Excited for #NCS2025! If you're attending, be sure to participate in the @neurocritical.bsky.social Social Media Contest to potential win some great prizes - see more below www.neurocriticalcare.org/Events/Annua...

Have you seen the new package insert tenecteplase dosing for stroke? It uses broad-stroke dose rounding that we think may put patients at risk of harm - a 40 kg patient will get a dose 50% higher than intended! See our editorial published today in Cerebrovascular Diseases karger.com/ced/article/...

Real-🌎 data in Veterans with fXaI-related ICH treated w/ andexanet alfa (AA; n=129) or 4F-PCC ( n=221) 🔷Propensity matched 🔷No difference in 90-day mortality 🔷⬆️30-day thrombotic events w/ AA (11.4 % vs. 2.4 %, p < 0.01) Free 👉https://www.sciencedirect.com/science/article/pii/S073567572500498X

🔥🔥Just published 🔥🔥 ATS CAP guidelines 2025 Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline Free access pdf #IDsky#EMIMCC www.atsjournals.org/doi/10.1164/...

Ah nothing quite as useless as a clonidine patch being ordered for acute agitation

Webb et al: Clinical Consequences of Disproportionate Free Valproate Elevation in Critically Ill Adult Patients: A Multicenter Retrospective Cohort Study Link: link.springer.com/ar... @neurocritical #neurocritcare @AJWPharm

Excited to be speaking for @neurocritical.bsky.social on the treatment of SE with some phenomenal co-presenters. The Masterclass will have an interactive portion where participants can ask questions and join in discussion about treatment controversies! www.neurocriticalcare.org/NCS-Learning...

Results of an important study

#LessIsMore Again... link.springer.com/article/10.1...

Finally made my way over to @bsky.app and the #pharmsky #cardiosky community! 🫀💊

Our team is expanding! One of our cardiology pharmacists is moving to a clinic position full time so are recruiting an additional full FTE inpatient cardiology pharmacist. massgeneralbrigham.wd1.myworkdayjobs.com/en-US/MGBExt...

I bet white coat hypertension is like a thousand times worse at the vet

Pharmacists- any book recommendations for textbooks on ICU/hospital pharmacology? I’m finishing up Critical Care Pharmacotherapy 2e by Erstad and it’s a banger, but I’d like to read a couple more books if more good ones are out there?

1/ Hi 👋 #medtwitter #neurotwitter #neurocritcare #FOAMed #meded today, as your #SoMeAmbassador for @neurocritcarej we will be breaking down an oldie but goodie @neurocriticalcarej paper! link.springer.com/ar...#medtwitter#neurotwitter#neurocritcare#FOAMed#meded#SoMeAmbassadorto 11/ for info on the paper

A great summary table of the available literature for neurostimulant use after stroke - lots of small, underpowered trials leave a lot to be desired when deciding whether starting a stimulant is worthwhile after stroke www.ahajournals.org/doi/abs/10.1...

Nifty RCT in @jama.com IM today evaluating the impact of targeted EM pharmacist intervention for patients presenting to the ED with medication related problems in France showing a dramatic ⬇️ in readmissions compared to SOC. Small and single center, but compelling! jamanetwork.com/journals/jam...

@steventong.bsky.social presents the results of the PSSA domain of the SNAP 🫰 trial - the worlds largest trial of staph aureus bacteremia - at #ESCMID2025 fluclox resulted in higher mortality and more AKI compared to penicillin for PSSA

We’ve all been there when you have a pharmacist + 🧠🩸. Ensure you’re not ⬇️ pressures too rapidly with over aggressive Tx. Slow and smooth BP reduction is >>>> drastic variability for ICH. Trust you have more ⏰ than you think. Slow is smooth. Smooth is fast. #PharmSky #NeuroSky PMID: 33017754

EXPECTS trial published revealing significant benefit of tPA given up to 24 hours after symptom onset in posterior stroke. Most strokes were minor and patients going for IAT were excluded, but very interesting data! www.nejm.org/doi/10.1056/...

At long last - the incredible effort of the @neurocritical.bsky.social Pharmacy Section Study Group FIX-ICH is published! Honored to have been a small part of this incredible effort journals.lww.com/ccmjournal/f...

Excited to share our work on disproportionate free VPA in the ICU, revealing that a) unexpected free VPA levels are extremely common, b) unchecked elevation is associated with ADE, and c) common factors like propofol use lead to these elevations link.springer.com/epdf/10.1007...

After years of work, our report on the link between hypertension in the NeuroICU and long-term poorly controlled BP is out! After adjusting for confounders, we found that inadequate BP control at NeuroICU tx was associated with ⬆️BP up to 2yrs post-discharge. www.neurology.org/doi/10.1212/...

