Case of the Week 725
This week ' s interesting case is generously donated by Dr. Justin Juskewitch. Hopefully all of you have been able to avoid this so far this summer! The patient is a young girl who developed this very itchy rash about 30 minutes after a swim in a fresh water lake in Maine (Northeastern United States). The rash developed to what is shown below over a period of several hours. Her two siblings had a similar presentation. All three children had resolution of itching with benadryl, corticosteroid cream, and oatmeal body wash baths over the next few hours, but the rash lasted for 5-7 days.What is the most likely diagno...
Source: Creepy Dreadful Wonderful Parasites - September 5, 2023 Category: Parasitology Source Type: blogs
Anaphylaxis, chest pain, and ST elevation in aVR
Sent by anonymous, written by Pendell MeyersA man in his late 40s presented to the ED with concern for allergic reaction after accidentally eating a potential allergen, then developing an itchy full body rash and diarrhea. In the ED he received methylprednisolone, diphenhydramine, and epinephrine for possible anaphylaxis. Shortly after receiving epinephrine, the patient developed new leg cramps and chest pain. The chest pain was described as sharp and radiated to both arms.During active chest pain an ECG was recorded:Meyers ECG interpretation: Sinus tachycardia, normal QRS complex, STD in V2-V6, I, II, III and aVF. R...
Source: Dr. Smith's ECG Blog - March 1, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Dear Patient, If You Have to Treat a Cold, Know This:
BY HANS DUVEFELT
Americans hate being sick. There are too many cold medicines out there to remember by name. But there are really only a handful of different drug classes to consider.
In order to choose any one of them, be clear about what you want to accomplish. It’s actually very simple.
1) Make my cold go away faster: Zink, echinacea, visualization/manifesting, sauna, prayer (may be mostly placebo effect ).
2) Stop my nose from running (including post nasal drip): You’ll want the crud to leave your body as soon as possible, so turning off the drain pipe that your nose has become can increase the risk of ...
Source: The Health Care Blog - February 9, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Cold Hans Duvefelt Medical Education Source Type: blogs
Two Small Pharma Firms Join The Struggle To Give Women Access to OTC Birth Control Pills
Jeffrey A. SingerTheNew York Timesreports today that two small oral contraceptive makers, Cadence and HRA Pharma, have been seeking to make their birth control pills over ‐the‐counter since 2016. The Food and Drug Administration has taken five years “dialoguing” with the pharmaceutical firms but has yet to give them “clearance” to formally apply for the switch. TheTimes article cites an FDA spokesperson as saying the agency hopes to reach a decision within 10 months of the companies submitting a formal application.As I have writtenhere, birth control pills are available over ‐the‐...
Source: Cato-at-liberty - December 14, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Wide and weird
Written by Clare Gunn MD, peer reviewed by Smith, Meyers, BraceyA 74-year-old female presented to the ER after a trip and fall (unclear if purely mechanical or due to possible unsteadiness) causing her to cut her leg. Due to chronic anticoagulation for atrial fibrillation, she could not stop the bleeding, so she came the ED. On arrival she is found to be hypoxemic requiring four liters of oxygen via nasal cannula. While getting her leg wound repaired, the patient was also evaluated for hypoxemia and tachycardia and was found to have this ECG:What do you think?Here was her most recent prior ECG on file for comparison:...
Source: Dr. Smith's ECG Blog - August 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Doxepin, a Little Known Super Drug in My Personal Black Bag of Tricks
By HANS DUVEFELT
A while back I was able to completely stop my mastocytosis patient’s chronic hives, which the allergist had been unable to control.
I did it with a drug that has been on the market since 1969 and is taken once a day at a cost of 40 cents per capsule at Walmart pharmacies.
Hives are usually treated with antihistamines like diphenhydramine (Benadryl). My super drug has a 24 hour duration of effect and is about 800 times more potent than diphenhydramine, which has to be taken every fours hours around the clock.
Histamine is involved in allergic reactions, but it also plays a role ...
Source: The Health Care Blog - April 9, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Senators Portman, Whitehouse, and Klobuchar Think They Know Better Than The CDC About How To Treat Acute Pain
This study came one year after a largerstudy of more than 568,000 “opioid‐naïve” patients treated for acute postsurgical pain from 2008–2016 found a total “misuse” rate of 0.6 percent.The press report onCARA 2.0 issued by Senator Portman ’s office states the three‐day limit is recommended by the CDC in its 2016Guideline for Prescribing Opioids for Chronic Pain (recommendation number 6). But these guidelines were aimed at treatingchronic pain, and were based on what the CDC stipulated was very limited evidence. The CDC also emphasized the guidelines were meant to be suggestive, not prescript...
Source: Cato-at-liberty - February 16, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
CBD and other medications: Proceed with caution
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
Doubling up on side effects
While generally considered safe...
Source: Harvard Health Blog - January 11, 2021 Category: Consumer Health News Authors: Katsiaryna Bykov, PharmD, ScD Tags: Drugs and Supplements Marijuana Medical Research Safety Source Type: blogs
Defusing the “Benadryl challenge”: Discussing danger with teens
Let’s start with the bottom line: Parents of teens need to help them understand that just because they have been “challenged” to do something doesn’t mean it’s a good idea. But as simple as that sounds to us, it’s tough for many teens to grasp.
