Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.

This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.

This podcast contains general information for educational purposes only. This is not

professional advice and should not be used in lieu of obtaining advice from a qualified health

care provider. And now on to the show. Welcome to Helix Talk episode 83. I'm your co-host

Dr. Kane. I'm Dr. Schumann. And I'm Dr. Patel. And today I'm really excited to bring another kind of mental health-focused topic.

So we're going to talk about flow and fluoxetine, evaluating antidepressant selection in chronic kidney disease.

And really the impetus for this episode actually came from a patient that I had in the ICU probably about a year ago, maybe a little bit longer than that.

So I'm going to kind of present that case as kind of a starting point for what is the clinical

conundrum or scenario associated with using antidepressants in patients with KD or even

ESRD in stage renal disease.

So then we'll kind of look at the importance of accurately recognizing symptoms in patients

with KD, look at the limited available evidence regarding treatment in the population,

and then maybe go on to discuss some of the guidelines and determine what are some of the better

treatment options we have in light of that evidence. So we'll kick it off with a 60-year-old male

who was admitted to the ICU following a multi-system

trauma with massive hemorrhage following a very severe car accident. So this particular patient

was in the hospital at this point for probably about three weeks. His hospital stay was

complicated by a number of surgeries, respiratory failure requiring tracheostomy, and prolonged

ventilator support, a number of infections requiring, again, prolonged courses of antibiotic therapy.

And then finally, his hospital course was complicated by acute kidney injury, eventually resulting

in his need for longer-term hemodialysis support because his renal function

...