Episódios
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Thrombolytic Dosing in PE: Versus Series
Special Guest: Lauren Igneri, PharmD, BCPS, BCCCP, FCCM
05:20 – High-risk PE
23:00 – Intermediate-risk
37:10 – Cardiac arrest
52:30 – Closing arguments
57:15 – Bonus: TNK v. tPA
Reference List: https://pharmacytodose.files.wordpress.com/2024/04/thrombolytic-dosing-in-pe-references.pdf
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Trial of the Week: SEPSISPAM
Special Guest: Katherine Spezzano, PharmD, MBA, BCCCP @KatSpazPharmD
Katherine Spezzano joins to discuss the April Trial of the Week “High versus Low Blood-Pressure Target in Patients with Septic Shock” the SEPSISPAM study, published in NEJM in 2014.
We set the scene by reviewing the concept of autoregulation, guideline recommendations, and pre-SEPSISPAM research assessing BP goals in sepsis. Then we do a deep dive into the SEPSISPAM trial of the week. Would we see these same results with other vasopressors? Did each group meet their BP goal range? How do we balance AKI prevention and longer ICU LOS? What do our guidelines recommend now? Trial fun facts, alternate trial acronym ideas, and much more!
Reference list: https://pharmacytodose.files.wordpress.com/2024/04/sepsispam-trial-of-the-week-references.pdf
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Glycemic Control in the Critically Ill: Part II
Special Guests: Judi Jacobi, PharmD, FCCP, MCCM, BCCCP @JudiJacobi
Michael Sirimaturos, PharmD, BCNSP, BCCCP, FCCM @MSirimaturos
04:10 – Becoming panel members
11:50 – Guideline scope and PICO questions
21:35 – 2012 v. 2024 guidelines
28:05 – Effect of TGC-FAST
30:40 – 2024 guideline deep-dive
42:00 – Clinical decision support tools
50:00 – Pediatric recommendations
54:40 – Important future research topics
66:05 – Guideline manuscript writing
76:10 – Take-home points
Reference List: https://pharmacytodose.files.wordpress.com/2024/04/glycemic-control-in-the-icu-part-ii-references.pdf
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Literature Review Series
November 2023
Special Guests: Arjay Mendoza, PharmD, BCPS, AAHIVP
Brock Townsend, PharmD @Townsend_PharmD
04:30 – Featured Articles
35:25 – Cardiology
48:05 – Precision-based medicine potpourri
58:50 – Infectious Diseases
69:10 – PharmD
Reference List: https://pharmacytodose.files.wordpress.com/2024/04/november-lrs-2023-references.pdf
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Trial of the Week: SOAP II
Special Guest: Jessica Casey, PharmD, BCPS, BCCP @jmc_cardspharmd
Jessica Casey joins to discuss the April Trial of the Week “Comparison of Dopamine and Norepinephrine in the Treatment of Shock,” the SOAP II study, published in NEJM in 2010.
We set the scene by reviewing catecholamine vasopressor receptor physiology, guideline recommendations, and pre-SOAP II research. Then we do a deep dive into the SOAP II trial of the week. Did including all forms of shock help or hurt? How does the mortality in this study compare with others? Would this have been as positive of a study in 2024? What do the guidelines recommend now? Is dopamine dead? Will anyone take norepinephrine’s throne? Jessica and I review trial fun facts, stand-out supplementary materials, and much, much more.
Reference list: https://pharmacytodose.files.wordpress.com/2024/04/soap-ii-trial-of-the-week-references.pdf
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Trials of the Week: Landmark Nimodipine Studies
Special Guest: Salia Farrokh, PharmD, BCCCP, FNCS @salia_farrokh
Salia Farrokh joins to highlight two landmark studies with nimodipine, “Cerebral Arterial Spasm – A Controlled Trial of Nimodipine in Patients with Subarachnoid Hemorrhage” published in NEJM in 1983 and “Effect of Oral Nimodipine on Cerebral Infarction and Outcome after Subarachnoid Hemorrhage: British Aneurysm Nimodipine Trial” published in 1989 in BMJ.
We review aSAH treatments in the 1970’s and 1980’s and what evidence existed for nimodipine use before highlighting our two trials of the week. How does the study methodology compare from then to now? Where did our nimodipine dosing regimen come from? Is the term cerebral artery vasospasm out of date? Is it still appropriate to use evidence from the 1980’s in the 2020’s? Is there more to research with respect to nimodipine? What to do with missed nimodipine doses? We do a deep dive into all things nimodipine for aSAH, discussing the above and much more.
