Archive for category: Pharmacology

The PEAPETT Trial: Half Dose tPA for PEA due to Massive Pulmonary Embolism

05 Jan
January 5, 2017

Background: Anyone who has run a code, knows that pulseless electrical activity (PEA) during cardiac arrest has a worse prognosis compared to patients with shockable rhythms.  In patients with suspected massive PE as the cause of their cardiac arrest the Advanced Cardiac Life Support (ACLS) and American Heart Association (AHA) guidelines do recommend consideration of […]

Question Tradition: Glucagon for Food Boluses

02 Jan
January 2, 2017

Background: How many of you have had this scenario…patient comes into ED, just ate a big steak and now they can’t swallow.  You call gastroenterology, who asks… “Did you try glucagon yet?” OK, well maybe not exactly like that, but you get what I am asking.  Esophageal foreign body impactions are a rare entity, that […]

IV Lidocaine for Renal Colic: Another Opioid Sparing Option?

06 Dec
December 6, 2016

Background : For anyone who has taken care of a patient with renal colic, the agony they experience is indelible.  I have had several female patients even tell me that the pain is worse than child birth.  Treatment of renal colic comes down to two key components: treatment of pain and expediting passage of the stone.  […]

Treatment of Submassive Pulmonary Embolism (PE): Full Dose, Half Dose, or No Dose?

03 Nov
November 3, 2016

Submassive pulmonary embolism (PE) is responsible for approximately 20% of all PEs.  Although the in-hospital mortality has been reported as about 5%, there is significant morbidity associated with this diagnosis such as chronic pulmonary hypertension, impaired quality of life, persistent right ventricular disfunction, and recurrent venous thromboembolism.  The literature suggests that systemic thrombolytics can improve […]

Baclofen Withdrawal

27 Oct
October 27, 2016

Definition: A dysfunctional condition in which removal of baclofen, an inhibitory neurotransmitter, from the central nervous system (CNS) causes CNS excitation.

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