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A patient presents to the emergency department complaining of increasing insomnia due to anxiety. She states that she is not actively suicidal nor homicidal but she has trouble “turning off...
William Paolo, MD |
Whether alteplase (tPA) is given for ischemic stroke, pulmonary embolism, or STEMI, there is an important practical issue to be aware of during administration. Dr. Charles Bruen (@resusreview) published a...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Local anesthetics (LAs) are widely employed to achieve tissue infiltration, peripheral and regional anesthesia, and neuraxial blockades. Despite their well-established toxic dose limits, these agents continue to pose a substantial...
David Murphy |
Rate control with IV medications is recommended for atrial fibrillation in the acute setting in patients without preexcitation. This was a Class 1 recommendation (Level of Evidence B) per the 2014 AHA/ACC/HRS Guideline...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
There are a few reasons why piperacillin/tazobactam (Zosyn) is not usually my first choice for a broad-spectrum gram-negative agent in the ED. First, at my institution, the Pseudomonas aeruginosa susceptibilities to pip-tazo are lower...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
A new antibiotic will soon be approved for skin and soft tissue infections (SSTIs): dalbavancin. The company behind the drug will likely begin marketing heavily to emergency physicians as many patients...
Zlatan Coralic, PharmD |
The acute episode of intoxication and agitation has subsided and your patient is calm. She has been medically cleared and is ready to be moved to a less acute, less...
Jill Logan, PharmD BCPS |
Sometimes, in an effort to make things simpler, we actually make them more confusing. Such is the case with phenytoin equivalents. Fosphenytoin is a water-soluble prodrug of phenytoin. After IV...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Over the last 5 years, the use of neuraminidase inhibitors for the treatment of influenza has skyrocketed. Emergency physicians have been pushed to prescribe these medications under the belief that...
Anand Swaminathan, MD MPH |
Fluoroquinolones are a widely used class of antibiotic that are effective in treating a wide variety of infections. Despite their popularity there is increasing concern regarding to the potential complications...
Matthew DeLaney, MD |
There is significant practice variability when providers are asked to determine if a patient is intoxicated. Some providers will evaluate a patient to determine if a patient is “clinically sober”,...
Matthew DeLaney, MD |
Don’t know when to use ketofol for procedure sedation or if you can rapidly load phenytoin? See the new PV-Plus Cards on AgileMD for free on any smartphone/tablet/desktop. Other topics include:...
Delphine Huang, MD |
Should we treat a cyclobenzaprine (Flexeril) overdose similar to a tricyclic antidepressant (TCA) overdose? With the only difference between the commonly prescribed muscle relaxant, cyclobenzaprine, and the TCA amitriptyline consisting...
Jill Logan, PharmD BCPS |
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