Free Book Giveaway
The friendly folks at High-Yield MED Reviews were gracious enough to provide 20 free copies of two of my new eBooks. To get your FREE eBook, email me at iempharmd@gmail.com. But do it fast before all 20 are gone!
L-carnitine and the Nike Oregon Project
What do a 45 mL infusion, L-carnitine and Androgel have in common?
Diphacinone Toxicity
Daniel Hu, PharmD, BCCCP Critical Care and Emergency Medicine Pharmacist Providence St. Peter Hospital Diphacinone (2-diphenylacetyl-1,3-indanedione, CAS Number 82-66-6) is an indandione-type anticoagulant.1,2 It falls into a class of compounds known as long-acting anticoagulant rodenticides, along with brodifacoum, bromadiolone, chlorophacinone, and difenacoum, which inhibit the synthesis of clotting factors II, VII, IX, and X. These compounds were developed to replace warfarin in rodenticides and many available mouse and rat baits today contain these superwarfarins.1 Diphacinone [...]
Is Thiamine IV Push Safe?
Thiamine IV push? @raviempharmD (Ravipal Singh, PharmD, BCCCP) dives deep to answer this question
Cannabinoid Hyperemesis Syndrome (CHS): Getting “Into the Weeds” on a Complication of Chronic Marijuana Use
Guest post by Evan Mulvihill, PharmD on the hot topic of Cannabinoid Hyperemesis Syndrome
The Cure For Burnout Starts Here
The cure for burnout is simple, and starts with one simple step
Pit Viper Antivenoms
A discussion of antivenom for pit viper envenomations.
“What is the INR of FFP?”
I frequently encounter people touting that "The INR of FFP is like 1.6 or something". Indeed I learned something similar myself at some point. It turns out however that the mean INR of FFP is actually 1.1 (Transfusion 2005;45:1234-5.). So why does it seem like no matter how much FFP you tend to give, it is very difficult to get the INR much lower than 1.6 or so?As can be seen from the image below [...]
“Balanced Crystalloids” and Hyperkalemia
With the recent publication of the SMART and SALT-ED trials, the chloride rich vs poor (balanced/buffered) crystalloid debate is back in the spotlight after a break post the orginal Yunos JAMA 2012 and SPLIT JAMA 2015. Something I commonly hear from internal medicine residents however is that LR and plasma-lyte should DEFINITELY be avoided in the setting of hyperkalemia, since they contain 4 and 5 meq/L of potassium respectively.It turns out however that normal saline [...]
I’ve Felt the Burn, and Live to Tell About It
After 6 years of experience since completion of my residency training, I have felt a tremendous amount of growth. As I have said earlier, the more experience I gain, the more I respect those who have it, and realize how little I truly have. There is no hidden meaning or cryptic message. Rather than resisting advice or guidance, I now listen to someone who's been through it all and come out wiser. It's such an [...]