Reference list: https://pharmacytodose.files.wordpress.com/2024/04/nimodipine-trial-of-the-week-references.pdf
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Norepinephrine Position Paper and Sepsis Research Priorities
Special Guests: Brittany Bissell Turpin, PharmD, PhD, FCCM, BCCCP @BissellBrittany
Patrick Wieruszewski, PharmD, BCCCP @pwierusz
Seth Bauer, PharmD, FCCM, FCCP, BCCCP @SethRBauer
07:30 – Norepinephrine position paper introduction
11:35 – When did we realize this and what are the implications?
36:00 – Key task force take-aways
51:00 – SSC Research Committee history
56:00 – Submitting and ranking research questions
27:00 – Top 5 clinical sepsis research priorities
62:00 – Basic science priorities
Reference List: https://pharmacytodose.files.wordpress.com/2024/04/norepi-position-paper-and-sepsis-research-references.pdf
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Final Four Preview and More: 2024 Critical Care Trials March Madness Bracket
Sepsis/Fluids Bracketologist: Clay Small, PharmD, BCCCP
CV/Pulm Bracketologist: Jolie Gallagher, PharmD, BCCCP
Bleeding/BG Bracketologist: Jason Hecht, PharmD, BCPS, BCCCP, FCCM
Neuro/PADIS Bracketologist: Karen Berger, PharmD, FASHP, FCCM, BCPS, BCCCP
06:10 – Region recaps
32:10 – Final Four preview and predictions
45:30 – Revisiting pre-tournament predictions
PubMed links for all 68 Critical Care March Madness trials: https://pharmacytodose.files.wordpress.com/2024/03/critical-care-trials-reference-list-all-regions.pdf
Listener Bracket: https://pharmacytodose.com/2024/04/01/final-four-2024-critical-care-trials-march-madness-bracket-preview-and-recap/
2024 Critical Care Trials March Madness blank bracket: https://pharmacytodose.com/2024/03/17/2024-critical-care-trials-march-madness-bracket/
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Literature Review Series
October 2023
Special Guests: Hailey Burns, PharmD @Hailey_rx36
Caitlyn Simonson, PharmD
03:45 – Featured Articles
38:15 – Neuro
50:10 – EM/Tox/Trauma
61:50 – Renal/Endocrine
66:38 – PharmD
70:10 – Sweet Emotion
Reference List: https://pharmacytodose.files.wordpress.com/2024/03/october-lrs-2023-references.pdf
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Sweet 16 Preview and Recap: 2024 Critical Care Trials March Madness Bracket Preview
04:06 – First round recap
13:25 – Second round recap
19:05 – Sweet 16 preview
PubMed links for all 68 Critical Care March Madness trials: https://pharmacytodose.files.wordpress.com/2024/03/critical-care-trials-reference-list-all-regions.pdf
2024 March Madness Bracket: https://pharmacytodose.com/2024/03/17/2024-critical-care-trials-march-madness-bracket/
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Pharmacotherapy in the Critically Ill Pregnant Patient: Part II
Special Guests: Allison Lankford, MD
Melissa Thompson Bastin, PharmD, PhD, BCCCP, FCCM, FCCP @mtbastin
04:50 – Obstetric hemorrhage
18:20 – Ectopic pregnancy
22:30 – Hypertensive emergency
28:45 – Pre-eclampsia/eclampsia
35:00 – Lactation considerations
39:35 – Take-home points
Pharmacotherapy “Caring for two in the ICU” articles:
Part I: https://pubmed.ncbi.nlm.nih.gov/36938691/
Part II: https://pubmed.ncbi.nlm.nih.gov/37323102/
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2024 Critical Care Trials March Madness Bracket Preview: Part II
Cardiac/Pulmonary and Sepsis/Fluids Regions
CV/Pulm Bracketologist: Jolie Gallagher, PharmD, BCCCP
Sepsis/Fluids Bracketologist: Clay Small, PharmD, BCCCP
PubMed links for all 68 Critical Care March Madness trials: https://pharmacytodose.files.wordpress.com/2024/03/critical-care-trials-reference-list-all-regions.pdf
2024 March Madness Bracket: https://pharmacytodose.com/2024/03/17/2024-critical-care-trials-march-madness-bracket/
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2024 Critical Care Trials March Madness Bracket Preview: Part I
Bleeding/Blood Glucose and Neuro/PADIS Regions
Bleeding/BG Bracketologist: Jason Hecht, PharmD, BCPS, BCCCP, FCCM
Neuro/PADIS Bracketologist: Karen Berger, PharmD, FASHP, FCCM, BCPS, BCCCP @karenccrx
PubMed links for all 68 Critical Care March Madness trials: https://pharmacytodose.files.wordpress.com/2024/03/critical-care-trials-reference-list-all-regions.pdf
2024 March Madness Bracket: https://pharmacytodose.com/2024/03/17/2024-critical-care-trials-march-madness-bracket/
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Trial of the Week: CHAMPION PHOENIX
Special Guest: Jack Pluenneke, PharmD, BCCP @JackPluenneke
Jack Pluenneke joins to discuss a March 2024 Trial of the Week, “Effect of platelet inhibition with cangrelor during PCI on ischemic events” the CHAMPION PHOENIX trial, published in 2013 in NEJM.
