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Pharmacy to Dose: The Critical Care Podcast
July 2024 Literature Review Series
Nov 26, 2024
Camille Casillas, a PGY2 Critical Care Pharmacy resident at MD Anderson, and Sarah Sindelar, also a PGY2 at Nebraska Medicine and an active voice on Twitter, dive into vital literature from July 2024. They discuss the TRACE III trial's impact on stroke protocols and innovative anticoagulation practices. The conversation shifts to the management of opioid-induced constipation with naloxegol versus methyl naltrexone. With a light-hearted mention of college football loyalty, they weave critical care insights into an engaging narrative.
01:37:33
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Quick takeaways
- The TRACE-3 trial indicates that administering tenecteplase within a 4 to 24-hour window significantly improves outcomes for acute ischemic stroke patients without access to thrombectomy.
- Results from the CONVINCE trial showed low-dose colchicine did not significantly affect stroke outcomes, yet it reduced C-reactive protein levels, hinting at possible anti-inflammatory properties.
Deep dives
Extended Treatment Windows for Acute Ischemic Stroke
Intravenous thrombolytic treatment, specifically with tenecteplase, is explored for acute ischemic strokes beyond the traditionally accepted treatment window of 4.5 hours. The TRACE-3 trial focused on administering tenecteplase within a 4 to 24-hour window for patients without access to mechanical thrombectomy. Results showed a significant increase in the absence of disability at 90 days among patients treated with tenecteplase compared to standard therapy. This trial highlights the need for further research into the efficacy of extended window treatments for large vessel occlusion strokes, particularly in populations lacking access to timely interventional procedures.
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