Pharmacy to Dose: The Critical Care Podcast

ACC 2024 Rapid Reaction: Part I Special Guest: Ryan Caputo, PharmD, BCCP @RyanCaputo1 04:05 – DanGer Shock 29:15 – REDUCE-AMI Reference List: https://pharmacytodose.files.wordpress.com/2024/05/acc-2024-part-i-references-1.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Rapid Sequence Intubation (RSI): Part II Special Guest: Christine Groth, PharmD, FCCM, BCCCP @GrothChristine Angela Slampak-Cindric, PharmD, BCPS, BCCCP, FCCM @AngelaSlampak Kevin Kaucher, PharmD, BCCCP 04:05 – Guideline development/involvement 12:50 – 2024 guideline overview 25:10 – Pharmacotherapy recommendations/considerations 42:40 – Non-pharmacologic recommendations/guideline insights 70:30 – Research ideas/conclusions Reference List: https://pharmacytodose.files.wordpress.com/2024/05/rsi-part-ii-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Trial of the Week: ESETT Special Guest: Ashley McCormick, PharmD, BCPS, BCCCP Ashley McCormick joins to discuss the April Trial of the Week “Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus” the ESETT study, published in NEJM in 2019. We set the scene by reviewing ASM PK/PD properties and discussing if there was a standard of care first-line treatment. Then we do a deep dive into the ESETT trial of the week. Did the 75kg dose cap influence results? How appropriate was the BZD dosing? How does this % of seizure cessation compare to other studies? Where did this dosing scheme come from? Trial fun facts, medication safety considerations, and much, much more. Reference list: https://pharmacytodose.files.wordpress.com/2024/04/esett-trial-of-the-week-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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 Learn more about your ad choices. Visit megaphone.fm/adchoices

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 PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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/ PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices