ALiEM - Pharm Pearls

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). Obstruction may also occur from clotted blood [9] or pleural effusion loculations [12, 13] within the catheter lumen.

Inpatient 183

Inpatient 183

Pharmacy Joe

DECEMBER 8, 2024

Subscribe on iTunes , Android , or Stitcher While pharmacists are not typically present when a bronchoscopy takes place, medications are involved both to help the patient tolerate the procedure and to address issues that come up as a result of the procedure. One such complication of flexible bronchoscopy is bleeding.

Inpatient 52

Inpatient 52

PharmD Live

FEBRUARY 26, 2025

Despite their efficacy, these treatments present significant challenges: Cost Barriers : High out-of-pocket expenses deter patients from starting or continuing therapy. Lowering Hospitalization Risks : Adherence-focused interventions prevent costly ER visits and inpatient stays.

Medication Therapy Management (MTM) 52

Medication Therapy Management (MTM) Hospitals Inpatient Diabetes 52

Pharmacy Joe

SEPTEMBER 20, 2023

For this reason, physicians will generally avoid intubation unless hypoventilation is present in these patients. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 98

Inpatient Hospitals 98

Pharmacy Joe

JUNE 23, 2024

Subscribe on iTunes , Android , or Stitcher While the use of thrombolytics for patients with acute ischemic stroke is usually done if the patient presents within 4.5 Episode 933: Can tenecteplase be used for acute ischemic stroke beyond 4.5 hours from time last know well? hour window is sparse. to 24 hours from the time last know to be well.

Inpatient 98

Inpatient Hospitals 98

Pharmacy Joe

JANUARY 24, 2024

Subscribe on iTunes , Android , or Stitcher There are two important criteria that are essential to fulfill when presenting an article to a journal club: 1. This will mean the student or resident can demonstrate a deeper understanding of the article in their presentation, and discussion guided by the preceptors can start out at a higher level.

Inpatient 98

Inpatient Hospitals 98

Express Pharma

MAY 15, 2024

Results from the primary analysis of TRANSCEND FL presented at the 2023 International Conference on Malignant Lymphoma showed an ORR of 97 per cent (95 per cent CI: 91.6-99.4; Patients in the TRANSCEND FL study were treated in the inpatient and outpatient setting. NR), with 80.9 one-sided p<0.0001).

Inpatient 110

Inpatient 110

Board Vitals - Pharmacist

JANUARY 2, 2023

Get Familiar with Patient Presentations. Patient presentations are a major feature on the internal medicine boards (over 75% of the exam).

Nursing Homes 98

Nursing Homes Inpatient Hospitals 98

Pharmacy Joe

MARCH 12, 2025

If you like this post, check outmy book A Pharmacists Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <– This is not the first time the issue of being awake during paralysis has come up with rocuronium. To get immediate access, go to pharmacyjoe.com/academy.

Hospitals 97

Hospitals Inpatient 97

Pharmacy Joe

MAY 8, 2024

The signs of methemoglobinemia depend on the degree of methemoglobin present. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <– To get immediate access, go to pharmacyjoe.com/academy.

Hospitals 98

Hospitals Inpatient 98

Pharmacy Joe

AUGUST 23, 2023

The authors reviewed the literature for similar cases and present 13 additional reports as well as an argument for their dosing strategy rather than the typical recommendations for protamine use found in the prescribing information or tertiary references. They were discharged home on apixaban 5 mg twice daily.

Inpatient 98

Inpatient 98

Pharmacy Joe

JANUARY 10, 2024

In this episode, I’ll discuss the ACEP clinical policy on adult patients presenting to the ED with severe agitation. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Hospitals 98

Hospitals Inpatient 98

ID Stewardship

DECEMBER 13, 2024

You may need to evaluate a whole slew of metrics, but you do not have to prepare graphs for everything when it comes time to make the presentation. It is essential to adapt presentations of data to the audience. One strategy is to close your presentation by providing people with a few talking points based on the data.

Communication 90

Communication Medical Records Inpatient Documentation 90

Pharmacy Joe

MAY 7, 2023

A recent abstract presented at the CHEST Congress and published in the Journal CHEST June 2020 highlighted this clinical dilemma. The authors describe the case of a 54-year-old male with a history of shellfish allergy who presented to the emergency department with dyspnea, dysphagia and urticaria shortly after ingesting shellfish.

Inpatient 52

Inpatient 52

Pharmacy Joe

MAY 7, 2023

A recent abstract presented at the CHEST Congress and published in the Journal CHEST June 2020 highlighted this clinical dilemma. The authors describe the case of a 54-year-old male with a history of shellfish allergy who presented to the emergency department with dyspnea, dysphagia and urticaria shortly after ingesting shellfish.

