Alexa Maisenbach, PharmD, BCPS
@alexamarie.bsky.social
ED Pharmacist in the Chicago suburbs 🚑🚨💊Ketamine enthusiast 💉
Surviving but probably not thriving 🌱✨
All views are my own
Surviving but probably not thriving 🌱✨
All views are my own
Everyone is talking about the new AHA cpr guidelines recing against mechanical compression devices. Note the caveat of considering it in settings where high-quality cpr cannot be maintained (think small EMS crews, long transport times). This rec was in the last update and has only changed in LOE!
October 24, 2025 at 7:43 PM
Everyone is talking about the new AHA cpr guidelines recing against mechanical compression devices. Note the caveat of considering it in settings where high-quality cpr cannot be maintained (think small EMS crews, long transport times). This rec was in the last update and has only changed in LOE!
👏👏👏
🚨 @acepnation.bsky.social ED Accreditation Criteria are out & thanks to @saemonline.bsky.social & #AEMP, a pharmacist is now required for all Level 1 & Level 2 sites - THIS is the work we're doing to advance EM pharmacy practice 🙌
www.acep.org/siteassets/s...
www.acep.org/siteassets/s...
April 22, 2025 at 8:34 PM
👏👏👏
Reposted by Alexa Maisenbach, PharmD, BCPS
🔥New EMPHARM-NET DONT EXPAND Study:
💊Propensity-matched, 11 EDs: desmopressin (n=35) vs. controls (n=140)
😷Desmo patients had higher baseline ICH volumes
🧠No difference in good or excellent hemostatic efficacy assessed via hematoma volumes www.sciencedirect.com/science/arti...
💊Propensity-matched, 11 EDs: desmopressin (n=35) vs. controls (n=140)
😷Desmo patients had higher baseline ICH volumes
🧠No difference in good or excellent hemostatic efficacy assessed via hematoma volumes www.sciencedirect.com/science/arti...
March 29, 2025 at 5:45 PM
🔥New EMPHARM-NET DONT EXPAND Study:
💊Propensity-matched, 11 EDs: desmopressin (n=35) vs. controls (n=140)
😷Desmo patients had higher baseline ICH volumes
🧠No difference in good or excellent hemostatic efficacy assessed via hematoma volumes www.sciencedirect.com/science/arti...
💊Propensity-matched, 11 EDs: desmopressin (n=35) vs. controls (n=140)
😷Desmo patients had higher baseline ICH volumes
🧠No difference in good or excellent hemostatic efficacy assessed via hematoma volumes www.sciencedirect.com/science/arti...
Reposted by Alexa Maisenbach, PharmD, BCPS
Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting - Annals of Emergency Medicine www.annemergmed.com/article/S019...
Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting
To determine if ketamine, when added to midazolam for the treatment of out-of-hospital
seizures, is associated with an increase in the rate of cessation of convulsions prior
to hospital arrival.
www.annemergmed.com
March 20, 2025 at 10:36 PM
Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting - Annals of Emergency Medicine www.annemergmed.com/article/S019...
Wonder where they got this dosing?
Neuro/EM/Pharm friends - TNK now FDA-approved for acute ischemic stroke - but the dosing in the package insert? Not the 0.25mg/kg we’ve all been using… is anyone planning to change to this dosing scheme? #EMRx
March 6, 2025 at 4:00 AM
Wonder where they got this dosing?
Considering just about every hospitalized patient gets ceftriaxone? Think it’s more likely that people with cardiac arrests just happened to also get ceftriaxone since we give it like candy 🍬
What’s the #PharmSky take on this? I’m genuinely baffled.
why are my favorite antibiotics always unfairly impugned?
piptazo doesn’t cause renal failure.
ceftriaxone is now being accused of causing cardiac arrest? 🧐
really hard to believe that ceftriaxone is assassinating people (if it were, we should have figured that out a long time ago).
piptazo doesn’t cause renal failure.
ceftriaxone is now being accused of causing cardiac arrest? 🧐
really hard to believe that ceftriaxone is assassinating people (if it were, we should have figured that out a long time ago).
March 6, 2025 at 3:55 AM
Considering just about every hospitalized patient gets ceftriaxone? Think it’s more likely that people with cardiac arrests just happened to also get ceftriaxone since we give it like candy 🍬
Reposted by Alexa Maisenbach, PharmD, BCPS
Everyone, I'm very proud to introduce @medsky.info, the #Medsky Misinformation Labeler. This is intended as a moderation tool to help make our communities safer.
Subscribe to this labeler to identify/block medical misinformation, and report posts you believe contain misinfo for review.
Subscribe to this labeler to identify/block medical misinformation, and report posts you believe contain misinfo for review.
