The Pharm So Hard Podcast: An Emergency Medicine and Hospital Pharmacy Podcast

The post Episode 107. Bupropion Toxicity with Thom Maciulewicz appeared first on The Pharm So Hard Podcast.

Show Notes from the Pharm So Hard Podcast with Dr. Thom MaciulewiczOverviewToxic alcohols like methanol, ethylene glycol, and isopropanol can cause severe metabolic acidosis and organ damage when ingested. This post summarizes key learnings from a podcast episode with toxicology expert Dr. Thom Maciulewicz on recognizing and managing toxic alcohol poisoning in the emergency setting.Key Topics Covered:

What are Toxic Alcohols?

Clinical Presentation

Metabolic Pathways

Diagnostic Approach

Treatment Principles

Specific AgentsMethanol

Ethylene Glycol

Isopropanol

Key Takeaways

The post Episode 106. Toxic Alcohols with Thom Maciulewicz appeared first on The Pharm So Hard Podcast.

This video is part of our Crazy Tox Case in the 2023 EMPoweRx Conference held in Austin, Texas. It was a requested topic of interest from many pharmacists and physicians in the emergency medicine world. In this video, we discuss the case study and provide insights into the treatment and management of a patient was Xylazine Toxicity. We hope that this video will be informative and helpful to those who are interested in emergency medicine.

The post Episode 105. Toxicology Crazy Case- Xylazine appeared first on The Pharm So Hard Podcast.

The post Episode 104. Toxicology Crazy Case – An EKG Gone Wrong appeared first on The Pharm So Hard Podcast.

The post Episode 103. In Patient Management of Clostridium difficile appeared first on The Pharm So Hard Podcast.

In this episode, we dive into the hot topic of using cefdinir, a third-generation oral cephalosporin antibiotic, in treating urinary tract infections (UTIs). Despite its low urine concentrations, cefdinir has shown clinical efficacy in treating UTIs, sparking a controversy that we explore in depth.

Background on Cefdinir: We discuss the role of cefdinir in treating UTIs and why its use is controversial.

Review of Literature: We delve into several clinical trials and studies that have been conducted on the use of cefdinir for UTIs:
Cardinale et al: High efficacy and safety of cefdinir in UTI treatment.
Sader et al., 2005: Cefdinir showed high activity against common UTI pathogens.
Bonsu et al., 2006: High susceptibility of urinary pathogens to cefdinir.
Oishi et al., 2011: Prophylactic cefdinir could prevent recurrent UTIs in pediatric patients.
Leigh et al., 2000: Clinical cure rates and microbiologic response rates for cefdinir and cefaclor were statistically equivalent.
Kim et al., 2014: Cefdinir has low urine concentrations, which could potentially affect its efficacy in treating UTIs.
Davis et al., 2022: The study found that despite high resistance rates to some antibiotics in the U.S.-Mexico border region, cefdinir, along with amoxicillin/clavulanate, cefuroxime, and nitrofurantoin, showed lower resistance rates and could be effective for outpatient UTI treatment.

Clinical Pearls: We share some key takeaways from the studies and discussions, including the role of cefazolin as the susceptibility surrogate for oral cephalosporins.

Discussion of Twitter Comments and Retweets: We discuss the results of a Twitter poll and the interesting discussions it sparked among healthcare professionals.

Check out the Twitter Poll on this topic: https://twitter.com/pharmso_hard/status/1667205066615410690

EMPoweRx Conference Homestudy Release: The EMPoweRx Conference Homestudy is now available! This is a great opportunity to learn from experts in the field at your own pace. Check it out at empowerx-conference.com.

PACUPrep BCEMP Question Bank Version 2.1 Release: The new version of the PACUPrep BCEMP Question Bank is now available at pharmacy-acutecareuniversity.com. This is a valuable resource for anyone preparing for the BCEMP exam.

