Neurocritical Care Society

Leading Insights

Leading Insights, Pharmacy

Cefepime’s Double-Edged Sword: Neurotoxicity in Critically Ill Patients

Written By: Michelle Payne, PharmD, BCCCP

As a fourth-generation anti-Pseudomonal cephalosporin, cefepime is one of the first-line antimicrobials used to treat various hospital-associated...

Leading Insights, Pharmacy

Cangrelor Use in Neurointerventional Radiology: Tackling the Unknowns

Written By: Catherine Donaldson, PharmD, PGY2 ; Veronica Bonderski, PharmD, BCCCP

The use of antiplatelet agents, such as P2Y12 inhibitors, is standard care in the management of numerous neurological pathologies and...

Leading Insights, Pharmacy

Communication After Isolation: The Challenge of Re-Engaging Family Members in Neurocritical Care

Written By: Elaina Etter, PharmD

Communication is a cornerstone of patient care. We are taught that patient-centered care requires trust, which can only be fostered if both...

Leading Insights, Pharmacy

Don’t Be Afraid of the Dark: Neurocritical Care Pharmacy at Night

Written By: Brittny Medenwald, PharmD, BCCCP; Jessie Lipstreuer, PharmD

Healthcare workers face unique challenges during evening and overnight hours: an abundance of unplanned intensive care unit (ICU) admissions,...

Leading Insights, Pharmacy

Transitioning Alteplase to Tenecteplase for Acute Ischemic Stroke

Written By: Brian Gilbert, PharmD, MBA, BCPS, BCCCP; Danielle Murray, PharmD; Peter Tran, PharmD; Kathryn Qualls, PharmD, BCPS, BCCCP

The transition from alteplase (ALT) to tenecteplase (TNK) in the management of acute ischemic stroke (AIS) has been an exciting and...

Leading Insights, Pharmacy

Bringing Neurocritical Care to Rural Virginia: Considerations When Transitioning to Tenecteplase for Acute Ischemic Stroke

Written By: Ashley Asbell, PharmD

In August 2022, I started a new job as a pharmacist at a small, rural community hospital not too far from where I trained. I completed two years...

Leading Insights, Pharmacy

Please Pass the Salt: Rapid Access to Hypertonic Saline and Considerations During Shortage

Written By: Lindsey Coppiano, PharmD, BCCCP; Jessica Ringler, PharmD, BCCCP

Hypertonic solutions are high risk yet life-saving medications which can make the difference between a good or poor outcome during a neurologic...

Leading Insights, Pharmacy, Resident/Fellow

Invited Clinical Pharmacist (ICP) Program

Written By: Scott DeBoer, MD, PhD; Salia Farrokh, PharmD; Melissa Dang, PharmD

The ICP program was designed and implemented in 2017 to provide NCS members a venue to initiate or expand clinical pharmacy services in the neuro...

Leading Insights, Pharmacy

Pediatric Neurology/Neurocritical Care Clinical Pharmacy Specialist: A Consult Service Aiding in Transitions of Care of Patients with Epilepsy

Written By: Renad Abu-Sawwa, PharmD, BCPPS

“When you adjust for hypoalbuminemia, his phenytoin level was therapeutic at 17.5 mcg/mL following his fosphenytoin load. In addition to...

Leading Insights, Pharmacy

Neuropharmacology Training for the Neurologist in the Neurocritical Care Unit: Multidisciplinary Situated Learning

Written By: Steven Lazar, MD; Jon Cokley, PharmD, BCPPS

Best practices in neurocritical care emphasize a multidisciplinary approach (Moheet et al., 2018). While various medical training pathways have...

Leading Insights, Pharmacy

Cleaning Up the Clutter: Polypharmacy Consults in Neurocritical Care Patients: A Pediatrics Experience

Written By: Marry Vuong, PharmD, BCPPS

Introduction Rates of chronic conditions in pediatric patients are steadily increasing and the medications used to treat these conditions are...

Leading Insights, Pharmacy

Dosing of Prothrombin Complex Concentrate in Factor Xa Inhibitor-Associated Intracranial Hemorrhage

Written By: Brian Gilbert, PharmD, MBA, BCCCP, BCPS; Brooke Barlow, PharmD; J. Spencer Dingman, PharmD, BCCCP

Optimal reversal strategies for factor Xa (FXa) inhibitor-associated intracranial hemorrhage (ICH) have garnered much attention in recent years....

Leading Insights, Pharmacy, International

Clinical Pharmacy Services in Neurocritical Care Units: The Experience from the MENA Region

Written By: Dana Bakdach; Farah Kablaoui; Nouran Salem; Rita Jebrin; Maha Elhamid

Background In the Middle East and North Africa (MENA), the scope of clinical pharmacy practice is relatively new and emerging. Several...

Leading Insights, Pharmacy

A World of Difference: A Pharmacist’s Perspective on Racial and Ethnic Diversity in Neurocritical Care

Written By: Sarah Jung, PharmD, MS, BCCCP

The rise of the COVID-19 pandemic in 2020 was also accompanied by the peak of the Black Lives Matter movement. According to the U.S. Census...

Leading Insights, Pharmacy

What is the Optimal Duration of Nimodipine for Aneurysmal Subarachnoid Hemorrhage?

Written By: Jocelyn Owusu-Guha, PharmD, BCCCP; Pamela Buschur, PharmD, BCPS

Nimodipine, a lipophilic calcium channel antagonist, has been established as a standard of care in the management of aneurysmal subarachnoid...

Leading Insights, Pharmacy

Hyperchloremia in the Neurocritically Ill Patient

Written By: Shivani Ghoshal, MD; Caroline Der Nigoghossan, PharmD, BCCCP

Intravenous crystalloid administration is one of the most common interventions performed in critically ill patients. However, during the last...

More Leading Insights

Leading Insights

The Magnetic Power of the Future: The Iseult CEA 11.7 T MRI

Written By: Shane Musick, MD; Nilufer Yalcin, MD

The Iseult CEA 11.7 Tesla (T) MRI machine marks a significant leap forward in magnetic resonance imaging, offering unmatched magnetic field...

Leading Insights, Ethics

Who Invited Legal Into the Peer Review Conference?

Written By: Krista Lim-Hing, MD; Alexandra Reynolds, MD; Daryl McHugh, MD; Julia Durrant, MD; Matthew N. Jaffa, DO

When asking physicians to reflect on their years of medical training, it is rare to find one without a formative memory connected to a morbidity...

Leading Insights

Tricks of the Trade: A Stepwise Approach to Managing Post-TBI Agitation

Written By: Christine Picinich, MS, AGACNP-BC, CCRN

Patients with traumatic brain injury (TBI) commonly develop agitation during their recovery.