February 7, 2025 at 10:14 PM
Everyone, I'm very proud to introduce @medsky.info, the #Medsky Misinformation Labeler. This is intended as a moderation tool to help make our communities safer.
Subscribe to this labeler to identify/block medical misinformation, and report posts you believe contain misinfo for review.
Subscribe to this labeler to identify/block medical misinformation, and report posts you believe contain misinfo for review.
As needed blood pressure meds probably aren’t needed! More data saying we do more harm by treating blood pressure aggressively acutely in asymptomatic patients.
#emsky #emedsky #foamedsky #medsky
@umemergencymed.bsky.social
#emsky #emedsky #foamedsky #medsky
@umemergencymed.bsky.social
February 9, 2025 at 9:57 PM
Reposted by Alexa Maisenbach, PharmD, BCPS
🚨 Have you joined us formally at
@saemaemp.bsky.social @saemonline.bsky.social
🗓️Have you renewed your @saemonline.bsky.social membership for the year?
🚑If not we would love to have you (re)join us in our journey to advance EM practice.
📷 Scan the QR code to learn more! #EMRx #AEMP #AEMPlify
@saemaemp.bsky.social @saemonline.bsky.social
🗓️Have you renewed your @saemonline.bsky.social membership for the year?
🚑If not we would love to have you (re)join us in our journey to advance EM practice.
📷 Scan the QR code to learn more! #EMRx #AEMP #AEMPlify
January 29, 2025 at 9:00 PM
🚨 Have you joined us formally at
@saemaemp.bsky.social @saemonline.bsky.social
🗓️Have you renewed your @saemonline.bsky.social membership for the year?
🚑If not we would love to have you (re)join us in our journey to advance EM practice.
📷 Scan the QR code to learn more! #EMRx #AEMP #AEMPlify
@saemaemp.bsky.social @saemonline.bsky.social
🗓️Have you renewed your @saemonline.bsky.social membership for the year?
🚑If not we would love to have you (re)join us in our journey to advance EM practice.
📷 Scan the QR code to learn more! #EMRx #AEMP #AEMPlify
Join us tomorrow at 1pm CT for our Journal Club Debate on tenecteplase vs. alteplase for the treatment of massive PE!
Featured Speakers:
Cecilia Schowe, PharmD, MS, BCPS
Natalie Pettit, PharmD
Judah Brown, PharmD, BCCCP, BCEMP
You do NOT need to be a member!
Register:
www.saem.org/detail-pages...
Featured Speakers:
Cecilia Schowe, PharmD, MS, BCPS
Natalie Pettit, PharmD
Judah Brown, PharmD, BCCCP, BCEMP
You do NOT need to be a member!
Register:
www.saem.org/detail-pages...
January 21, 2025 at 5:57 AM
Join us tomorrow at 1pm CT for our Journal Club Debate on tenecteplase vs. alteplase for the treatment of massive PE!
Featured Speakers:
Cecilia Schowe, PharmD, MS, BCPS
Natalie Pettit, PharmD
Judah Brown, PharmD, BCCCP, BCEMP
You do NOT need to be a member!
Register:
www.saem.org/detail-pages...
Featured Speakers:
Cecilia Schowe, PharmD, MS, BCPS
Natalie Pettit, PharmD
Judah Brown, PharmD, BCCCP, BCEMP
You do NOT need to be a member!
Register:
www.saem.org/detail-pages...
Reposted by Alexa Maisenbach, PharmD, BCPS
🚨📢EM Clinicians: Have you heard of anti-amyloid therapies (AATs) for Alzheimer's Disease? Our @AnnalsofEM review explains what you should know, the challenges of recognizing patients, & how AATs impact common ED complaints like AIS & anticoagulant Rx kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
kwnsfk27.r.eu-west-1.awstrack.me
January 17, 2025 at 6:56 PM
🚨📢EM Clinicians: Have you heard of anti-amyloid therapies (AATs) for Alzheimer's Disease? Our @AnnalsofEM review explains what you should know, the challenges of recognizing patients, & how AATs impact common ED complaints like AIS & anticoagulant Rx kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F...
I personally love how the floors will randomly make up a blood pressure cutoff and REFUSE to take a patient unless it’s lower than this arbitrary number 🤷🏼♀️ #emedsky #medsky #pharmsky
I remember as an intern getting calls in the night to give unfamiliar patients intravenous hydralazine for their asymptomatic elevated blood pressure.
Decades later, I'd have thought we know this is harmful and nonsensical, but apparently not entirely. #medsky
jamanetwork.com/journals/jam...
Decades later, I'd have thought we know this is harmful and nonsensical, but apparently not entirely. #medsky
jamanetwork.com/journals/jam...
