iiinova — where your digital self keeps evolving

Reposted by Andy Webb

Dr Linda Dykes @drlindadykes.bsky.social · 28/04/2026

Ever left a job/relationship/situation? Chances are one of these core emotional concerns were not being met - Samantha Louden at #RCEMAC26

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Andy Webb @ajwpharm.bsky.social · 17/12/2025

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/...

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Andy Webb @ajwpharm.bsky.social · 11/12/2025

Thanks for at least serving as conference pro-con debate fodder for almost 10 years Andexanet alfa, 2018-2025

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Andy Webb @ajwpharm.bsky.social · 11/12/2025

End of an era, you will not be missed

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NEJM.org @nejm.org · 10/12/2025

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

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.

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Andy Webb @ajwpharm.bsky.social · 04/12/2025

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...

pharmacytimes.org

Pharmacy Times Continuing Education - PTCE

Free Continuing Education By Pharmacists For Pharmacists

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Andy Webb @ajwpharm.bsky.social · 24/11/2025

Found on the same MAR Which one will win!

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Andy Webb @ajwpharm.bsky.social · 20/11/2025

Petition to ban the phrase "maxed out on pressors" There is not a max dose of any pressor Sign below 👇🏼

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Andy Webb @ajwpharm.bsky.social · 18/11/2025

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 🤷

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Andy Webb @ajwpharm.bsky.social · 17/11/2025

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...

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.

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Andy Webb @ajwpharm.bsky.social · 12/11/2025

Kicking off SOCHIMI 2025 in beautiful Pucon, Chile listening to Jason Roberts discuss PK/PD of antibiotics in the ICU

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Reposted by Andy Webb

josh farkas 💊 @pulmcrit.bsky.social · 29/10/2025

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.

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Andy Webb @ajwpharm.bsky.social · 07/10/2025

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/

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Andy Webb @ajwpharm.bsky.social · 16/09/2025

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...

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Andy Webb @ajwpharm.bsky.social · 28/08/2025

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/...

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Reposted by Andy Webb

Megan A Rech, PharmD, MSc @meganarech.bsky.social · 23/07/2025

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

sciencedirect.com

Andexanet alfa increases 30-day thrombotic events relative to four-factor prothrombin complex concentrate for factor Xa inhibitors-related intracerebral hemorrhage in veterans

Two hemostatic agents are commonly used to reverse factor Xa (fXa) inhibitor-related intracranial hemorrhage (ICH): andexanet alfa (AA) or 4-factor pr…

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Reposted by Andy Webb

Antibiotic Steward 🅱️C🆔🅿️🌟 @absteward.bsky.social · 20/07/2025

🔥🔥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/...

atsjournals.org

Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline | American Journal of Respiratory and Critical Care Medicine | Articles in P...

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Andy Webb @ajwpharm.bsky.social · 21/06/2025

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

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Reposted by Andy Webb

Neurocritical Care @neurocritcarej.bsky.social · 12/06/2025

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

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Andy Webb @ajwpharm.bsky.social · 11/06/2025

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...

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Andy Webb @ajwpharm.bsky.social · 08/06/2025

Results of an important study

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Reposted by Andy Webb

Ashley Schenk, PharmD, BCPS, BCCP @aschenkpharmd.bsky.social · 14/05/2025

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

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Andy Webb @ajwpharm.bsky.social · 14/05/2025

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...

massgeneralbrigham.wd1.myworkdayjobs.com

Clinical Pharmacist, Cardiology

Site: The General Hospital Corporation Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to adva...

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Reposted by Andy Webb

😱 Spooky SpectreKILLoquy 🔪 🩸 @caulimovirus.bsky.social · 19/09/2024

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

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Reposted by Andy Webb

josh farkas 💊 @pulmcrit.bsky.social · 02/05/2025

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?

media.tenor.com

a cartoon of a girl holding a book with the words i love this book

ALT: a cartoon of a girl holding a book with the words i love this book

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Andy Webb @ajwpharm.bsky.social · 30/04/2025

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...

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Andy Webb @ajwpharm.bsky.social · 28/04/2025

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...

jamanetwork.com

Emergency Department Visits for Medication-Related Events With vs Without Pharmacist Intervention

This randomized clinical trial assesses the efficacy of a pharmacist-led transition of care program in reducing emergency department visits related to the same medication-related event at 6 months com...

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Reposted by Andy Webb

Erin McCreary, PharmD @erinmccreary.bsky.social · 12/04/2025

@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

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Reposted by Andy Webb

Brian Gilbert, PharmD, MBA, FCCM, FNCS, FKCHP @bgundiluted.bsky.social · 08/04/2025

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

media.tenor.com

a man with a beard is holding his head with the words " my brain hurts " written below him

ALT: a man with a beard is holding his head with the words " my brain hurts " written below him

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Andy Webb @ajwpharm.bsky.social · 06/04/2025

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/...

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Andy Webb @ajwpharm.bsky.social · 26/03/2025

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...

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Andy Webb @ajwpharm.bsky.social · 21/03/2025

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/...

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Reposted by Andy Webb

WHO @who.int · 18/03/2025

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.

Measles is preventable with just two doses of measles vaccine.

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Andy Webb @ajwpharm.bsky.social · 18/03/2025

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...

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Andy Webb @ajwpharm.bsky.social · 18/03/2025

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

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Reposted by Andy Webb

Mike Ginn @shutupmikeginn.bsky.social · 08/03/2025

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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Andy Webb @ajwpharm.bsky.social · 06/03/2025

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...

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Andy Webb @ajwpharm.bsky.social · 25/02/2025

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

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Andy Webb @ajwpharm.bsky.social · 24/02/2025

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

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Andy Webb @ajwpharm.bsky.social · 23/02/2025

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

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Andy Webb @ajwpharm.bsky.social · 23/02/2025

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

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Andy Webb @ajwpharm.bsky.social · 23/02/2025

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

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Reposted by Andy Webb

Caitlin Brown @cbthepharmd.bsky.social · 23/02/2025

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

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Andy Webb @ajwpharm.bsky.social · 16/02/2025

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...

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