Archive for category: Pharmacology

Skin Anesthesia: Lidocaine vs Bupivacaine +/- Epinephrine

23 Apr
April 23, 2015

  When selecting a local anesthetic agent for skin wounds I have historically been taught to use lidocaine to provide a faster onset, and to use bupivacaine for a longer duration of action. It can be time consuming to find 0.5% Bupivacaine with epinephrine and 2% Lidocaine with Epinephrine to produce a final mixture of […]

Lidocaine + Bupivacaine vs Bupivacaine Alone for Digital Nerve Blocks

09 Apr
April 9, 2015

When I first learned digital nerve blocks in the late 1990’s I was taught to mix Lidocaine and Bupivacaine 50/50 to provide faster onset (Lidocaine) and a longer duration of action (Bupivacaine). My use of two agents for digital nerve blocks was recently questioned by one of my colleagues. Any time additional medications are drawn […]

January 2015 REBELCast

10 Jan
January 10, 2015

Welcome to the January 2015 REBELCast, where Swami and I are going to tackle a very important scenario that comes up in the daily practice of not only Emergency Medicine, but also in Medicine.  Today we are going to specifically tackle one topic: Topic: Is the use of cephalosporin antibiotics in patients with a history of […]

Colchicine for Treatment of Pericarditis

11 Aug
August 11, 2014

Acute and recurrent pericarditis are frequently diagnosed in the emergency department.  Traditionally, treatment has consisted of anti-inflammatory medications (eg. ASA or NSAIDs) or corticosteroids.  Colchicine is an underutilized therapy for pericarditis and provides significant benefit when combined with NSAIDs/ASA. Addition of colchicine to standard therapy results in earlier reduction in pericarditis symptoms, greater remission at […]

Topical Tranexamic Acid for Epistaxis or Oral Bleeds

14 Jul
July 14, 2014

Recently, there has been a lot of buzz about the use of topical tranexamic acid for epistaxis or oral bleeds on multiple social media platforms. Everyone seems so happy that it works so well, but we thought we would look through the literature and see what the evidence for use of topical tranexamic acid (TXA) is […]

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