One-Time and As-Needed Blood Pressure Medication and Adverse Outcomes in VA Hospitals
This cohort study evaluates the risk for acute kidney injury and other adverse effects from as-needed and 1-time blood pressure medications in hospitalized veterans.
jamanetwork.com
January 4, 2025 at 4:01 AM
Reposted by Alexa Maisenbach, PharmD, BCPS
💯 There is deep anxiety about oral antibiotics not being “aggressive” enough with a “severe” infection, with the concern about an error of omission rather than commission. Meaning, a bad outcome by doing less outweighs concerns about a bad outcome by doing more. #IDsky
Though "Oral is the New IV" with antibiotics (h/t @bradspellberg.bsky.social), it's not always easy to convince reluctant inpatient clinicians -- especially (in my experience) surgeons, who want to treat "aggressively".
Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...
Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...
On the Inpatient ID Consult Service, Oral Antibiotics Have a Rocky Road to Acceptance
Having just completed a stint doing inpatient ID consults, I came away impressed with three things: Staph aureus remains the Ruler of Evil Invasive Pathogens in the hospital setting. You can “jinx” a ...
blogs.jwatch.org
January 4, 2025 at 1:31 AM
💯 There is deep anxiety about oral antibiotics not being “aggressive” enough with a “severe” infection, with the concern about an error of omission rather than commission. Meaning, a bad outcome by doing less outweighs concerns about a bad outcome by doing more. #IDsky
Reposted by Alexa Maisenbach, PharmD, BCPS
In @annalsofem.bsky.social we published on the shocking rise in UFH use for PE www.annemergmed.com/article/S019.... We wanted to know why, so we conducted a qual study out in @jama.com and found some interesting things jamanetwork.com/journals/jam... #education #MedSky #EMSky #EMedSky #BlueSky
January 3, 2025 at 4:28 PM
In @annalsofem.bsky.social we published on the shocking rise in UFH use for PE www.annemergmed.com/article/S019.... We wanted to know why, so we conducted a qual study out in @jama.com and found some interesting things jamanetwork.com/journals/jam... #education #MedSky #EMSky #EMedSky #BlueSky
“The bacteria don’t care how the drug got there, just that it did.” Unfortunately, even ID shows reluctance to make the switch. Would love to see more PO! #IDsky
Though "Oral is the New IV" with antibiotics (h/t @bradspellberg.bsky.social), it's not always easy to convince reluctant inpatient clinicians -- especially (in my experience) surgeons, who want to treat "aggressively".
Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...
Interesting dynamic ...
blogs.jwatch.org/hiv-id-obser...
On the Inpatient ID Consult Service, Oral Antibiotics Have a Rocky Road to Acceptance
Having just completed a stint doing inpatient ID consults, I came away impressed with three things: Staph aureus remains the Ruler of Evil Invasive Pathogens in the hospital setting. You can “jinx” a ...
blogs.jwatch.org
January 3, 2025 at 11:51 PM
“The bacteria don’t care how the drug got there, just that it did.” Unfortunately, even ID shows reluctance to make the switch. Would love to see more PO! #IDsky
New year, new membership! Excited to be a part of SAEM! @saemonline.bsky.social #emergencymedicine #saem
January 3, 2025 at 11:19 PM
New year, new membership! Excited to be a part of SAEM! @saemonline.bsky.social #emergencymedicine #saem
Reposted by Alexa Maisenbach, PharmD, BCPS
Shorter Length of Hospital Stay for #Endocarditis After Publication of POET Trial
#CardioSky #IDSky #JACC
@accintouch.bsky.social @jaccjournals.bsky.social
www.jacc.org/doi/10.1016/...
#CardioSky #IDSky #JACC
@accintouch.bsky.social @jaccjournals.bsky.social
www.jacc.org/doi/10.1016/...
December 1, 2024 at 4:53 PM
Shorter Length of Hospital Stay for #Endocarditis After Publication of POET Trial
#CardioSky #IDSky #JACC
@accintouch.bsky.social @jaccjournals.bsky.social
www.jacc.org/doi/10.1016/...
#CardioSky #IDSky #JACC
@accintouch.bsky.social @jaccjournals.bsky.social
www.jacc.org/doi/10.1016/...
Reposted by Alexa Maisenbach, PharmD, BCPS
December 1, 2024 at 5:17 PM
Reposted by Alexa Maisenbach, PharmD, BCPS
Ocular infections are some of the most challenging to treat. Uncertain penetration of systemic antibiotics into ocular tissue, need for intravitreal antibiotics, high risk for vision loss and even enucleation. This review in CID is fantastic. #IDSKY 🧪
academic.oup.com/cid/article/...
academic.oup.com/cid/article/...
