Bradycardia, SOB, in a Dialysis Patient
A dialysis patient presented with dyspnea and a heart rate of 33. His medications included amlodipine and carvedilol. He has a history of hypertension and DM. His BP was 150/45 (bradycardia leads to long run-off time after each systolic beat, leading to low diastolic pressure). He appeared comfortable, in no distress.QRS duration is normal at 97 ms. What is the diagnosis until proven otherwise?This ECG shows a junctional bradycardia (either sinus arrest with junctional escape, or severe sinus bradycardia with junctional escape), with retrograde P-waves (see the negative deflection just after t...
Source: Dr. Smith's ECG Blog - July 13, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs
“We deeply regret and apologize for the fact that our promotional activities were partially inappropriate,” - Takeda CEO
The president of Takeda Pharmaceutical Co. just acknowledged that the firm engaged in what has been described as so-called “inappropriate expressions” in the marketing of one of its blood pressure medications.Yasuchika Hasegawa, Takeda Pharmaceutical Co. president, recently announced in a news conference in Tokyo that the firm used what he described as “inappropriate expressions” in the way in which it promoted one of its drugs used in the treatment of high blood pressure, according to a The Wall Street Journal report. Mr. Hasegawa also said that while “inappropriate expressions” were used, his company did not ...
Source: PharmaGossip - March 3, 2014 Category: Pharma Commentators Authors: insider Source Type: blogs
Side Effects of Alzheimer's and Dementia Drugs
This study published in the journal Archives of Internal Medicine caught my attention.
In the case of my mother, her heart rate did slow after she was put on the combination of Aricept and Namenda.
When I first noticed this (her heart rate came up when I was taking her blood pressure) it disturbed me, and I decided to discuss the issue with her personal care physician. He told me to continue to monitor her heart rate, and let him know if it dropped below 55.
My mother was not fainting. However, she did tell me repeatedly each day that she felt like she was going to faint, or she said, I'm dizzy. This is probably the sid...
Source: Alzheimer's Reading Room, The - October 26, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Worsening edema – a diagnostic puzzle
70-something woman admitted to our service with worsening lower extremity edema. She is “billed” as worsening CHF. We know the following things about this woman:
COPD – but not on home oxygen
Systolic dysfunction – last left ventricular ejection fraction 25%
Type II Diabetes Mellitus for approximately 4 years
history of hypertension
Medications include
Insulin
carvdelilol
amlodipine
furosemide 40 mg daily
She has spent 2 weeks in a nursing home. Does not complain about dyspnea, only about lower leg edema.
Examination slows the patient is afebrile, pulse 68, BP 130/90, respirations 18
lungs are cl...
Source: DB's Medical Rants - October 19, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs
Prescription drugs: are they doing you more harm than good? - by Dr Phil Hammond
How do you react to websites that claim they could save your life? Normally I pass, but having recently and reluctantly become a patient, I'm now the proud possessor of a pre-paid NHS prescription card for my two drugs a day for life. So a website pointing out questions we should ask about prescription drugs that could save your life at least got the click through from me.
To save you the hassle, here they are:
- How does this drug work, how much improvement can I expect, and how soon?
- If I don’t take this drug now, and instead wait for a while, what will happen?
- What are the most likely side effects?
- Are there any...
Source: PharmaGossip - October 14, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
It may have been a flawed #OpenAccess "Sting" but WE ROCKED IT so submit to our journal ...
I suppose I knew this was coming ... but did not expect it so soon ... see the email I received below. Focus in particular on the part highlighted in yellow ....
Dear Colleague,
British Biotechnology Journal (BBJ) is an OPEN peer-reviewed, OPEN access, INTERNATIONAL journal, inspired from the great OPEN Access Movement. We offer both Online publication as well as Reprints (Hard copy) options. Article Processing Charge is only 50 US$ as per present offer. This journal is at present publishing Volume 4 (i.e. Fourth year of operation).
2. Transparent and High standard Peer review:
In order to maint...
Source: The Tree of Life - October 6, 2013 Category: Medical Scientists Authors: Jonathan Eisen Source Type: blogs
Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated joy of working in healthcare. Physicians often forget just how alien the language of medicine is to people who don't live it everyday. The best part about being a physician is not helping people recover from critical illness. The best part is not about listening and understanding with compassion and empathy. Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process. Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Dissection of a needless hospitalization
If Hattie had but one flaw, it was that she held her doctors in too high esteem. It was not unusual for an eighty-year-old woman of her culture to want to please her cardiologist. So when her blood pressure came up a little high, she was too embarrassed to admit that she had forgotten to pick up the Toprol and hadn’t taken it in over a week.
The cardiologist hemmed and hawed, he buried his head in the computer, and eventually wrote for Norvasc, a new blood pressure medication. What he didn’t do was ask about whether she had regularly taken her pills. He also forgot to tell her that leg swelling is a side effect...
Source: Kevin, M.D. - Medical Weblog - September 13, 2013 Category: Family Physicians Tags: Physician Heart Hospital Hospitalist Source Type: blogs
The Anatomy Of A Hospital Admission
If Hattie had but one flaw, it was that she held her doctors in too high esteem. It was not unusual for an eighty year old woman of her culture to want to please her cardiologist. So when her blood pressure came up a little high, she was too embarrassed to admit that she had forgotten to pick up the toprol and hadn't taken it in over a week. The cardiologist hemmed and hawed, he buried his head in the computer, and eventually wrote for norvasc, a new blood pressure medication. What he didn't do was ask about whether she had regularly taken her pills. He also forgot to tell her that leg swelling is a side effect of the medi...
Source: In My Humble Opinion - September 2, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Doctors Prescribe, Pharmacists Dispense, Patients Suffer
Spotted in LKS’ blog
by Product Of The System
Real Life Scenario
Madam Ong is a 52-year-old lady with a twelve-year-history of hypertension and diabetes. She complained of generalised lethargy, lower limb weakness, swelling and pain. She brought along her cocktail of medications for my scrutiny. Her regular medications included the oral antidiabetics metformin and glicazide and the antihypertensives amlodipine and irbesatan. Madam Ong also had a few episodes of joint pains three months ago for which she had seen two other different doctors. The first doctor suspected rheumatoid arthritis and started her on a short co...
Source: Malaysian Medical Resources - January 4, 2013 Category: Health Medicine and Bioethics Commentators Authors: palmdoc Tags: - Ethics - Guest - Nation Dispensing doctors MOH Pharmacists Source Type: blogs
