In this episode of My Favorite Learners, host Chloe Gomez, DNP, CRNA sits down with Becky Motykiewics, DNAP, CRNA, a pediatric anesthesia expert and educator at Drexel University. Together they break down why “kids are not just small adults,” diving into pediatric pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (volatile agents, opioids, benzos, neuromuscular blockers). From the higher MAC needs of infants to clinical pearls for managing pyloric stenosis and tonsillectomies, this episode gives SRNAs, CRNAs, and anesthesia providers practical insights for caring for neonates and children.

Whether you’re starting your first pediatric rotation or brushing up on safe dosing, you’ll walk away with confidence, memorable analogies, and board-relevant takeaways.

Keywords: pediatric anesthesia, CRNA podcast, pharmacokinetics in pediatrics, pharmacodynamics in pediatrics, SRNA education, neonatal anesthesia, pharmacology podcast, anesthesia pharmacology

In this episode of My Favorite Learners, Chloe Gomez, DNP, CRNA, sits down with Dr. Rhea Temmermand, PhDc, MSN, CRNA, FAANA—neuropharmacology researcher at Drexel University, adjunct professor, textbook co-editor, and co-founder of Atomic Anesthesia—to make pharmacogenetics practical for the OR.

We unpack how genetic variability shapes drug response beyond PK/PD: SNPs, drug targets and transporters, and the CYP450 story (including CYP2D6 phenotypes and why prodrugs like codeine can be risky). Rhea debunks the redhead/CYP2D6 myth, clarifies pseudocholinesterase deficiency with the dibucaine number you’ll see on boards, and walks through malignant hyperthermia (RYR1/CACNA1S) with real cases—plus the team dynamics of giving RYANODEX under pressure. We close with when genetic testing might help, ethical considerations, and Rhea’s evergreen clinical mantra: start low, titrate slow, go multimodal.

Timestamps
00:52 Rhea’s path from clinical CRNA to researcher & educator
08:00 Polymorphisms, CYP450, and phenotype basics
20:30 Pseudocholinesterase deficiency & dibucaine number (boards tip)
27:30 MH recognition, treatment, and RYANODEX in the real world
32:30 Pharmacogenetic testing: utility & ethics
39:00 Practical takeaways for SRNAs & CRNAs

Perfect for: SRNAs prepping for boards, CRNAs updating practice, and anyone curious about precision anesthesia.

In this episode of My Favorite Learners, host Chloe Gomez, DNP, CRNA sits down with Dr. Richard Wilson, DNAP, CRNA, FAANA to explore one of anesthesia’s most urgent crisis scenarios: Local Anesthetic Systemic Toxicity (LAST).

Together, they break down:

• How LAST progresses from early CNS warning signs (tinnitus, metallic taste, agitation) to cardiovascular collapse

• The mechanism of sodium-channel blockade and why high-risk populations (pregnancy, extremes of age, hepatic/renal disease) need extra vigilance

• Prevention strategies: test doses, incremental injection, ultrasound guidance, and crisis checklists

• The history and pharmacology behind lipid emulsion therapy (lipid rescue) and the latest simplified dosing updates

• Adjustments to ACLS protocols specific to LAST (small-dose epinephrine, avoiding vasopressin)

• Practical insights from both OB anesthesia and regional anesthesia practice

Dr. Wilson also shares his journey from practicing CRNA to academic leader, faculty, and mentor through CRNA School Prep Academy, along with timeless advice for anesthesia learners: “The days are long, but the weeks are short.”

Whether you’re a SRNA preparing for boards, a CRNA in clinical practice, or an educator teaching crisis management, this episode will leave you more confident in recognizing, preventing, and treating LAST.

Don’t forget to subscribe, share with your anesthesia colleagues, and check out the ASRA LAST checklist for your own practice setting.