Afleveringen
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Literature Review Series
January 2024
Special Guests: Haley Torr, PharmD
Nick Tran, PharmD
06:55 – Featured Articles
32:55 – PAD-IS articles
37:10 – Cardiology articles
46:00 – Heme articles
51:40 – Potpourri articles
60:05 – Pharmacist-featured articles
67:30 – Sweet Emotion articles
Reference List: https://pharmacytodose.com/wp-content/uploads/2024/06/jan-2024-lrs-references.pdf
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Trial of the Week: PROWESS-SHOCK
Special Guest: Paul Szumita, PharmD, FCCM, FASHP, BCCCP, BCPS @paulszumita
03:30 – Background studies/Setting the scene
30:25 – PROWESS-SHOCK discussion/Where are we now
Paul Szumita joins to highlight a June Trial of the Week “Drotrecogin alfa (activated) in adults with septic shock” published in the New England Journal of Medicine in 2012.
To fully understand the discussion regarding drotrecogin alfa, Paul and I review the mechanism of action and its proposed action in the treatment of sepsis. Then we review earlier studies and the controversy behind the FDA approval process. Finally, we go into detail on what Clinical Pharmacists were tasked with doing at the time based on treatment protocols or hospital restrictions.
Then we dive into the Trial of the Week, discussing the study design and results. What was the mood in ICUs and Pharmacy Departments after this publication? How much did our sepsis care improve from PROWESS to PROWESS-SHOCK? What lessons did we learn with the Xigris FDA approval process? Is there a patient population that could still benefit from drotrecogin alfa treatment? Plus, trial fun facts, issues with calculating APACHE II scores, and so much more.
Reference list: https://pharmacytodose.com/wp-content/uploads/2024/06/prowess-shock-trial-of-the-week-references.pdf
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Zijn er afleveringen die ontbreken?
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Literature Review Series
2023 Year-In-Review
Special Guests: Jacquelyn Crawford, PharmD @jacuronium
Kathleen Hartman, PharmD @HartKate8
04:30 – Neurology
11:05 – Cardiology
18:50 – Cardiac Arrest
26:30 – Pulmonary
35:00 – Sepsis
44:05 – Endocrine/Renal
52:30 – Trauma
61:05 – Infectious Diseases
Reference List: https://pharmacytodose.com/wp-content/uploads/2024/06/yir-2023-lrs-references.pdf
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Trial of the Week: Ketamine for EM Agitation
Special Guest: Justin Lin, PharmD, BCPS, BCCCP @jjlinpharmd
Justin Lin joins to review the May Trial of the Week “Efficacy of ketamine for initial control of acute agitation in the emergency department: a randomized study” published in the American Journal of Emergency Medicine in 2021.
We set the scene by discussing how this research idea started, review the classic agitation presentation at his institution, and highlight evidence comparing pharmacotherapy treatment options prior to this study. Then we dive into the Trial of the Week, discussing the study design and results. What was the biggest pushback from providers or the IRB? Any unique education strategies? Would results stay the same with increased IV push administration? What would the comparator arm be if this study was replicated today? Plus, the most challenging part of this project, Justin’s favorite agent, and so much more.
Reference list: https://pharmacytodose.com/wp-content/uploads/2024/05/ketamine-for-em-agitation-trial-of-the-week-references.pdf
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Sanford Guide Q&A
Special Guest: Doug Black, PharmD
04:40 – Doug’s background/Sanford guide introduction
14:20 – Print v. digital guide/included content
34:35 – Tables/tools highlights
41:55 – Doug’s favorites/conclusions
Sanford Guide Website: https://web.sanfordguide.com/
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Code ICH
Special Guest: Gabe Fontaine, PharmD, MBA, BCPS, BCCCP, FNCS, FCCM @gabe_fontaine
04:00 – Code ICH and history of ICU bundled care
15:15 – BP control
22:50 – Hemostasis
33:15 – Challenges & future directions
Reference List: https://pharmacytodose.com/wp-content/uploads/2024/05/code-ich-references.pdf
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Trial of the Week: MENDS2
Special Guest: John Devlin, PharmD, BCCCP, MCCM, FCCP @devlinpharmd
03:20 – PADIS background and research introduction
35:25 – MENDS2 discussion
John Devlin joins to review the May Trial of the Week “Dexmedetomidine or Propofol for Sedation in Mechanically Ventilated Adults with Sepsis” the MENDS2 study, published in NEJM in 2021.
We set the scene by discussing how John developed an interest with PADIS research, discussing PK/PD sedative properties and considerations, landmark trials prior to MENDS2, and how much background work is required for a large RCT.
Then we dive into the MENDS2 trial itself. Any significant findings? Biggest methodologic differences from MENDS2 and previous studies? Most challenging process of blinding? Any potential safety concerns? How to avoid unblinding study patients (and why that’s so important)? Plus, trial fun facts, seeing your name in a NEJM research article, applying MENDS2 findings into daily practice, and so much more.
Reference list: https://pharmacytodose.com/wp-content/uploads/2024/05/mends2-trial-of-the-week-references.pdf
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Rapid Reaction: ANNEXA-I
02:35 – Study design/results
18:30 – Considerations/questions
Reference List: https://pharmacytodose.files.wordpress.com/2024/05/annexa-i-references.pdf
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Trial of the Week: DESIRE & In-Flight Medical Emergencies References
Special Guests: Jim Miller, PharmD, BCCCP @millerjtm
Michael Liu, PharmD, MBA, BCCCP, BCNSP, BCPS
04:05 – DESIRE trial
31:15 – In-flight medical emergencies
The episode starts off with special guest, Jim Miller, helping review the DESIRE study as a Trial of the Week.
We set the scene reviewing dexmedetomidine pharmacokinetic advantages and landmark dexmedetomidine research. Then we highlight the DESIRE trial itself discussing the study methodology and results. What was considered usual care with regards to sedation? What is the external validity in this trial? What was the effect of changing the primary outcome measure mid-study? Are there anti-inflammatory properties with dexmedetomidine? What did Jim’s novel research show? What would Jim and I want for sedation if mechanically ventilated? And much more.
Then the episode closes with Michael Liu highlighting his experience assisting with an in-flight medical emergency.
We review his AJHP article describing his experience. Was this his first time in this situation? Biggest difference between in-hospital and out-of-hospital emergency response? What advice would he give others? And so much more.
Reference list: https://pharmacytodose.files.wordpress.com/2024/05/desire-trial-of-the-week-references.pdf
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December 2023 Literature Review Series
Special Guests: Jenna Self, PharmD
Hannah Millard, PharmD
04:30 – Featured Articles
38:45 – Cardiology
49:30 – Potpourri
53:20 – Sepsis
60:00 – PharmD
65:00 – Sweet Emotion
Reference List: https://pharmacytodose.com/wp-content/uploads/2024/05/december-2023-lrs-references.pdf
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ACC 2024 Rapid Reaction: Part II
Special Guest: Snehal Bhatt, PharmD, BCPS, FASHP, AACC @SnayCardsPharmD
04:05 – EMPACT-MI
29:35 – ULTIMATE-DAPT
Reference List: https://pharmacytodose.files.wordpress.com/2024/05/acc-2024-part-ii-references.pdf
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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
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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
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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
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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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