Contributor:  Peter Bakes, MD Educational Pearls: Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment For outpatient treatment, antibiotic selection is driven by presence or absence of comorbid health conditions (chronic lung/kidney/liver disease, DM, immunocompromised state, alcoholism, asplenia) No comorbidities: High dose amoxicillin, doxycycline, azithromycin Comorbidities: augmentin, cephalosporin, doxycycline, macrolide with…

Contributor:  Aaron Lessen, MD Educational Pearls: Droperidol for sedation in agitated patients in the emergency department was studied compared to ziprasidone (Geodon) and lorazepam (Ativan) Double-blinded RCT showed droperidol was 65% effective to get patients to a good level of sedation in 15 minutes compared to ativan and geodon which were 25-35% effective Droperidol had…

Contributor: Dylan Luyten, MD Educational Pearls: D10 may be a better alternative to D50 in correcting hypoglycemia Risks of D50:  Can cause extravasation injury Risk of rebound hypoglycemia D10 does not have the same risks and has no significant difference in reversal time of hypoglycemia compared to D50 References Kiefer MV, Gene Hern H, Alter…

Educational Pearls: The CDC has made new formal recommendations for treating Gonorrhea due to increasing resistance to Rocephin and Azithromycin. New recommendations: Confirmed gonorrhea: Ceftriaxone 500 mg once Empiric treatment: Ceftriaxone 500 mg once followed by 7 days Doxycycline 100 mg BID No longer using Azithromycin due to high resistance Second line: Gentamycin IM Cefixime…

Contributor: Don Stader, MD Educational Pearls: Zyprexa (olanzapine) is a second generation antipsychotic with multiple other uses Excellent for treating nausea in patients undergoing chemotherapy or with THC hyperemesis syndrome Helps with the psychological and emotional aspect of pain Effective in treatment of headaches Can be given under the tongue Fewer incidences of dystonic reactions…

Contributor: Sam Killian, MD Educational Pearls: Droperidol (Inapsine) is an antipsychotic drug with efficacy for  nausea, vomiting, headaches, and treating agitation In the early 2000’s, Droperidol received a black box warning for QT prolongation This caused a precipitous drop of in administration and ultimately led to a stop in production More careful analysis since has…

Contributor: Aaron Lessen, MD Educational Pearls: True allergies to penicillin compared to reported allergies from patients ranges around 10% Recent study took patients undergoing sensitivity tests and developed the PEN(icillin)-FAST score to address reported penicillin allergies PEN-FAST has four components for a total score of 0-4: o   F = five years or less since…