Managing anticoagulation in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) is a complex clinical challenge. In this episode, we explore the delicate balance between preventing venous thromboembolism (VTE) and minimizing bleeding risks in this vulnerable population. We discuss the evolving role of direct oral anticoagulants (DOACs), including the limited and often controversial evidence supporting their use in ESRD, alongside the continued relevance of warfarin. Drawing on guideline recommendations, observational studies, and emerging research on novel agents such as Factor XI inhibitors, we highlight the nuances of decision-making and the importance of individualized therapy. Whether you’re a clinician, researcher, or learner, this episode provides a concise yet comprehensive look at where the field stands and where it’s headed.
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20:44
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20:44
SQuID Protocol in Mild-Moderate DKA
What if treating diabetic ketoacidosis didn’t always require IV drips, ICU beds, or long hospital stays? In this episode, we explore the SQuID protocol, a cutting-edge approach that uses subcutaneous insulin for mild to moderate DKA. Evidence shows it can safely resolve DKA, speed up recovery, and free up critical hospital resources...all while keeping outcomes comparable to traditional treatment. We’ll also discuss the important limitations, safety considerations, and the steps needed before this approach can be widely adopted. Tune in to hear how SQuID could transform the way we manage DKA.
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18:42
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18:42
Rapid Antiseizure Medication Administration
When every second counts, speed matters. But how fast is too fast when it comes to giving intravenous antiseizure medications? In this episode, we dive into the latest research on rapid administration of lacosamide, levetiracetam, and valproate. From intravenous push to piggyback infusions, we break down what the data says about safety, side effects, and real-world efficiency. Join us as we explore how faster medication delivery could reshape emergency seizure care and what hospitals need to consider before making the switch.https://academic.oup.com/ajhp/advance-article-abstract/doi/10.1093/ajhp/zxaf214/8237247?redirectedFrom=fulltext&login=false
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17:12
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17:12
Warfarin and Antibiotic Interactions
Dive into the world of pharmacology as we explore how warfarin interacts with antibiotics at a molecular level. This episode highlights the crucial role of CYP2C9 metabolism in regulating S-warfarin and explains why certain antibiotics, like metronidazole and fluconazole, can significantly impact INR levels. We also unpack the challenge of separating true drug-drug interactions from infection-driven effects, giving you a clear look at the science behind these complex interactions. Perfect for pharmacists, clinicians, and anyone fascinated by how drugs work in the body.
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15:47
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15:47
Tranexamic Acid Unpacked: Evidence vs. Expectations
Tranexamic acid (TXA) has been hailed as a game-changer in bleeding management...but does the evidence really support its widespread use? In this episode, we dive into the research behind TXA across multiple clinical settings: trauma, surgery, postpartum hemorrhage, GI bleeds, intracranial hemorrhage, and more. We explore landmark trials like CRASH-2 and CRASH-3, discuss why small positive studies don’t always translate into meaningful patient outcomes, and unpack the nuances of timing, context, and risk. Join us as we separate hype from evidence and ask the big question...where does TXA truly belong in emergency medicine?
About Pharmacy - Emergency Medicine Deep Dive Podcast
Pharmacy - Emergency Medicine Deep Dive Podcast delivers high-impact, high-yield clinical pearls in emergency medicine, with a focus on pharmacotherapy and EM critical care. Each episode explores real-world cases, unpacks emerging research, and breaks down the latest evidence to support confident, informed decisions at the bedside. Created with help from Notebook LM AI, the podcast blends expert insight with cutting-edge tools to bring you timely, practical knowledge. If you're into meds, mechanisms, and making critical calls—this one's for you.
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