Pharmacology Archives - Page 3 of 9 - The Emergency Medical Minute

Pharmacology

Colorado MAT Part 3: Medications for MAT in the ED

There are three MAT drugs available to treat addiction: naltrexone (brand name Vivitrol), methadone (brand names Dolophine or Methadose) & buprenorphine (brand name Suboxone, Subutex, and Sublicade). The only MAT drug appropriate for initiation in the ED is buprenorphine. Buprenorphine is a semi-synthetic opioid which acts as partial agonist at the mu receptor. Buprenorphine does…

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Colorado MAT Part 2: Medication Assisted Treatment

Medication Assisted Treatment or (Medication for Addiction Treatment) is an important frontier in ED care of patients with Opioid Use Disorder. Naltrexone, methadone and buprenorphine are the medications approved for the treatment of OUD. Addiction is a disease that is widely misunderstood and rarely taught in medical school. It is a dangerous myth that the…

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Colorado MAT Part 1: Understanding Addiction & Opioid Use Disorder

Addiction is widely misunderstood by the public and by many healthcare providers. It is not taught in most medical schools. Combating the opioid epidemic will require providers to understand Opioid Use Disorder (OUD) and its treatment. Addiction is a chronic, relapsing disease with extraordinarily high morbidity and mortality. It is the transition from controlled to…

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Podcast # 496: Hallucinogens

Author: David Holland, MD Educational Pearls: Hallucinogenics have been used for a variety of cultural and religious reasons for thousands of years In the 1960’s a Harvard professor began experimenting with psilocybin mushrooms. There was resulting public outcry, eventually leading to all hallucinogens being listed as schedule I drugs Common hallucinogens include: LSD (acid), Mescaline…

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Podcast # 492: Pain While on Buprenorphine

Contributor: Don Stader, MD Educational Pearls: Buprenorphine is a partial Mu-agonist and binds with higher affinity than most opioids Pain management with opioids therefore can be difficult in patients taking buprenorphine Ketamine is a good option for pain control in these patients You can also consider using additional buprenorphine Intravenous buprenorphine is dosed differently than…

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Podcast # 491: Buprenorphine for Withdrawal

Educational Pearls: Buprenorphine is a semi-synthetic derivative of the opium poppy FDA approved for the treatment of opiate use disorder and chronic pain Benefit in emergency department use is the ceiling effect – producing less euphoria as well as respiratory depression with higher doses It has an onset of 30-60 minutes, peak effect at 1-4…

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Podcast # 488: Dalbavancin

Contributor: Nick Hatch, MD Educational Pearls: Dalbavancin (Dalvance®) is an antibiotic that can be used for skin and soft tissue infections, providing MRSA coverage It cannot be used in other infections or sepsis Dalbavancin may be appealing as a single dose lasts about 2 weeks Expense is currently a large barrier to use Patients with…

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Podcast # 484: Elevated ICP

Contributor: Charleen Gnisci, PharmD Educational Pearls: Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma.  While definite treatment is to remove the offending cause, there are emergency medicine   Non-pharmacologic methods include elevating head of bed and removing noxious stimuli Pharmacologic options include mannitol and hypertonic saline Hypertonic saline is best delivered through…

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Podcast # 483: Dual Antiplatelet Therapy in TIA

Contributor: Don Stader, MD Educational Pearls: Antiplatelets include Aspirin and Clopidogrel, and are generally used for arterial clotting (MI, stroke) Anticoagulants such as Coumadin, Xarelto, Eliquis are generally used for venous clotting (DVT/PE) Growing data suggests that dual antiplatelet therapy (Aspirin+Clopidogrel) is superior to aspirin alone in reducing stroke for diagnosed with TIA References: Kheiri…

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Podcast # 482: Tetracyclines and Hyperpigmentation 

Contributor: Michael Hunt, MD Educational Pearls: Tetracycline antibiotics such as minocycline can cause greyish hyperpigmentation This hyperpigmentation can sometimes be reversible but not always Minocycline has been used for its effects in autoimmune and neurological diseases, where it is  often taken chronically, which can lead to increased pigmentation   References La Placa M, Infusino SD, Balestri…

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