It'll probably end up hurting more than it helps. APAP's absorption is so dependent on stomach emptying time that you're simultaneously at risk of false positives and negatives
Waste of time and resources. Tells whether they might be absorbing APAP if it's timed right and pretty much nothing else
Once had a patient with a therapeutic VPA lvl on PO and the team ordered one, it came back "negative" so they switched everything to IV
Like ???
www.nephjc.com/news/...
Check out the excellent #NephJC summary by @msocomd.bsky.social and @sejalplakhani.bsky.social
Found this nifty RCT cited in the guidelines which addresses a question we often face - a patient comes in on an ASM and is dx with PNES. What do you do with the ASM, immediately dc or taper?
Immediate d/c seems better than "delayed withdrawal" (DW)
pubmed.ncbi.nlm.nih.gov/20726877/
AAN guidelines for functional seizure/PNES were just published, which covers a small group who end up in the unit
Key takeaways:
1️⃣ Median time to dx is 7-8 YEARS!
2️⃣ Pts can have both PNES & epilepsy
3️⃣ Psych/therapy can reduce PNES freq
4️⃣ Meds don't work for PNES
www.neurology.org/doi/10.1212/...
Always ahead of your time 😂
Perfect 😂
Thanks for at least serving as conference pro-con debate fodder for almost 10 years
Andexanet alfa, 2018-2025
Confirmed with some good sources that this is indeed true 🫣
Truly the Xigris of the 2020s
Not "official" but I've seen it independently a few times now. That or we're all just sharing the same fake letter lol
End of an era, you will not be missed
CCR Down Under 2025 Original Article | Dec. 9, 2025 | NEJM.org Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults Figure 1. In-Hospital Death, According to Trial Group. The NEJM identity sits at the bottom.
In a randomized trial involving critically ill patients undergoing intubation in EDs or ICUs, the use of ketamine for the induction of anesthesia did not lead to significantly lower in-hospital mortality than etomidate. Full trial results: nej.md/44EOlxB
@criticalcarereviews.com
Looking to learn more about aSAH care and get some CE credit? Tune in to my webinar today at 1pm or 8pm EST on nimodipine in aSAH
For my pharmacist friends - this is accredited for med safety! Tis the season to get your CEs
www.pharmacytimes.org/courses/unde...
Mortal Kombat: Pharmacology
Found on the same MAR
Which one will win!
But don't worry, CHIROPRACTORS made the list
Ffs
Petition to ban the phrase "maxed out on pressors"
There is not a max dose of any pressor
Sign below 👇🏼
Putting together a presentation on aSAH and I am always amazed re-reading the nimodipine trials just how different aSAH care is from how it was then
Mean time to azm clipping in British Aneurysm Trial was ~11 DAYS and they simply stopped tx if no azm was found
Best data we have 🤷
Standard (A) and modified (B) Bland–Altman plots representing the performance of the Fraser equation in an external cohort. In the standard Bland–Altman plot (A), the x axis represents the actual (measured) free valproate concentration while the y axis represents the difference between the Fraser predicted and the actual free valproate concentration. The solid black line represents a difference of 0 mg/L (i.e., an accurate prediction) and the dashed lines represent the 95% confidence interval of the mean difference between the predicted and actual values. Individual dots represent a single valproate concentration. In the modified Bland–Altman plot (B), the x axis represents the actual (measured) free valproate concentration, and the y axis represents the Fraser predicted free valproate concentration. The dashed line represents a perfect y = x correlation while the solid line represents the observed linear relationship between the actual and predicted concentrations. Both figures depict the worsening under-estimation as measured free valproate increases.
Standard (A) and modified (B) Bland–Altman plots representing the performance of the modified Fraser equation with patient effect.In the standard Bland–Altman plot (A), the x axis represents the actual (measured) free valproate concentration while the y axis represents the difference between the Fraser predicted and the actual free valproate concentration. The solid black line represents a difference of 0 mg/L (i.e., an accurate prediction) and the dashed lines represent the 95% confidence interval of the mean difference between the predicted and actual values. Individual dots represent a single valproate concentration. In the modified Bland–Altman plot (B), the x axis represents the actual (measured) free valproate concentration, and the y axis represents the Fraser predicted free valproate concentration. The dashed line represents a perfect y = x correlation while the solid line represents the observed linear relationship between the actual and predicted concentrations. Performance with the modified equation was significantly improved when individual patient effect was included.
Excited to share our newest work on free VPA: improving ability to predict levels with the Fraser equation. We reveal that the orig eq. is modestly accurate in an external cohort and make improvements to the eq, but confirm measurement remains ideal
@cbthepharmd.bsky.social
doi.org/10.1002/phar...
Really eye opening - carbapenem resistance is just another day in the office for so much of the world
Listening to Richard Ferrer, a Spanish microbiologist, discuss AMR and I am just stunned by this antibiogram from Barcelona
<2/3 of PsA isolates are cefepime sensitive 🤯
#SOCHIMI2025
Kicking off SOCHIMI 2025 in beautiful Pucon, Chile listening to Jason Roberts discuss PK/PD of antibiotics in the ICU
Augmented renal clearance (ARC) is so important, we all need to think about this more. 👌👌
ARC most commonly comes into play regarding antibiotics, but it can be relevant for any renally cleared drug.
I miss that commute so much 😩
Do you use vasopression for MAP augmentation in your SCI patients?
In our newly published series, we describe significant hyponatremia frequently develops when used just to push up the MAP - quite literally induced SIADH
pubmed.ncbi.nlm.nih.gov/41051384/
Simple solution - import the safe European analgesic paracetamol!
We're missing you here!! #NCS2025
