Category Archives: Pharmacology

Episode 42: Post-op Nausea and Vomiting (PONV)

May 2, 2017 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 42: Post-op Nausea and Vomiting (PONV)

00:00 / 29:21

In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV). I discuss risk factors, complications, treatment and prevention and side effects.

CME: https://earnc.me/31KodT

Outline by April Liu: Outline

UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV. However, a good friend and colleague, Dr. Michael Grant, did a nice meta-analysis of available trials which concluded that it actually does work fairly well. Check out his study:

Grant MC, Kim J, Page AJ, et al. The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting: A Meta-Analysis. Anesthesia & Analgesia: 2016:122(3); 656–663.

Anesthesia, Anesthetic agents, Critical Care, Pharmacology, Show Notes

Episode 41: Local Anesthetics

April 21, 2017 ACCRAC 8 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 41: Local Anesthetics

00:00 / 24:15

In this episode, episode 41, I review local anesthetics including the mechanism of action, commonly used agents, pharmacodynamics and kinetics, toxicity and treatment, and common blocks.

CME: https://earnc.me/rbqGL8

Outline by April Liu: Outline

Anesthesia, Cardiac, Critical Care, Pharmacology

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

January 17, 2017 ACCRAC Leave a comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

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

00:00 / 33:19

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

Anesthesia, Anesthetic agents, Critical Care, Pharmacology, Show Notes

Episode 26: Sugammadex with Dr. Amit Prabhakar

December 21, 2016 ACCRAC 4 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 26: Sugammadex with Dr. Amit Prabhakar

00:00 / 21:55

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

Anesthesia, Critical Care, Pharmacology, Show Notes

Episode 24: The Evils of Sodium Bicarbonate

December 11, 2016 ACCRAC 11 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 24: The Evils of Sodium Bicarbonate

00:00 / 20:31

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

Anesthesia, Critical Care, Pharmacology, Show Notes

Episode 19: Vasoactive medications

November 11, 2016 ACCRAC 15 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 19: Vasoactive medications

00:00 / 27:59

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

Anesthesia, Anesthetic agents, Critical Care, Pharmacology

Episode 14: Opioids part 2

August 17, 2016 ACCRAC 6 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 14: Opioids part 2

00:00 / 28:45

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

Anesthesia, Anesthetic agents, Critical Care, Pharmacology

Episode 13: Opioids part 1

August 13, 2016 ACCRAC 7 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 13: Opioids part 1

00:00 / 29:09

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!

Anesthesia, Anesthetic agents, Pharmacology

Episode 10: IV Induction Agents

July 19, 2016 ACCRAC 5 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 10: IV Induction Agents

00:00 / 55:06

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

Anesthesia, Anesthetic agents, Pharmacology

Episode 9: Basic Med Setup

July 9, 2016 ACCRAC 12 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 9: Basic Med Setup

00:00 / 32:28

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