This episode covers practical, evidence-informed strategies for reversing anticoagulant and antiplatelet medications in critical bleeding scenarios, including intracerebral hemorrhage. We review reversal protocols for warfarin, dabigatran, and Factor Xa inhibitors, and discuss the roles of PCC, FFP, DDAVP, and tranexamic acid. Key pitfalls in reversal therapy are examined, along with guidance on tailoring interventions to individual patients.

In this episode, we break down how to assess liver injury and understand its impact on drug therapy. We explore the difference between liver enzymes and true liver function tests, why normal labs can be misleading in cirrhosis, and how impaired hepatic metabolism affects drug efficacy and toxicity. Tune in for practical insights on adjusting medications safely in patients with liver dysfunction.

This episode takes a deep dive into the fundamentals of medication overdose management in hospital and critical care settings. We explore the four key pillars of treatment: supportive care, antidotes, decontamination, and enhanced elimination...highlighting why supportive care often makes the greatest impact. You’ll also learn key clinical pearls and considerations to guide decision-making and navigate the limited landscape of antidotes. A must-listen for pharmacists and healthcare professionals facing toxicologic emergencies on the front lines.

This episode highlights the vital role of emergency pharmacists during high-stakes resuscitations such as cardiac arrests and trauma codes. We explore how their involvement improves patient outcomes by reducing medication errors, ensuring accurate dosing, and contributing to rapid clinical decision-making. Backed by research, we also discuss the importance of targeted training programs that go beyond standard life support, equipping pharmacists with the skills and confidence needed to excel in these fast-paced, high-pressure environments. From managing crash carts to anticipating medication needs, emergency pharmacists are a critical, but often overlooked, part of the code team. As an emergency medicine pharmacist, this topic is deeply personal...I’ve seen how timely medication support and clinical decision-making can make a life-saving difference during high-stakes resuscitations. Tune in to learn how empowering pharmacists can make a life-saving difference!

In this episode, we dive into the complex issue of diuretic resistance in congestive heart failure (CHF), focusing especially on loop diuretics. We break down how these medications work, why they sometimes stop working, and the physiological mechanisms behind resistance including post-diuretic sodium retention, the braking phenomenon, and cardiorenal syndrome. You'll also hear about evidence-based strategies to overcome resistance, from dietary interventions and dosing adjustments to combination diuretic therapy. Whether you're a clinician or a curious learner, this episode will help you understand why diuretics fail...and what to do about it.

In this episode, we explore the role of levetiracetam (LEV) dosing in the management of benzodiazepine-refractory status epilepticus (BRSE), a life-threatening neurologic emergency. We review recent evidence comparing lower (<30 mg/kg) versus higher (≥30 mg/kg) weight-based LEV loading doses. The findings suggest that higher doses are more effective in terminating seizures and are linked to improved outcomes, including reduced need for intubation, ICU admission, and lower mortality. Join us as we discuss how these results may inform clinical decisions and optimize care in status epilepticus.

https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/evaluating-levetiracetam-weightbased-dosing-in-benzodiazepinerefractory-status-epilepticus/6F4AE79B03D3A38F0874CFDC4E5B74C5

In this episode, we examine phenobarbital monotherapy as an emerging approach to managing alcohol withdrawal syndrome. We discuss the advantages of phenobarbital over traditional benzodiazepine-based regimens, including more predictable pharmacokinetics, a wider therapeutic index, and broader neurological effects. Topics include accurate diagnosis, the benefits of phenobarbital’s long half-life for sustained symptom control and auto-tapering, and its potential to reduce intubation rates and complications. We also address contraindications and practical considerations for implementing a phenobarbital-first strategy in clinical practice.

In this episode, we explore ActionADE—a web-based application designed to prevent repeat adverse drug events (ADEs), a major cause of emergency room visits in Canada. We discuss how the platform improves communication across healthcare settings by standardizing ADE documentation and sharing it through connected electronic systems. Learn how pharmacists and clinicians are using ActionADE to make safer prescribing decisions, coordinate care, and protect patients from harmful re-exposures. Discover how this simple intervention is transforming medication safety and creating a more connected, collaborative healthcare system.

https://actionade.org/

In this episode, we explore evidence-based pharmacological treatments for severe gastrointestinal bleeding, drawing from Cochrane systematic reviews. Topics include the use of antibiotic prophylaxis in cirrhotic patients to prevent infections and reduce mortality, the impact of proton pump inhibitors (PPIs) started before endoscopy on patient outcomes, and the effectiveness of somatostatin analogues for managing acute bleeding from esophageal varices. Join us for a deep dive into strategies that improve care and outcomes in upper gastrointestinal hemorrhage.

In this episode, we focus on Advanced Trauma Life Support (ATLS) principles, with a special emphasis on the role of tranexamic acid (TXA) in trauma care. We review key clinical trials, including CRASH-2 and CRASH-3, discussing their findings, methodologies, and ongoing debates about TXA’s efficacy and safety in major trauma and traumatic brain injury. Additionally, we cover important trauma management topics such as the use of intravenous calcium during massive transfusions and the strategy of permissive hypotension.