In this 119th episode I welcome Dr. Robert Sawyer to the show. Dr. Sawyer was the PI on the STOP-IT trial comparing a short course of antibiotics versus a longer course for complicated intraabdominal infections. We discuss the trial, the outcomes, and what the future of antimicrobial management in the surgical ICU may look like.
CME: https://earnc.me/jeCfMt
Reference:
STOP-IT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1411162
In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts.
CME: https://earnc.me/k6e6gK
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866
In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in episode 109.
CME: https://earnc.me/oDhyER
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866/ R
In this episode, episode 77, I discuss reversal of neuromuscular blockade. This is a follow up to episode 66 in which I covered neuromuscular blockade.
CME: https://earnc.me/An714h
Outline by Brian Park: NMB Reversal Outline
References:
Miller’s Anesthesia 8th Edition. Reversal (Antagonism) of Neuromuscular Blockade. Murphy GS, de Boer HD, Eriksson LI and Miller RD. Chapter 35, 995-1027.e5.
Appiah-Ankam J, Hunter J. Pharmacology of neuromuscular blocking drugs. Cont Educ Anaesthesia Critical Care & Pain. 2004;4(1):2-7.
Hristovska AM, Duch P, Allingstrup M, Afshari A. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. Cochrane Database Syst Rev. 2017 Aug 14;8:CD012763.
Keating GM. Sugammadex: A Review of Neuromuscular Blockade Reversal. Drugs. 2016 Jul;76(10):1041-52.
McLean DJ, Diaz-Gil D, Farhan HN, Ladha KS, Kurth T, Eikermann M. Dose-dependent Association between Intermediate-acting Neuromuscular-blocking Agents and Postoperative Respiratory Complications. Anesthesiology. 2015 Jun;122(6):1201-13.
Schaller S, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evidence. 2013;8:57-67.
In this episode, episode 66, I go through an overview of neuromuscular blockers including how they work, how to use them, and what their adverse effects are. Happy New Year!
CME: https://earnc.me/9GRFyG
The dose of glycopyrrolate should be 0.01 to 0.015mg/kg, not 0.1 to 0.15.
Outline by Brian Park: Outline
References:
Miller’s Anesthesia 7th edition: Chapter 29: Pharmacology of Muscle Relaxants and Their Antagonists. Naguib M and Lien C.
Rocuronium vs succinylcholine for rapid sequence induction intubation. https://www.ncbi.nlm.nih.gov/pubmed/26512948
Neuromuscular blockade: what was, is and will be: https://www.ncbi.nlm.nih.gov/pubmed/25622380
Reversal of neuromuscular block: https://www.ncbi.nlm.nih.gov/pubmed/19468024
In this episode, episode 63, I welcome back Andrew Jarrell to learn to pronounce his name properly, and to discuss VTE and stress ulcer prophylaxis.
CME: https://earnc.me/tcjDJm
References are here: References
In this episode, episode 60, I welcome Andrew Jarrell, one of our amazing surgical ICU pharmacists to the show. We discuss antibiotic prophylaxis for surgery including what to use, how to time it, how long to continue it, and what the evidence says about things like indwelling drains.
CME: https://earnc.me/MthcTD
A fantastically helpful outline of the episode put together by Brian Park is here: Outline
In this episode, episode 58, I welcome our two OB Anesthesia fellows to the show, Dr. Dave Berman and Dr. Anh Nguyen. We discuss the medications used for neuraxial anesthesia including local anesthetics, opioids, and adjuncts such as epinephrine, clonidine and more.
CME: https://earnc.me/N8xw8b
Outline by Brian Park: Outline
Dave’s email is db******@**mi.edu and Anh’s is tn******@**mi.edu.
References can be found here: Neuraxial references
In this episode, episode 57, I welcome back Rachel Kruer, our amazing SICU pharmacist and we complete our two part series on bugs and drugs in the ICU. We discuss different infections that are commonly seen in ICUs and how to treat them.
CME: https://earnc.me/OMacEP
In this episode, episode 56, I welcome Rachel Kruer to the show. Rachel is one of our amazing ICU pharmacists and we discuss common bacteria and the drugs we use to treat them. This is part 1 of a 2 part series that I’ll be doing with Rachel on this topic.
CME: https://earnc.me/1McYTq
Pharmacodynamics vs. Pharmacokinetics (1:08)
Categorizing Bacteria (7:10)
Beta-Lactams (12:10)
Aztreonam (19:40)
Carbapenems (21:20)
Case Examples (24:20)
Fluoroquinolones (30:36)
Vancomycin (33:15)
Aminoglycosides (35:31)
Macrolides (39:45)
Linezolid (40:33)
Daptomycin (43:05)
Sulfonamide Antibiotics (44:05)
Clindamycin (45:49)
Colistin (47:17)
Glycylcycline (48:43)
Metronidazole (Flagyl) (49:55)
Vancomycin Resistant Enterococcus (51:11)
Surgical Prophylaxis (53:40)
Outline by April Liu
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