Inpatient 52

Inpatient 52

Pharmacy Joe

JUNE 28, 2023

However, a low heparin anti-Xa level may be clinically useful to identify patients that do not have relevant concentrations of Xa inhibitors present. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient 52

Pharmacy Joe

JUNE 28, 2023

However, a low heparin anti-Xa level may be clinically useful to identify patients that do not have relevant concentrations of Xa inhibitors present. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient 52

Pharmacy Joe

MAY 31, 2023

Most patients do not present with coma but rather severe hypothyroidism with altered consciousness, confusion, or lethargy. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 59

Inpatient Hospitals 59

Pharmacy Joe

JUNE 25, 2023

While these two syndromes are very similar in presentation, they can usually be differentiated by looking at three specific things: 1. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient 52

Pharmacy Joe

OCTOBER 18, 2023

The hypokalemic effects of digoxin fab fragments can also be compounded if the patient with digoxin toxicity presented with hyperkalemia and insulin and/or sodium bicarbonate were given to lower potassium levels before the diagnosis of digoxin toxicity was made. To get immediate access, go to pharmacyjoe.com/academy.

Immunization 52

Immunization Immunity Hospitals Inpatient 52

Pharmacy Joe

OCTOBER 18, 2023

The hypokalemic effects of digoxin fab fragments can also be compounded if the patient with digoxin toxicity presented with hyperkalemia and insulin and/or sodium bicarbonate were given to lower potassium levels before the diagnosis of digoxin toxicity was made. To get immediate access, go to pharmacyjoe.com/academy.

Immunization 52

Immunization Immunity Hospitals Inpatient 52

Pharmacy Joe

JUNE 25, 2023

While these two syndromes are very similar in presentation, they can usually be differentiated by looking at three specific things: 1. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient 52

Pharmacy Joe

OCTOBER 23, 2024

This type of trial is suggested to reduce immortal time bias, selection bias, and even some confounding bias that is normally present in a retrospective review. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

OCTOBER 23, 2022

Subscribe on iTunes , Android , or Stitcher Some clinicians prefer phenobarbital over benzodiazepines for alcohol withdrawal patients presenting to the emergency department. Episode 759: Does phenobarbital offer a clinically meaningful advantage over benzodiazepines for alcohol withdrawal in the ED?

Hospitals 52

Hospitals Inpatient 52

Pharmacy Joe

SEPTEMBER 20, 2023

For this reason, physicians will generally avoid intubation unless hypoventilation is present in these patients. If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

JUNE 22, 2022

Question 7 presented the same 4 antibiotics and asked: “How are these antibiotics cleared?” Question 8 presented a list of 5 conditions and asked: “What are risk factors for augmented renal clearance?” And for those with AUC:MIC goals, either the dose can be reduced or the dosing interval increased.

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

JULY 7, 2024

Subscribe on iTunes , Android , or Stitcher When a hospital microbiology laboratory performs antimicrobial susceptibility testing using microdilution or disk diffusion methods, not all of the results are presented to clinicians in the medical record. To get immediate access, go to pharmacyjoe.com/academy.

Medical Records 52

Medical Records Hospitals Inpatient 52

Pharmacy Joe

JULY 31, 2024

Additional good practice statements suggest that pharmacologic SUP be discontinued before the patient leaves the ICU when risk factors are no longer present, and that patients who present to the ICU on a PPI or H2RA but without risk factors have the need for such medications compared against whether an actual indication exists.

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

SEPTEMBER 28, 2022

The study was a multi-center randomized controlled trial of patients who presented with acute pancreatitis. The moderate fluid resuscitation group received a bolus of 10 mL/kg only if hypovolemia was present – otherwise they received no bolus, followed by 1.5 To sign up go to pharmacyjoe.com/academy.

Hospitals 52

Hospitals Inpatient 52

Pharmacy Joe

JANUARY 24, 2024

Episode 890: How to Succeed at Journal Club Without Really Trying Subscribe on iTunes , Android , or Stitcher There are two important criteria that are essential to fulfill when presenting an article to a journal club: 1. The article should be of high quality 2. To get immediate access go to pharmacyjoe.com/academy.

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

JUNE 15, 2022

If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <– In episodes 536 and 637 I discussed how the oral anti-Xa inhibitors can be detected using non-calibrated and calibrated heparin Xa plasma assays.

Inpatient 52

Inpatient 52

Pharmacy Joe

APRIL 16, 2023

On presentation to the ED she had a seizure and cardiac arrest. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

MAY 31, 2023

Most patients do not present with coma but rather severe hypothyroidism with altered consciousness, confusion, or lethargy. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

APRIL 16, 2023

On presentation to the ED she had a seizure and cardiac arrest. If you like this post, check out my book – A Pharma cist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <–

Inpatient 52

Inpatient Hospitals 52

Pharmacy Joe

JUNE 15, 2022

If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies. <– In episodes 536 and 637 I discussed how the oral anti-Xa inhibitors can be detected using non-calibrated and calibrated heparin Xa plasma assays.

Inpatient 52

Inpatient 52

Pharmacy Joe

MAY 29, 2024

One notable advantage to nebulized ketamine is that it can be delivered without first establishing IV access, and this may be desirable in patients who present to the ED with acute pain but do not otherwise have a need for IV access.

Inpatient 52

Inpatient 52

Pharmacy Joe

JULY 1, 2020

A recent abstract presented at the CHEST Congress and published in the Journal CHEST June 2020 highlighted this clinical dilemma. The authors describe the case of a 54-year-old male with a history of shellfish allergy who presented to the emergency department with dyspnea, dysphagia and urticaria shortly after ingesting shellfish.

Inpatient 40

Inpatient 40