Pharmacology Archives - Page 11 of 13 - The Emergency Medical Minute

Pharmacology

Podcast # 336: Hypokalemia

Author: Dylan Luyten, MD Educational Pearls: Most important questions to answer with low potassium are 1. What are their symptoms? 2. Can they take potassium by mouth? Oral repletion is faster, cheaper, and more effective than IV repletion. Give IV potassium when patients have K < 2.5 mmol/L or present with arrhythmias and/or characteristic EKG…

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Podcast #332: Door To Furosemide Time

Author: Nick Hatch, MD Educational Pearls: Recent study argues that CHF patients receiving furosemide within 60 minutes of arrival had a lower in-hospital mortality than those receiving it after (2.3% vs. 6.0%, p=0.002). A flaw in the study is that there were significant baseline differences between groups. References: Matsue Y et al. Time-to-Furosemide Treatment and…

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Podcast # 331: Oral Rehydration Therapy (ORT)

Author: Nick Hatch, MD Educational Pearls: The sodium-glucose cotransporter in the gut is essential for rehydration. Oral rehydration therapies require an equimolar concentration of glucose and sodium to be effective. ORT has saved millions of lives globally. Consider using ORT in patients with dehydration. Especially useful in resource limited settings. References: Victora CG, Bryce J,…

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Podcast #324: Superwarfarin

Author: Rachel Beham, PharmD Educational Pearls: Some synthetic cannabinoids have been contaminated with Brodifacoum. Brodifacoum is a Vitamin K antagonist and can present with a severe coagulopathy. Brodifacoum is commonly known as “superwarfarin” and has a very long half life of 120+ days. Check PT/INR in patients with a bleeding diathesis in setting of synthetic…

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Podcast #310: Bicarb in DKA

Author: Gretchen Hinson, M.D. Educational Pearls: Controversial topic. Pathophysiology – acidosis leads to an extracellular potassium shift. Patients in DKA will be intracellularly potassium deplete, but will have a falsely normal/elevated serum potassium. 3 risk of giving bicarb in DKA – alkalosis will drive potassium intracellularly but can overshoot (hypokalemia) and  increase risk of arrhythmias;…

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Podcast #306: Tramadol Drama

Author: Nick Hatch, M.D. Educational Pearls Tramadol acts at multiple receptors and is a partial agonist at the mu opioid receptor, but also blocks reuptake of serotonin and norepinephrine throughout the body among others.   One major side effect to be aware of is that it lowers the seizure threshold. Useful in setting of pain…

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Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Author: Aaron Lessen, M.D. Educational Pearls A “stuffer” is a term for someone who hastily and conceals a bag of drugs orally/rectally/vaginally in an unplanned situation. A “packer” is someone who is planning to smuggle drugs, and does so in a similar manner.   “Stuffers”are more likely to have the drug container open up in…

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Podcast #300: Probiotics

Author: Peter Bakes, M.D. Educational Pearls Probiotics are living bacteria that are taken as an oral supplement. Most of the data to support their use is in the prevention of antibiotic-related diarrhea and the reduction of the symptoms of ulcerative colitis (UC). Some studies have some a reduction of the incidence of antibiotic-related diarrhea in…

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Podcast #297: Truvada

Educational Pearls Truvada (Emtricitabine/tenofovir) is a combination nucleotide reverse transcriptase inhibitor that can be used as pre-exposure prophylaxis (PrEP) for HIV. It has been shown to dramatically reduce the risk of contracting HIV. It is used in high-risk patients, like the MSM community or those who are in a relationship with someone with HIV. Side…

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Podcast #296: Synthetic Cannabinoids

Author: Rachael Duncan, PharmD Educational Pearls A NEJM study report in July 2016 discussed a situation in New York during which 30 people became “zombie-like” after ingesting synthetic cannabinoids (aka “Spice). The ER managed to coordinate with the CDC to evaluate  blood samples from 18 patients who were transported to the hospital. Of those who…

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