 2. Answer the drug information question "Which antibiotics should be given to a patient with necrotizing pancreatitis?" 3. Share a r

Show notes at pharmacyjoe.com/episode88 In this episode, I'll discuss the treatment of loperamide toxicity. Loperamide is often referred to as "the poor man's methadone". It has been used as both a drug of abuse and as a way of self-treating opi

Show notes at pharmacyjoe.com/episode87 In this episode I'll: 1. Discuss an article about using platelet infusions to treat intracerebral hemorrhage (ICH) from antiplatelet medications. 2. Answer the drug information question "Why were the contraindicat

Show notes at pharmacyjoe.com/episode86 In this episode I'll discuss updated toxicology guidelines when using intravenous lipid emulsion (ILE) for drug toxicity. In episode 30 I discussed the use of ILE for drug toxicity. In April the American Colle

Show notes at pharmacyjoe.com/episode85 In this episode I'll: 1. Share an article about using earplugs to reduce ICU delirium. 2. Answer the drug information question: "Should dextrose containing solutions be avoided in ischemic stroke patients?" 3. Sha

Show notes at pharmacyjoe.com/episode84 In this episode I'll discuss chemical sedation for acute agitation. Chemical sedation is part of the array of options to treat acute agitation. Prevention strategies, verbal de-escalation techniques, and physical