We review PK/PD advantages with cangrelor, go over the CHAMPION trials, and then highlight why the CHAMPION PHOENIX trial was necessary. Then we dive into the Trial of the Week: CHAMPION PHOENIX trial and discuss its findings as well as study design. Are these patients we’d see in our ICU? How does cangrelor compare to glycoprotein 2b/3a inhibitors? Is it a weakness that the comparator group uses clopidogrel? The episode closes with medication safety considerations, cangrelor’s place in therapy, and much more.
Reference list: https://pharmacytodose.files.wordpress.com/2024/03/champion-phoenix-trial-of-the-week-references-1.pdf
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Corticosteroids in the Critically Ill
Special Guest: Andrea Nei, PharmD, BCPS, BCCCP, FCCM @Dre_pharmd
04:40 – Guideline introduction/background
08:35 – Scope/authorship
13:35 – PICO questions/recommendations
14:22 – Sepsis
17:20 – CAP
19:10 – ARDS
21:55 – Research priorities/Take-home points
28:50 – Working with your spouse
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Trial of the Week: REDUCE
Special Guest: Matt Duprey, PharmD, PhD, BCCCP
Matt Duprey joins to discuss the March Trial of the Week, published in 2018 in JAMA: “The Effect of Haloperidol on Survival Among Critically Ill Adults with a High Risk of Delirium: the REDUCE Randomized Clinical Trial.”
We review the history of antipsychotic pharmacotherapy treatment and prophylaxis in delirium, reviewing guideline recommendations from that time. Then we dive into the Trial of the Week: REDUCE trial and discuss its findings as well as study design. Would results be the same with another medication? Why is delirium research so challenging? Prevalent v. incident delirium? What’s the best outcome to measure? What questions still need answered? These questions and so much more are answered in today's episode.
Reference list: https://pharmacytodose.files.wordpress.com/2024/03/reduce-references.pdf
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Pharmacotherapy in the Critically Ill Pregnant Patient: Part I
Special Guests: Allison Lankford, MD
Melissa Thompson Bastin, PharmD, PhD, BCCCP, FCCM, FCCP @mtbastin
08:05 – PK/PD changes
12:50 – Medication safety/Drug information resources
20:15 – Maternal sepsis
33:15 – ARDS
43:15 – PADIS
48:45 – Cardiogenic shock & cardiac arrest
59:00 – VTE
Pharmacotherapy “Caring for two in the ICU” articles:
Part I: https://pubmed.ncbi.nlm.nih.gov/36938691/
Part II: https://pubmed.ncbi.nlm.nih.gov/37323102/
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Trial of the Week: Levetiracetam Rapid IV Push
Special Guest: Olivia Morgan, PharmD, BCCCP, BCGP
I’m joined by Olivia Morgan to discuss her first author 2020 Neurocritical Care article entitled “Safety and Tolerability of Rapid Administration Undiluted Levetiracetam.”
We review previous administration techniques and discussing how this study came to be before highlighting all the findings from this Trial of the Week. Then we discuss how the protocol has changed since this study, administering other ASM via rapid IV push, and much, much more.
Reference list: https://pharmacytodose.files.wordpress.com/2024/03/keppra-rapid-ivp-references.pdf
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Glycemic Control in the Critically Ill: Part I
Special Guest: Traci Grucz, PharmD, BCCCP @tmgrucz
04:50 – ICU hyperglycemia mechanism
09:52 – Background/landmark research
27:00 – Current recommendations
30:25 – Hyperglycemia and hypoglycemia tips/tricks
46:30 – Treatment considerations
54:50 – Take-home points
Reference List: https://pharmacytodose.files.wordpress.com/2024/02/glycemic-control-in-the-icu-part-i-references.pdf
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Literature Review Series
September 2023
Special Guests: Garrett Terhune, PharmD
Caroline Blankemeier, PharmD
04:35 – Featured Articles
32:28 – Pulm
38:35 – PADIS
46:50 – Neuro
53:40 – Trauma
62:00 – PharmD
68:10 – Grab Bag
Reference List: https://pharmacytodose.files.wordpress.com/2024/02/september-lrs-2023-references.pdf
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