2.       Cardinale B, et al. Retrospective Comparison of Cefdinir, Cephalexin, and Sulfamethoxazole-Trimethoprim in the Treatment of Outpatient Pediatric Urinary Tract Infections. Clin Pediatr (Phila). 2023 Jan;62(1):47-54. PMID: 35861216.

3.       Sader HS, et al. Antimicrobial activity of cefdinir (FK482), an orally administered cephalosporin, against pathogens isolated from respiratory tract and skin and soft tissue infections. Diagn Microbiol Infect Dis. 2005;51(1):27-33. Link

4.       Bonsu BK, et al. Susceptibility of recent bacterial isolates to cefdinir and selected antibiotics among children with urinary tract infections. Pediatr Emerg Care. 2006;22(1):18-21. Link

5.       Oishi T, et al. Prophylactic cefdinir for pediatric cases of complicated urinary tract infection. Pediatr Int. 2011;53(1):57-61. Link

6.       Leigh AP, et al. Cefdinir versus cefaclor in the treatment of uncomplicated urinary tract infection. Clin Ther. 2000;22(7):818-825. Link

7.       Kim YC, et al. Effects of 1α,25-dihydroxyvitamin D3, the natural vitamin D receptor ligand, on the pharmacokinetics of cefdinir and cefadroxil, organic anion transporter substrates, in rat. J Pharm Sci. 2014;103(11):3793-3805. Link

8.       Nguyen HM, et al. Cefazolin as a class representative for oral cephalosporins and uncomplicated urinary tract infections caused by indicated Enterobacteriaceae. Diagn Microbiol Infect Dis. 2013;77(4):350-352. Link

9.       https://www.fda.gov/drugs/development-resources/rationale-fdas-position-use-cefazolin-breakpoints-surrogate-determining-breakpoints-oral.

10.   Gupta K,; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20. PMID: 21292654.

11. Coleman A et al. Antibiotic Utilization and Efficacy Associated With Treating Pediatric Urinary Tract Infections in Texas Medicaid Patients in the First Year of Life. Pediatr Infect Dis J. 2021 Nov 1;40(11):993-996. PMID: 34321440.

12. Davis WH, Magee MR, Monks SM, Geno KA, Crawford SB. Assessment of nationally recommended antibiotics for treatment of UTI in U.S.-Mexico border emergency departments. Am J Emerg Med. 2022 Nov;61:12-17. 14. PMID: 36027632

The post Episode 102. The Controversy of Cefdinir in UTIs appeared first on The Pharm So Hard Podcast.

The post Episode 101. Aspiration Pneumonia: Antibiotic Stewardship and Evidence-Based Treatment Strategies appeared first on The Pharm So Hard Podcast.

How do you tell a medical doctor?

Real doctors: *reluctant to state they are doctors in public/social forums*

Non-MD/DOs: *take every opportunity to say they are a doctor…* (chiropractors, naturopaths, pharmacists, apothecaries, charlatans…) https://t.co/OSVrViNZS1

The Society for Academic Emergency Medicine is pleased to host EMPoweRx at SAEM23. The Emergency Medicine Pharmacotherapy with Resuscitation (EMPoweRx) Conference is an annual international, multidisciplinary conference dedicated to celebrating advancements in research and practice of emergency medicine pharmacotherapy.

While still new, emergency medicine pharmacists and pharmacotherapy has not had its own platform to present the latest evidence and issues facing emergency medicine pharmacy, until now. 

The EmpoweRx Conference, to be held in concurrently with the SAEM Annual Meeting, is designed by practicing emergency medicine pharmacists. The program will include a multidisciplinary and multispecialty speaker lineup to present on the latest in resuscitation, emergency medicine pharmacotherapy, and administrative issues that are unique to the emergency department.

The post Episode 100. Charlatan So Hard: Dispelling Myths and Shaping the Future appeared first on The Pharm So Hard Podcast.

The post Episode 99. Backbreakers! Steroids in Spinal Cord Injuries appeared first on The Pharm So Hard Podcast.

The post Episode 98. Literature Review on TRACE-2 Trial appeared first on The Pharm So Hard Podcast.