Pharmacy to Dose: The Critical Care Podcast Nick Peters

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

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

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

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

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

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