July 2022

Volume, Frequency of IV "Hidden Fluids" in ICU Patients
Fluid stewardship involves promoting the appropriate use of fluids to prevent adverse outcomes. "Hidden fluids," which are defined as blood products, enteral nutrition, IV medications, diluents, and flushes, are often overlooked when calculating fluid requirements. This is because these products' volumes are generally not specifically prescribed and may contribute to fluid overload in the unstable ICU patient. Read more.


Reviewing Monoclonal Antibody Adverse Effects
Monoclonal antibody therapy has revolutionized the management of oncologic and immunologic diseases. However, they also are associated with adverse effects. In a comprehensive review of adverse effects of 110 agents that have been approved by FDA and/or by the European Medicines Agency, the authors identified both immune- and nonimmune-mediated adverse reactions associated with these drugs. Read more.

Clinic-Based Real-World Experience With IV Ketamine for Depression
While esketamine, the S-isomer of ketamine, is approved by the FDA for treatment-resistant depression and major depressive disorder with suicidality, IV ketamine—a mixture of R- and S-isomers—remains off-label for this indication. In a position paper, the American College of Clinical Pharmacy expressed concern about the inherent unfavorable risk-benefit profile of off-label ketamine. Read more.

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