State-of-the-Art Review: Ocular Infections
Collaborations between ophthalmologists and infectious disease specialists are critical for optimizing care of many patients with eye infections. We review
academic.oup.com
November 25, 2024 at 8:31 PM
Ocular infections are some of the most challenging to treat. Uncertain penetration of systemic antibiotics into ocular tissue, need for intravitreal antibiotics, high risk for vision loss and even enucleation. This review in CID is fantastic. #IDSKY 🧪
academic.oup.com/cid/article/...
academic.oup.com/cid/article/...
Reposted by Alexa Maisenbach, PharmD, BCPS
The CDC has released the 2025 schedule of recommended immunizations by vaccine/other agents and age group, from birth through 18 years of age. The resource is available at www.cdc.gov/vaccines/hcp...
#IDSky #vaccines #immunizations #pedsID
#IDSky #vaccines #immunizations #pedsID
November 26, 2024 at 9:09 PM
The CDC has released the 2025 schedule of recommended immunizations by vaccine/other agents and age group, from birth through 18 years of age. The resource is available at www.cdc.gov/vaccines/hcp...
#IDSky #vaccines #immunizations #pedsID
#IDSky #vaccines #immunizations #pedsID
Reposted by Alexa Maisenbach, PharmD, BCPS
Oral cephalosporins for pyelonephritis?!
🆕️⚡️⚡️COPY-ED
Multicenter, retrospective study
N=851
No difference in 14-day pyelonephritis treatment failure for oral cephalosporins* vs FQ/TMP-SMX for outpatient pyelonephritis in the ED #idsky #medsky
* Mostly cephalexin
www.sciencedirect.com/science/arti...
🆕️⚡️⚡️COPY-ED
Multicenter, retrospective study
N=851
No difference in 14-day pyelonephritis treatment failure for oral cephalosporins* vs FQ/TMP-SMX for outpatient pyelonephritis in the ED #idsky #medsky
* Mostly cephalexin
www.sciencedirect.com/science/arti...
November 25, 2024 at 12:42 PM
Oral cephalosporins for pyelonephritis?!
🆕️⚡️⚡️COPY-ED
Multicenter, retrospective study
N=851
No difference in 14-day pyelonephritis treatment failure for oral cephalosporins* vs FQ/TMP-SMX for outpatient pyelonephritis in the ED #idsky #medsky
* Mostly cephalexin
www.sciencedirect.com/science/arti...
🆕️⚡️⚡️COPY-ED
Multicenter, retrospective study
N=851
No difference in 14-day pyelonephritis treatment failure for oral cephalosporins* vs FQ/TMP-SMX for outpatient pyelonephritis in the ED #idsky #medsky
* Mostly cephalexin
www.sciencedirect.com/science/arti...
Ton of great literature in the replies! #evidencebasedmedicine
Pretty solid set of literature discussed on rounds today! Always appreciate rounding with people that keep up on studies on can apply to our patients!
a cartoon of spongebob reading a book with a sponge flower in the background
ALT: a cartoon of spongebob reading a book with a sponge flower in the background
media.tenor.com
December 2, 2024 at 2:22 AM
Ton of great literature in the replies! #evidencebasedmedicine
Reposted by Alexa Maisenbach, PharmD, BCPS
Have you seen our report (PMID: 39237721) describing a new binding site for KETAMINE on NMDA receptors?
It explains how low-dose KETAMINE can inhibit mildly and SELECTIVELY tonically active receptors, while leaving unaltered synaptically active receptors.
www.linkedin.com/posts/jacobs...
It explains how low-dose KETAMINE can inhibit mildly and SELECTIVELY tonically active receptors, while leaving unaltered synaptically active receptors.
www.linkedin.com/posts/jacobs...
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo on LinkedIn: #ubuffalo #ketamine #depression #mentaldisorders #nmdareceptors
University at Buffalo researchers — including senior author Gabriela K Popescu, PhD — have identified the binding site of low-dose ketamine, providing critical…
www.linkedin.com
December 1, 2024 at 1:47 PM
Have you seen our report (PMID: 39237721) describing a new binding site for KETAMINE on NMDA receptors?
It explains how low-dose KETAMINE can inhibit mildly and SELECTIVELY tonically active receptors, while leaving unaltered synaptically active receptors.
www.linkedin.com/posts/jacobs...
It explains how low-dose KETAMINE can inhibit mildly and SELECTIVELY tonically active receptors, while leaving unaltered synaptically active receptors.
www.linkedin.com/posts/jacobs...
Reposted by Alexa Maisenbach, PharmD, BCPS
Consciousness is a propofol deficiency
November 12, 2024 at 6:41 PM
Consciousness is a propofol deficiency