Pharmacy Education and Millennials Over the holiday, I began reading one of the William Osler biographies. While reading his inspiring and influential journey, which to this day continues to guide and lead others, I paused to reflect on my own profession. Although I’m searching for the pharmacy equivalent to such influential figures in medicine, our education methods are far more interesting. Though books and lectures were a component of the late 19th century and early [...]

Tale of the Comeback Kid: Procainamide in the ED It seems as though the traditional "go-to" management of atrial fibrillation in the setting of rapid ventricular response in the emergency department involves rate control and anticoagulation. Can we break this tradition and consider alternative therapeutic management in certain subpopulations of patients with dysrhythmias? Recently, there has been some discussion regarding the use of rhythm control for new-onset atrial fibrillation, particularly procainamide, which used to be [...]

Alternative routes of administration for STEMI Here is my attempt at a trick of the trade. This one is focused on the intubated STEMI patient in whom the EMS crew couldn’t get the 324mg of aspirin on board, and the cardiologist wants to load with clopidogrel 600mg as well as atorvastatin 80mg. Provided we can drop an OG tube before the patient gets sent to the cath-lab, this is how we get the meds into [...]

Culture follow-up and outpatient antibiogram As I was preparing a post discussing antimicrobial double coverage, I was describing the utility of a hospital antibiogram in aiding in the selection empiric therapy.  Let’s just say I’m glad I have had teachers and mentors whose favorite question was “why.”  While trying to answer that simple question, I came across this article from 2007 [1] that did an excellent job describing the limitations of antibiograms. Although I was [...]