SCCM Resource Library-November Journal Club: Spotlight on Pharmacy (2025)

Video Transcription

Video Summary

This Journal Club Spotlight on Pharmacy webcast featured three key presentations addressing critical care pharmacotherapy challenges. <br /><br />Lauren Koback discussed early aspirin withdrawal after PCI in acute coronary syndrome (ACS) patients. She reviewed a multicenter randomized trial evaluating potent P2Y12 inhibitor monotherapy versus standard dual anti-platelet therapy (DAPT) with aspirin plus P2Y12 inhibitors post-PCI. Results showed monotherapy was not non-inferior to DAPT for preventing ischemic events, with an increased risk of adverse outcomes, especially early post-procedure. However, bleeding was lower with monotherapy. Subgroup analyses suggested certain patients (e.g., STEMI, males without diabetes, single PCI) benefited more from DAPT. The study emphasizes individualizing antiplatelet therapy based on ischemic vs. bleeding risk.<br /><br />Morgan Crawford compared quetiapine and haloperidol for ICU hyperactive delirium in a double-blind RCT of 100 patients. Both drugs showed similar efficacy in reducing delirium severity by day 3, but quetiapine led to better sleep and shorter ICU stays by day 7 with fewer extrapyramidal side effects, making it a reasonable alternative to haloperidol in ICU patients without imminent safety risks.<br /><br />Jillian LaChapelle presented a retrospective study evaluating opioid requirements in mechanically ventilated patients on buprenorphine/naloxone prior to admission. Findings indicated these patients had similar opioid needs as opioid-naive patients and lower needs than opioid-tolerant patients. Most institutions do not address OUD pain management in protocols. The study highlights the need for prospective research on continuing buprenorphine during critical illness to optimize analgesia and withdrawal prevention.<br /><br />Overall, the webcast underscored the importance of individualized therapy decisions in critical care based on patient risk profiles, pharmacologic nuances, and clinical context.

Asset Subtitle

Pharmacology, Cardiovascular, Neuroscience

Meta Tag

Content Type Webcast

Knowledge Area Pharmacology

Knowledge Area Cardiovascular

Knowledge Area Neuroscience

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Delirium

Tag Analgesia and Sedation

Tag Acute Coronary Syndrome

Year 2025

Keywords

Webcast

Pharmacology

Cardiovascular

Neuroscience

Delirium

Analgesia and Sedation

Acute Coronary Syndrome

2025

Associate

Professional

Select

early aspirin withdrawal

P2Y12 inhibitor monotherapy

dual anti-platelet therapy

ICU hyperactive delirium

quetiapine vs haloperidol

opioid requirements

buprenorphine/naloxone

critical care pharmacotherapy

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