ACADEMIC EMERGENCY MEDICINE TOX & MEDICATIONS
Breaking the Cycle: ED Management of Cannabinoid Hyperemesis Syndrome

What is cannabinoid hyperemesis syndrome? Cannabinoid hyperemesis syndrome (CHS) is a condition in which patients who have been using cannabis or synthetic cannabinoids for a prolonged period of time develop a pattern of episodic, severe vomiting (usually accompanied by abd...

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EM PHARMACY PEARLS TOX & MEDICATIONS
Succinilcolina y el riesgo de hiperpotasemia

Antecedentes La succinilcolina se utiliza con frecuencia en el servicio de urgencias para facilitar la intubación, pero en algunos casos puede evitarse debido al riesgo de hiperpotasemia. La fisiología subyacente de este efecto parece estar directamente relacionada con su ...

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EM PHARMACY PEARLS PULMONARY TOX & MEDICATIONS UNCATEGORIZED
Nitroglicerina en dosis altas para el edema pulmonar agudo con choque simpático

Antecedentes La nitroglicerina (NTG) es una intervención importante a considerar para los pacientes con edema pulmonar agudo por colisión simpática (SCAPE), ya que reduce significativamente la precarga e incluso reduce modestamente la poscarga con dosis altas. Para el edem...

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CARDIOVASCULAR CRITICAL CARE/ RESUS EM PHARMACY PEARLS TOX & MEDICATIONS
Betabloqueantes para las arritmias ventriculares inducidas por inhalantes

Antecedentes Hay algunos escenarios únicos en los que los betabloqueantes pueden estar indicados para pacientes con paro cardíaco. El uso de esmolol para la fibrilación ventricular refractaria se resumió en una publicación de PharmERToxGuy de 2016 acompañada de una infogra...

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EM PHARMACY PEARLS TOX & MEDICATIONS
Utilidad de la naloxona nebulizada

Antecedentes La naloxona se puede administrar por múltiples vías y la nebulización ha ganado popularidad en la última década. Un truco del oficio anterior de ALiEM presentó este método único de administración. Para que la naloxona nebulizada sea eficaz, los pacientes deben...

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EM PHARMACY PEARLS NEUROLOGY TOX & MEDICATIONS
Bupropion Overdose: Factors Associated with Seizures

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 toxicologist Dr. Dan Rusyniak details his hatred of this drug in overdose in a Tox & Hound blog post a...

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EM PHARMACY PEARLS INFECTIOUS DISEASE TOX & MEDICATIONS UNCATEGORIZED
One-Time Vancomycin Doses in the Emergency Department

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. The take-home points from this post were: No evidence that a one-time vancomycin has any benefit This practice is not rec...

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CARDIOVASCULAR EM PHARMACY PEARLS NEUROLOGY TOX & MEDICATIONS
Safety and Efficacy of Clevidipine for Acute Blood Pressure Control

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 these situations, with nitroprusside being a less appealing alternative. The most recent AHA/ASA Acute Ischemi...

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EM PHARMACY PEARLS GERIATRICS TOX & MEDICATIONS
Droperidol for Agitation in Older Adults in the Emergency Department

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 patients specifically? Droperidol Efficacy Two Australian studies evaluated droperidol in more than 200 older adults (≥ 65 years...

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