The latest challenge in the news is the “Benadryl challenge” that appeared on TikTok, a popular social media video platform. The idea was to take a whole lot of Benadryl (diphenhydramine, a common antihistamine) in order to cause a high, with hallucinations. While it’s true that diphenhydramine can make you high and make you hallucinate, when you take too much ...
Source: Harvard Health Blog - November 2, 2020 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Adolescent health Behavioral Health Children's Health Parenting Source Type: blogs
Cough and cold season is arriving: Choose medicines safely
With the summer winding down and fall moving in, colder weather will arrive soon — along with cold and flu season. Millions of Americans get the common cold each year, often more than once. To counter coughs and runny noses, many will turn to over-the-counter (OTC) medications available for relief without a prescription.
Heading to the pharmacy for some relief? Read this first
While OTC medicines do not cure or shorten the common cold or flu, they can ease some symptoms. Finding a product that fits your needs, however, may not be so straightforward. A recent study evaluated brand-name OTC medications marketed as cold, al...
Source: Harvard Health Blog - September 22, 2020 Category: Consumer Health News Authors: Katsiaryna Bykov, PharmD, ScD Tags: Cold and Flu Drugs and Supplements Health Infectious diseases Source Type: blogs
10 Ways to Stay Strong When Everything Seems to Be Going Wrong
If you find yourself wondering if everything will go wrong in 2020, you are far from alone. This year has seen more than its share of heartache, and it isn’t over yet. Help may never arrive — how can you keep going?
It’s challenging to stay strong when everything seems to be going wrong. While the tips below are no substitute for professional care, financial and other circumstances don’t always make seeking treatment an option. These 10 self-care practices may keep you from capsizing when the seas grow rocky.
1. Take a Deep Breath
Many times, you grow anxious from future fears, not from what’s happ...
Source: PickTheBrain | Motivation and Self Improvement - September 17, 2020 Category: Consumer Health News Authors: Mia Barnes Tags: featured motivation self-improvement covid_19 meditation positivity self improvement Source Type: blogs
Epinephrine is the only effective treatment for anaphylaxis
Anaphylaxis is a severe allergic reaction that can potentially lead to death if not promptly treated. Allergic reactions typically begin suddenly after exposure to an allergen, which may be a food, medication, insect sting, or another trigger. Anaphylaxis can occur in anyone at any time; it can sometimes be triggered by allergens that a person has only had mild reactions to in the past — or to which they have never reacted to before.
Recognizing anaphylaxis
A mild allergic reaction may consist of hives, itching, flushing, swelling of the lips or tongue, or some combination of these.
However, throat swelling or tightening...
Source: Harvard Health Blog - July 9, 2020 Category: Consumer Health News Authors: Parul Kothari, MD Tags: Allergies Emergency Planning Source Type: blogs
The Itchy, Bumpy Blues: How to Treat and Prevent Mosquito Bites and Related Conditions
Mosquito bites may be a nuisance, but fortunately, in the U.S., they tend to amount to nothing more than that. Upon being bitten, most Americans experience a bit of swelling and itchiness, and nothing more. However, there are exceptions to this, including stronger allergic reactions to bites and cases of mosquito-borne illness.
Insect and arachnid bites, including ticks, account for approximately 2,000 cases of malaria and 30,000 cases of Lyme disease in the U.S. annually. In addition, millions of people worldwide die of malaria each year. It is helpful to protect yourself against insect bites, not only to avoid pesk...
Source: Conversations with Dr Greene - June 7, 2020 Category: Child Development Authors: Alan Greene MD Tags: Dr. Greene's Blog Environmental Health Insect Bites & Stings Insects & Animals Outdoor Safety Source Type: blogs
Goodbye, Benadryl: It is time for you to retire
Sometimes, old ideas and time-tested treatments remain the best. Newer doesn ’t always mean better. Except in the case of one of our oldest antihistamines, tried-and-true Benadryl. It is time for that old drug to be retired, sent off to pasture, and never used again. Goodbye, Benadryl. Fare thee well, adieu, and don’t let the door […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 8, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/roy-benaroch" rel="tag" > Roy Benaroch, MD < /a > < /span > Tags: Meds Allergies & Immunology Source Type: blogs
A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?
Conclusion of this paper: Fever is a great risk factor for arrhythmia events in Brugada Syndrome patients. Patients with known fever-triggered Brugada syndrome should be surveilled closely during fever and be started on antipyretic therapy as soon as possible. There are limited data regarding the impact of EP study in BrS patients triggered by fever. An EP study might be helpful in symptomatic patients (Sroubek et al., 2016) in the presence of spontaneous BrS ECG or drug-induced ECG.The prognostic significance of fever-induced Brugada syndrome. Heart Rhythm 2016.Eighty-eight asymptomatic patient...
Source: Dr. Smith's ECG Blog - December 4, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
