Utility of Nebulized Naloxone
May 29, 2021
Background Naloxone can be administered via multiple routes, with nebulization gaining popularity in the past decade. A previous ALiEM Trick of the Trade presented this...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP
ACMT Toxicology Visual Pearl: Questions about green pee? Urine luck!
May 26, 2021
Which of the following medications is likely responsible for this urine discoloration in an intubated and sedated ICU patient? Fentanyl Ketamine Lorazepam Midazolam Propofol ...
Clare Gunn, MD
Bupropion Overdose: Factors Associated with Seizures
May 8, 2021
Background Bupropion ingestions are one of the scarier poisonings due to a relatively narrow therapeutic index and the numerous adverse effects that may occur. Medical...
One-Time Vancomycin Doses in the Emergency Department
May 1, 2021
Background A previous ALiEM post from 2013 by an EM pharmacist colleague argued the case against one-time vancomycin doses in the ED prior to discharge....
Safety and Efficacy of Clevidipine for Acute Blood Pressure Control
April 24, 2021
Background Rapid and precise control of blood pressure is vital for patients with a hypertensive emergency or an acute stroke. Commonly, nicardipine is utilized in...
Mike O'Brien, PharmD
Droperidol for Agitation in Older Adults in the Emergency Department
April 17, 2021
Droperidol is safe and effective for the treatment of severely agitated patients in the ED [1-3]. But what about its use for agitation in elderly...
Is Lactated Ringer’s Solution Safe for Hyperkalemia Patients?
April 10, 2021
Background There are three primary fluids used for resuscitation, each contains varying amounts of potassium per liter (Table 1): 0.9% Sodium Chloride (normal saline) Lactated...
ACMT Toxicology Visual Pearls – In “Spore” Taste
April 7, 2021
A 15-year-old male presents symptomatic several hours after inhaling spores of this mushroom as a home remedy for epistaxis. What is the presentation and pathophysiology...
Bryan Ross, MD
ACMT Toxicology Visual Pearls – Necrotic Spider Bite
February 10, 2021
A patient bitten by the pictured creature with the pictured lesion should be screened for which pathology? Acute liver failure Ascending paralysis Hemolysis Meningitis Myocarditis...
Michael Simpson, MD
Colchicine Toxicity: A New Threat from COVID-19 Treatments
January 30, 2021
In the continued fight against COVID-19, a January 22, 2021 press release from the Montreal Heart Institute touted the potential of colchicine, citing results from...
2020 ACLS Guidelines on Medications for Toxicology-Related Conditions
January 23, 2021
The 2020 ACLS guidelines provide recommendations on the medication-specific management recommendations for toxicology [1]. Although the name of the guidelines emphasize they are ‘Advanced,’ these...
2020 ACLS Guidelines on Medications for Management of Specific Arrhythmias
The 2020 ACLS guidelines provide recommendations on the medication-specific management for arrhythmias including wide-complex tachycardia, regular narrow-complex tachycardia, atrial fibrillation/flutter, and bradycardia [1]. There are...