Pharmacology

Podcast # 463: Buproprion Overdose

Author: Erik Verzemnieks, MD Educational Pearls: Buproprion is used as an antidepressant and for smoking cessation Severe buproprion overdoses can cause seizures and lead to cardiac dysrhythmias Benzodiazepines are treatment of choice for seizures Bicarbonate and Interlipid are also possible treatment options with less evidence References Stall N, Godwin J, Juurlink D. Bupropion abuse and…

Read More

Podcast # 463: Buproprion Overdose

Podcast # 462: Death after OD

Author: Don Stader, MD Educational Pearls: 10% of patients seen in the emergency department for opioid overdose patients will die within a year Half of these overdoses will occur in the next month This mortality rate is higher than patients with STEMI, of which 7% will die within one year Take-home naloxone, as well as…

Read More

Podcast # 462: Death after OD

Podcast # 459 Clonidine Ingestion

Author:  Julian Orenstein, MD Educational Pearls:   Severe clonidine ingestion can present as a fluctuating mental status between typically accompanied by changes in vital signs (hypotension/bradycardia) Respiratory depression requiring intubation is not uncommon   References Isbister GK, Heppell SP, Page CB, Ryan NM. Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not…

Read More

Podcast # 459 Clonidine Ingestion

Podcast # 458: A Tylenol a Day Keeps the Delirium Away?

Author: Nick Hatch, MD Educational Pearls:   A recent study investigated the effect of scheduled IV acetaminophen on the incidence of delirium in post-CABG patients in the ICU The use of scheduled IV acetaminophen reduced the rate of delirium in these patients compared to placebo This may be due to the analgesic effect of acetaminophen…

Read More

Podcast # 458: A Tylenol a Day Keeps the Delirium Away?

Podcast # 455: Hunting for PeeCP

Author: Michael Hunt, MD Educational Pearls:   Like all tests, urine toxicology (utox) screens can have false positives Prescription medications such as demerol, antipsychotics, ketamine, and tramadol can all produce a false positive utox for PCP Over-the-counter medication such as dextromethorphan also mimic PCP on utox   References Doyon S. (January 2014). False Positive Urine…

Read More

Podcast # 455: Hunting for PeeCP

Podcast # 454: Tylenol Overdose

Educational Pearls:   Acetaminophen overdose can also present in patients taking too much over the course of days to weeks – not just intentional ingestions If acute overdose is suspected, refer to the Rumak-Matthew nomogram to guide treatment based on time of ingestion and the time of level In chronic overdose, Tylenol levels will not…

Read More

Podcast # 454: Tylenol Overdose

Podcast # 451: NSAIDs

Author: Don Stader, MD Educational Pearls: Non-steroidal anti-inflammatory drugs (NSAIDs) are effective pain relievers but come with important side effects NSAIDs inhibit COX-1 and/or COX-2, which decreases the production of prostaglandins, which reduce pain and inflammation Side effects of NSAIDS include increased rates myocardial infarction, stroke, and gastrointestinal bleeding, CVA Effective pain reliever doses of…

Read More

Podcast # 451: NSAIDs

Podcast # 450: Probiotics in Gastroenteritis

Author: Sam Killian, MD Educational Pearls: Viral gastroenteritis alters the gut microbiome and it is theorized that probiotics may help reduce the duration and severity of the disease. Double-blind randomized controlled trial involving almost 900 children with viral gastroenteritis compared 5 days of probiotics to a control group. There was no difference in the rates…

Read More

Podcast # 450: Probiotics in Gastroenteritis

Podcast #447:  IV Tylenol

Author: Dylan Luyten, MD Educational Pearls: Recent randomized controlled trial compared intravenous to oral acetaminophen in emergency department patients There was no difference in pain relief between the groups While the actual acquisition cost of these drugs are not significant, the cost multipliers that are passed onto patients lead to real dollars With the significant…

Read More

Podcast #447:  IV Tylenol

Podcast # 439 : Oops I did it again

Author: Aaron Lessen, MD Educational Pearl: A double ingestion of a single pill is typically a benign event but several drug classes may cause problems A published review of 10 years of single medication double dose ingestion found 12 out of 876 cases had adverse events. The drugs and events were: Propafenone ingestion leading to…

Read More

Podcast # 439 : Oops I did it again

 

Stay up to date by
joining our mailing list!