Archive for category: Pharmacology

Morphine Kills in Acute Decompensated Heart Failure

08 Jun
June 8, 2015

Background: Intravenous morphine use has been reported in nearly one of seven patients hospitalized with acute decompensated heart failure (ADHF). I have anecdotally, even seen physicians giving morphine as a “first-line” agent: Nitroglycerine, Non-Invasive Positive Pressure Ventilation (NIPPV), and Morphine. There is surprisingly little evidence supporting routine use of morphine in ADHF, and no major […]

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 […]

Optimization WordPress Plugins & Solutions by W3 EDGE