The Elective Rotation: A Critical Care Hospital Pharmacy Podcast

By Pharmacy JoeMedicine Education

Ranking
4th
on Training
Favorites
157
Followers
Typical duration
4 min
per episode

Based on Podcast App listening data

The Elective Rotation: A Critical Care Hospital Pharmacy Podcast episodes

April 25, 2016 80: Phenytoin dosage, adjustment, and monitoring
Show notes at pharmacyjoe.com/episode80. In this episode I ll discuss the drug phenytoin.
10 min
April 25, 2016 80: Phenytoin dosage, adjustment, and monitoring - Critical Care Pharmacy Podcast
Show notes at pharmacyjoe.com/episode80

In this episode I’ll discuss the drug phenytoin.

Indications

Common indications for the use of phenytoin are:

Control of generalized tonic-clonic and complex partial (psychomotor, temporal lobe) seizures

Prevention and treatment of seizures occurring during or following neurosurgery

Prevention of early (within 1 week) post-traumatic seizures following traumatic brain injury

Initial dose

The initial dose of phenytoin is a loading dose of 15-20 mg/kg, followed by a maintenance dose of 5-6mg/kg/day.

How can I tell if the phenytoin concentration is therapeutic?

To determine if a patient has a therapeutic phenytoin level, I look at 4 things in the following order:
10 min
April 21, 2016 79: Methylprednisolone shortage alternatives
Show notes at pharmacyjoe.com/episode79. In this episode I’ll discuss the methylprednisolone shortage.
9 min
April 21, 2016 79: Methylprednisolone shortage alternatives - Critical Care Pharmacy Podcast
Show notes at pharmacyjoe.com/episode79

If you haven’t been hit by the methylprednisolone shortage yet, get ready…it looks like it may be coming to a pharmacy near you!

According to the ASHP drug shortage bulletin, 40 and 125 mg vials of methylprednisolone are in short supply. Pfizer appears to be experiencing a manufacturing delay, and Fresenius Kabi states the reason for the shortage is increased demand.

This isn’t the first time we’ve faced a shortage of methylprednisolone. In 2011 and 2014 similar problems occurred.

Can an equivalent dose of another corticosteroid be substituted? Dexamethasone is probably the steroid most similar to methylprednisolone.

Compared to methylprednisone, dexamethasone also has no mineralcorticoid activity but is a bit longer acting. Finding a steroid equivalency chart is the easy part. In this episode I’ll review the evidence behind some alternative corticosteroids.

COPD

For patients with a COPD exacerbation, methylprednisolone was compared to
9 min
April 18, 2016 78: Correlating mechanism of action to pathophysiology of disease
Show notes at pharmacyjoe.com/episode78. In this episode I ll discuss my secret to learning, recalling, and applying pharmacotherapy knowledge to patient care: correlating mechanism of action to the pathophysiology of disease.
9 min
April 18, 2016 78: Correlating mechanism of action to pathophysiology of disease - Critical Care Pharmacy Podcast
Show notes at pharmacyjoe.com/episode78

In this episode I’ll discuss My secret to learning, recalling, and applying pharmacotherapy knowledge to patient care: correlating mechanism of action to the pathophysiology of disease.

Earlier in my career, I noticed that most physicians and some other more experienced clinicians seem to have this natural ability to apply their knowledge to any patient scenario, no matter how complex.

I often wondered, “How can I do that?” So, I began to observe, talk with, and study these clinicians and how they analyze and act when caring for a patient.

After careful study, I have arrived at a method to learn, recall, and apply pharmacotherapy knowledge to patient care. I call this method
9 min
April 14, 2016 77: Acute kidney injury with vancomycin and piperacillin-tazobactam, hypotonic dextrose infusion for hypernatremia, and G6PD resources
Show notes at pharmacyjoe.com/episode77. In this episode I’ll: 1. Discuss an article that looks at the incidence of acute kidney injury in ICU patients receiving vancomycin and piperacillin-tazobactam 2. Answer the drug information question “Should 2.5% dextrose ever be infused?” 3. Share a resource about G6PD deficiency
9 min
April 14, 2016 77: Acute kidney injury with vanco & pip-taz, hypotonic dextrose for hypernatremia, G6PD resources - Critical Care Pharmacy Podcast
Show notes at pharmacyjoe.com/episode77

IIn this episode I'll:

1. Discuss an article that looks at the incidence of acute kidney injury in ICU patients receiving vancomycin and piperacillin-tazobactam
2. Answer the drug information question "Should 2.5% dextrose ever be infused?"
3. Share a resource about G6PD deficiency

Article

Comparative Incidence of Acute Kidney Injury in Critically Ill Patients Receiving Vancomycin with Concomitant Piperacillin-Tazobactam or Cefepime: A Retrospective Cohort Study

Lead author: Drayton Hammond
Published online in Pharmacotherapy April 2016

Background

Beta-lactam antibiotics are usually
9 min
April 11, 2016 76: How to use dexmedetomidine for ICU sedation and ventilator weaning
Show notes at pharmacyjoe.com/episode76. In this episode I ll discuss how to use dexmedetomidine for sedation in the ICU.
7 min
April 11, 2016 76: How to use dexmedetomidine for ICU sedation and ventilator weaning - Critical Care Pharmacy Podcast
Show notes at pharmacyjoe.com/episode76

In this episode I’ll discuss how to use dexmedetomidine for sedation in the ICU. If you are wondering about the use of dexemedetomine in agitated delirium or alcohol withdrawal, check out episodes 67 & 70.

Mechanism of action

Dexmedetomidine is a selective a2-adrenoceptor agonist. I like to think of it as an intravenous version of clonidine. As a sedative, dexmedetomidine is unique in that it:

1. Does not suppress the respiratory center
2. Acts as an analgesic adjunct, reducing the dose of opioids required

Cost

Despite having recently been made available as a generic medication in the US, dexmedetomidine has the highest drug cost when compared to propofol or midazolam.

Adverse effects

Dexmedetomidine commonly causes bradycardia and hypotension at rates that are similar to those of
7 min

About The Elective Rotation: A Critical Care Hospital Pharmacy Podcast

From the publisher's feed

The Elective Rotation - the number 1 ranked Hospital Pharmacy podcast - is created for YOU Pharmacy Nation! If you are a Pharmacy Student, Resident, Pharmacist, Nurse, Physician, or Critical Care…