Category Archives: Pharmacology

Episode 30: Management of anticoagulation for non-valvular a-fib

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 30: Management of anticoagulation for non-valvular a-fib
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In this episode, episode 30, I discuss the new American College of Cardiology Guidelines for the periprocedural management of anticoagulation for patients with non-valvular atrial fibrillation.  This includes whether to stop, when to stop, whether to bridge, how to bridge, and how and when to restart.

CME: https://earnc.me/522vst

Outline by Brian Park: AC for Afib Outline

Episode 26: Sugammadex with Dr. Amit Prabhakar

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 26: Sugammadex with Dr. Amit Prabhakar
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In this episode I welcome Dr. Amit Prabhakar, one of our critical care fellows, to the show to discuss Sugammadex, a relatively recently approved (in the USA) reversal agent for Rocuronium and Vecuronium.

CME: https://earnc.me/h9cIdh

Outline by Brian Park: Sugammadex outline

Episode 24: The Evils of Sodium Bicarbonate

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 24: The Evils of Sodium Bicarbonate
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In this episode I first suggest you take a look at the recently published (ahead of print) VANCS study on the use of vasopressin as a sole agent in the treatment of vasoplegic shock.  Then I review the reasons never to use sodium bicarbonate in lactic acidosis.

CME: https://earnc.me/3CX3ha

The Vancs study: https://www.ncbi.nlm.nih.gov/pubmed/27841822

The two articles I recommend on bicarb:

Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227

Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160

Outline by Brian Park: Outline

Episode 19: Vasoactive medications

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 19: Vasoactive medications
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In this episode I review the receptors that vasoactive drugs act on.  I then review the main vasoactive medications used in the OR and the ICU to treat acute hypotension and the ones used to treat acute hypertension.

CME: https://cmefy.com/moment?id=3VcC8Y8

Outline by April Liu: Outline

Episode 14: Opioids part 2

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 14: Opioids part 2
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This is the second of two episodes about opioid medications.  In this episode I cover the pharmacokinetics and pharmacodynamics of opioids, some of the common uses for these medications, mixed agonist-antagonist compounds, opioid antagonists, and opioid interaction with other medications.

CME: https://cmefy.com/moment?id=kNv6n0N

Slides to go along with this episode are here: Opioids part 2

Episode 13: Opioids part 1

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 13: Opioids part 1
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This is the first of a 2 part series on opioid medications.  In this first episode I will talk about how opioids are categorized and their effects on the different body systems.  In the next episode I will discuss their pharmacokinetics and pharmacodynamics as well as their various uses and some details on mixed agonist/antagonists.

CME: https://cmefy.com/moment?id=xPdz_TY

Slides to go along with this episode are here: Opioids part 1

PLEASE NOTE: Around minute 12 I say that auditory evoked potentials are the most sensitive to anesthetics.  This is incorrect.  I should have said visual evoked potentials.  Thanks to Howard Zee for catching that!

Episode 10: IV Induction Agents

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 10: IV Induction Agents
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In this episode I review the common IV agents used in anesthesia excluding opioids.  I cover Propofol, Barbiturates, Benzodiazepines, Ketamine, Etomidate and Dexmedetomidine.

CME: https://cmefy.com/moment?id=txf7gHH

NOTE: There is an error in the audio recording regarding the dosing units for dexmedetomidine.  I say on the podcast that the dosing units are mcg/kg/min which is INCORRECT.  The correct dosing units are mcg/kg/HOUR.  I have corrected this in the accompanying slides. Thanks to Melanie Browder for picking this up!

Good luck to the recent graduates taking their written board exam on July 29th!

Slides to go along with the podcast are here: IV induction agents slides

Episode 9: Basic Med Setup

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 9: Basic Med Setup
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In this episode I review the basic medication setup for the operating room including premedication, induction, neuromuscular blockade, antibiotics, reversal and antiemetics.  I discuss weight based dosing and comment on a few alternatives to consider once you have the basic setup down.  This episode should be useful for new CA-1s getting started in the OR but I would also like to ask senior residents to comment on what their basic setup is and how it may differ from what I’ve mentioned here.

CME: https://cmefy.com/moment?id=nG8Bz4H

Here is a list of the medications I discuss: Basic med setup w dosing

Episode 3: Announcements and FIO2 in one lung ventilation

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 3: Announcements and FIO2 in one lung ventilation
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There are a few announcements I wanted to make including:

Check out pedsanesthesia.net.  Dr. Robert Greenberg, a pediatric anesthesiologist here at Johns Hopkins runs it and it has lots of great information and topics in pediatric anesthesiology.

CME: https://cmefy.com/moment?id=VZ7M3tT

If you have suggestions for a better website than this one please let me know!

If you know a good way to set up an email list serve for these kinds of announcements please let me know that as well.

And, finally, I address a surgeon’s comment to one of our residents that you should always use 100% fio2 when ventilating one lung during a thoracic case.  Listen to the podcast for details but the bottom line is you should NOT use 100% oxygen unless you have to in order to prevent hypoxia.

Here is a link to a great review on this topics published last year in Critical Care: https://www.ncbi.nlm.nih.gov/pubmed/26278383

Episode 1: Properties and laws of volatile anesthetics

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 1: Properties and laws of volatile anesthetics
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This is a very high yield episode to help you review for the anesthesia board exam.  I cover the board key word section entitled gas laws which includes a focus on volatile anesthetics, their properties, and how they act on, and in, the human body.

CME: https://cmefy.com/moment?id=hV2xv_t

Topics covered will include:

Continue reading Episode 1: Properties and laws of volatile anesthetics