The Pharm So Hard Emergency Medicine & Hospital Pharmacy Podcast

In this episode of The Pharm So Hard Emergency Medicine Podcast, host Jimmy Pruitt, PharmD, BCPS, BCCCP, BCEMP, is joined by William Amarquaye, PharmD, to discuss Journavix, the first non-opioid pill approved for moderate to severe acute pain in over 20 years. They break down its mechanism as a NAV1.8 sodium channel blocker, compare it to existing analgesics, and analyze clinical trial data on its efficacy and safety. The conversation also tackles key considerations like side effects, drug interactions, and cost implications for real-world use.

Episode 120. Ketamine for Benzodiazepine-Resistant Status Epilepticus – A Game-Changer?

In this episode of The Pharm So Hard Emergency Medicine Podcast, host Jimmy Pruitt, PharmD, BCPS, BCCCP, BCEMP dives deep into an exciting new study exploring ketamine as a rescue agent for benzodiazepine-resistant status epilepticus. Traditionally, managing refractory seizures often requires intubation, high-dose propofol, or other antiepileptics. But could ketamine provide rapid and effective seizure control in these critical moments?

Jimmy discusses key findings from the study, practical implications for the ED, and how this data could influence your choice of induction agents during intubation. Plus, he shares valuable clinical pearls and caveats when considering ketamine use in different patient populations.

00:00 Introduction

02:16 The Clinical Dilemma: Benzodiazepine-Resistant Status Epilepticus

03:39 Introducing the Study: Ketamine as a Rescue Drug

05:16 Key Findings: Rapid Seizure Termination

06:05 Safety and Dosing Insights

06:42 Clinical Implications: Ketamine in ED Practice

07:05 Caveats and Patient Populations

07:55 Conclusion

In Episode 119 of The Pharm So Hard Emergency Medicine Podcast, Jimmy Pruitt, PharmD, BCPS, BCCCP, BCEMP, dives into the COPY-ED study, which explores cephalosporins as a viable option for treating outpatient pyelonephritis. Jimmy challenges the fluoroquinolone-dominant narrative, breaks down the study’s methods and results, and highlights the implications for emergency medicine pharmacists.

In this episode of The Pharm So Hard Podcast, host Jimmy Pruitt, PharmD, BCPS, BCCCP, BCEMP, and guest Rosa Malloy-Post, MD, delve into the debate over the most suitable paralyzing agent for rapid sequence intubation (RSI). They weigh the advantages and disadvantages of Succinylcholine ("Succ") and Rocuronium ("Roc") by comparing their pharmacologic properties, onset, duration, side effects, and clinical use cases. Listen for expert perspectives, practical insights, and essential factors to consider when choosing the right agent in emergency settings, and find out if "Roc truly rocks" or if "Succs really suck.

In this episode, host Jimmy L. Pruitt III, PharmD, BCPS, BCCCP, BCEMP, welcomes Tessa R. Cox, PharmD, BCCCP, and Brian W. Gilbert, PharmD, MBA, FCCM, FNCS, BCCCP, to discuss their study on the early administration of subcutaneous (SQ) basal insulin in mild to moderate diabetic ketoacidosis (DKA). The episode covers the definition and treatment of DKA, the role of insulin therapy, and the design and results of the retrospective study, which found no significant difference in hospital length of stay between early and non-early SQ basal insulin groups. The discussion includes an analysis of the study outcomes, clinical implications, and the need for further research. Tessa R. Cox and Brian W. Gilbert share their expert insights on DKA management and the relevance of the study findings to emergency medicine.

Amazon Link: https://www.amazon.com/InteGREAT-Guidebook-Creating-Healthcare-Teams/dp/1946665706

This episode of the Pharm So Hard podcast discusses the use of clinical pharmacy practitioners in the emergency room and their impact on sepsis antibiotic interventions author by Aubrie Hammond, Regan Porter, Taylor Cason, et al. The study found that the involvement of EMCPPs significantly improved the selection and timing of antibiotic administration in septic patients. The pharmacist-driven protocol improved the rate of appropriate antibiotic selection from 57% to 86% and reduced the time to administration by 64 minutes. The study also highlighted areas where antibiotic selection could be further improved, such as UTIs and intra-abdominal infections. The role of pharmacists in optimizing treatment time and expanding the pharmacist-driven sepsis management model was also discussed.

In this episode of the Pharm So Hard Podcast's PharmD Literature Highlight Series, host Jimmy Pruitt, PharmD, BCPS, BCCCP, BCEMP discusses the study "Risk of arrhythmia in post-resuscitative shock after out-of-hospital cardiac arrest with epinephrine versus norepinephrine" by Sarah Normand, Pharm.D., Courtney Matthews, Pharm.D., Caitlin S. Brown, Pharm.D., Alicia E. Mattson, Pharm.D., Kristin C. Mara, M.S., Fernanda Bellolio, M.D., M.S., and Erin D. Wieruszewski, Pharm.D.

Full Text

The study found no significant differences in outcomes based on time to administration of four-factor PCC for patients with warfarin-associated intracranial hemorrhage. More data is needed to determine the optimal time to administer four-factor PCC and develop personalized protocols for anticoagulation-related ICH.

Standardization of radiologists' interpretations and reporting of CT scans is important for future studies in this area.

The study highlights the importance of resident research in answering important clinical questions.

Pharmacists and healthcare professionals should continue to strive for personalized medicine and individualized care for patients with anticoagulation-related ICH.

In this episode of The Pharm So Hard Podcast, host Jimmy Pruitt, PharmD, BCPS, BCCCP, alongside guests Robert O'Connell, PharmD, BCCCP, BCEMP, Louisa Sullivan, PharmD, BCPS, BCEMP, Mark Mixon, PharmD, BCPS, BCIDP, BCCCP, and Joshua Senn, PharmD, BCPS, share their experiences at last year's EMPoweRx conference. As they gear up for this year's conference, gain exclusive insights into their preparations and aspirations, offering a glimpse into their pursuit of excellence in pharmacy practice.