Toxicology

Podcast #42: Andexanet for Xarelto?!

Run Time: 2 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Eliquis and Xarelto are oral anticoagulants that inhibit the clotting cascade. Currently prothrombin complex concentrate or PCC can be used to reverse the effects of Xarelto or Eliquis by overpowering the inhibition of the clotting cascade. Andexanet is a medication currently in phase III trials that is…

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Podcast #39: Propranolol Overdose

Run Time: 4 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Propranolol overdose presents with bradycardia, hypotension, decreased activity, and decreased body temperature. Propranolol is a lipophilic beta-blocker. Appropriate reversal agents for overdose on propranolol are epinephrine, dopamine, glucagon, calcium, levophed, and an IV lipid sink to sequester the propranolol. In cardiogenic shock, the heart begins…

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Podcast #29: Management of Stingray Injuries

Run Time: 3 minutes Author: Dr. Eric Miller Educational Pearls: Do not urinate on the stingray envenomation site – does not work for jellyfish either. First, wash the wound thoroughly with warm, not hot, water to denature the proteins in the venom. Second, care for the penetration wound and explore for a foreign body with…

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Podcast #26: Salicylate and Camphor Poisoning

Run Time: 2 minutes Author: Dr. John Winkler Educational Pearls: Camphor from Vicks Vapor rub and Tigerbalm has a very low toxic level and can cause lethargy, altered mental status, and seizures – very dangerous for children. Oil of Wintergreen contains Salicylates – basically aspirin – which only takes 1 teaspoon to be deadly for…

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Podcast #15: Ketamine!

Run Time: 4 minutes Author: Dr. Michael Hunt Educational Pearls: Ketamine is a dissociative anesthetic that can be used for sedation, anesthesia, or to calm down agitated patients. Can be given IV at 1-2 mg per kilo or IM at 4-5 mg per kilo every ten minutes and will last anywhere from five to thirty minutes…

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Podcast #12: TXA in the ED

Run Time: 3 minutes Author: Dr. Nicholas Hatch Educational Pearls: TXA is short for tranexamic acid. Most often use in the ED is with severe bleeding or problematic bleeding associated with trauma. Crash II trial determined the benefit of TXA is only applicable for about three hours after a trauma. Typical dosing is 1 gram in…

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Podcast #7: Heroin Overdose and OTC Narcan

Run Time: 4 minutes Author: Dr. Donald Stader Educational Pearls: Mexico is number 2 in opium production in the world – Opioids now kill more people than car accidents in the United States. Heroine originally marketed as a less addictive form of Morphine – actually more addictive. 20 in 100,000 deaths in CO are due to…

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Podcast #4: Isopropyl Alcohol for Nausea

Run Time: 5 minutes Author: Dr. Donald Stader Educational Pearls: Can be inhaled for relief from nausea – works for approximately 50% of people within 10 minutes. Administered by cupping the swab in the hands and inhaling through the nose and exhaling out of the mouth. Works through a process known as olfactory distraction, but it…

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Podcast #2: Buprenorphine

Run Time: 4 minutes Author: Dr. Jared Scott Educational Pearls: Semi-synthetic methadone used for chronic pain and nausea treatment. Partial agonist to opioid receptors, which decreases respiratory depression – theoretically decreases likelihood of respiratory arrest in a patient who overdoses. Patients on Buprenorphine chronically need Sufentanil for surgery – 10 times more potent than Fentanyl and…

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