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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 · 25/02/2026

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

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Andy Webb @ajwpharm.bsky.social · 25/02/2026

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 ???

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

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/

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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

Always ahead of your time 😂

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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

Confirmed with some good sources that this is indeed true 🫣

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

Truly the Xigris of the 2020s

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

Not "official" but I've seen it independently a few times now. That or we're all just sharing the same fake letter lol

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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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Reposted by Andy Webb

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

Mortal Kombat: Pharmacology

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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 · 21/11/2025

But don't worry, CHIROPRACTORS made the list Ffs

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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

Really eye opening - carbapenem resistance is just another day in the office for so much of the world

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

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

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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 · 17/10/2025

I miss that commute so much 😩

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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 · 27/09/2025

Simple solution - import the safe European analgesic paracetamol!

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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 · 30/08/2025

This has always perplexed me lol Love breaking the vicious cycle of "they're agitated because of the vent" -> increased propofol -> "they need the vent because of their propofol requirement"

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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

These cases are brutal. If you can get them through the worst of it, I've seen some incredible recoveries even after being in a coma for 1-2+ weeks We will sometimes use siltuximab (IL6 antibody) instead of tocilizumab because it avoids the theoretical IL6 sequestration risk

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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 · 02/05/2025

I'm a little biased as a contributing author, but this book was recently published on critical care pharmacotherapy. It's a bit more detailed than CCP so should have some more pharmacology content, although it's not specifically a pharmacology book. link.springer.com/book/10.1007...

link.springer.com

The Pharmacist's Expanded Role in Critical Care Medicine

This book helps critical care pharmacists develop a clinical sense to assist with evaluation, diagnosis, and provide better pharmacotherapy interventions.

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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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