The #measles vaccine has saved an estimated 5 lives every second since 2000. 👉Prevent measles by getting vaccinated with two doses of the measles vaccine.

In severe ARDS, sedation with inhaled sevoflurane led to fewer vent-free days and higher mortality than sedation with propofol in the French SESAR trial Will be interesting to compare the INSPiRE-ICU1 trial which was the just-finished US-based isoflurane study jamanetwork.com/journals/jam...

You love to see it Board prep CEs done until 2028 😎

its amazing how chatgpt knows everything about subjects I know nothing about, but is wrong like 40% of the time in things im an expert on. not going to think about this any further

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More data on the safety of AC resumption after ICH - shocking news, patients had fewer strokes but more recurrent ICHs Median time from ICH to enrollment was 49 days! www.thelancet.com/journals/lan...

The real value of conferences is reconnecting with pals at a piano bar that has a bubble machine at 1:30am

More MGH pharmacy research - pharmacokinetics of phenobarbital in ECMO presented by MICU extraordinaire Natasha Lopez and TCD response to milrinone in aSAH by our PGY2 Julie Jeong #SCCM2025

More MGH pharm research! Kalynn Northam (future PGY2 RPD) presenting our experience using romiplostim for thrombocytopenia associated with critical illness Platelets went up, but probably because they still got transfusions

Neurosciences pharmacotherapy year in review lead by Leslie Hamilton discussing ANNEXA-I to a packed house! #SCCM2025

Excited to see our PGY2 CC resident Julie Jeong present her PGY1 research on the accuracy of cystatin C based renal function estimates in the ICU! #SCCM2025

Kicking SCCM off with research snapshots! @ajwpharm.bsky.social & Brian are ready to answer your questions at their booth #sccm2025

Always love stumbling upon old RCTs that didn't seem to survive the years - like this RCT looking at pre-hospital IV nimodipine in out-of-hospital VF arrest which suggested nimodipine might improve outcomes in patients with ACLS delays of >10 min jamanetwork.com/journals/jam...

Would love to know what the complex calculation my dog's nose is doing when she's taking 5 minutes to decide where to take a dump

More data suggesting thrombolysis is safe in pts on DOACs at the time of stroke. Plenty of nuance in interpreting this, but given an RCT is likely infeasible, at some point these retrospective studies will come to a critical mass and prompt practice change onlinelibrary.wiley.com/doi/abs/10.1...

Our inpt neuro pharm team is expanding at MGH! We are recruiting a pharmacist for a neurology/complex care position, where the pharmacist would split their time w/ the inpt stroke team and the complex care consult team. Reach out to me w ❓! massgeneralbrigham.wd1.myworkdayjobs.com/en-US/MGBExt...

me watching the news every day this week

PO droxidopa to wean off vasopressor infusions (instead of midodrine): the mechanism of conversion to norepi *inside* neurons is beautiful. this may restore normal functioning of the sympathetic nervous system no robust data yet thoughts? criticism? experiences? #EMIMCC @ajwpharm.bsky.social

NCS published formal guidelines on seizure prophylaxis on sICH, the second in a set of three guidelines on seizure prophylaxis. Big picture: no role for prophylaxis in sICH, but if it is used, a short course of LEV is preferred over PHT doi.org/10.1007/s120...

Working with medical records databases for research has really made me despise the non-diagnosis of "altered mental status"

Dosing insulin for calcium channel blocker overdose:

I have a student on rotation with me which means teaching on pressors - I always love going *why* the different pressors have different receptor effects and thus clinical effects rather than just spitting out the facts Gives me an excuse to remind my students why we learn med chem as pharmacists!

Lorazepam shortages seem to be happening more often and every time (at our institution at least) I ask why midazolam has historically been restricted to ICUs only. Happy to see some data supporting a benzo is a benzo, and there's nothing special about midaz! journals.sagepub.com/doi/abs/10.1...

When AC is needed in acute cerebrovascular dz, heparin is usually chosen for its reversibility. Doses are often low-balled for safety, but does this come at a cost? Fast AC is needed in CSVT, and we saw that time to therapeutic PTT/AXa can >24h with low-intensity dosing! doi.org/10.1016/j.jo...

I've stopped saying both sorry for delay or thank you for patience; it feels like when stand up comics say 'I hope you find me funny' because the recipient's disappointment is pre-assumed. It's imposter syndrome talk, and I promised myself I'd shove it aside.

Before you freak reflexively order IV hydralazine for that BP of 180/90, remember that people get BPs up to 480/350 (yes that is in mmHg) while weight lifting and don't "stroke out" pubmed.ncbi.nlm.nih.gov/3980383/

A lesser described experience of getting a puppy is truly random people in our neighborhood coming up and saying "she's getting so big!" and greeting her like they are old pals