Olanzapine for the Prevention of Chemotherapy-Induced Nausea...
Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting via Now@NEJM Posted on infosnack. (Source: Kidney Notes)
Source: Kidney Notes - July 12, 2016 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs
The Rigid Patient
A 24-year-old man with a history of schizophrenia presented with altered mental status. His mother said he had become more catatonic and rigid over the previous two days. She reported that he was prescribed Abilify 5 mg by mouth daily for three years, but a long-acting depot of Abilify 400 mg had been administered two days before by court order. His vital signs include a heart rate of 120 bpm, blood pressure 140/90 mm Hg, temperature 38.5°C, respiratory rate is 14 bpm, and SPO2 is 98% on room air. The patient is alert and diaphoretic. Pupils are 3 mm. Cogwheeling, rigidity, and two beats of ankle clonus are also o...
Source: The Tox Cave - June 2, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
LITFL Review 218
Welcome to the 218th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Rob “The Machine” Mac Sweeney of Critical Care Reviews has published his 2016 book reviewing the top 30 articles of 2015. Originally given to the delegates at the CCR 2016 meeting, it’s now free- and breaks down key papers in incredible det...
Source: Life in the Fast Lane - February 7, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
To See or Not to See
A
A 17-year-old boy presented to the emergency department after having a seizure. Initial vital signs included a temperature of 38°C, heart rate of 134 beats/min, respiratory rate of 22 breaths/min, blood pressure of 142/93 mm Hg, and pulse oximetry of 97% on room air. His physical exam is significant for tachycardia and pupils are 5 mm bilaterally and reactive to light with horizontal nystagmus. He is awake, confused, and combative.
Paramedics report that his mother found him in his bedroom was acting strangely before he fell to the floor and began convulsing. ED staff administered 2 mg intravenous lorazepam, ...
Source: The Tox Cave - January 4, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Prescription Drugs And The Slowdown In Health Care Spending
Several studies have examined the underlying sources for the recent slowdown in health care spending. These analyses have focused largely on the role of the 2007-2009 recession, the increasing prevalence of high deductible health insurance plans, and other structural changes in the payment and delivery of care. However, the studies examining these factors do not account for the full decline in spending, or raise questions about the pattern and timing of the slowdown.
Role Of Prescription Drugs In The Health Spending Slowdown
Certainly the recession accounted for a component of the post 2007 slowdown in spending. However, t...
Source: Health Affairs Blog - November 18, 2015 Category: Health Management Authors: Kenneth Thorpe and Jason Hockenberry Tags: Costs and Spending Drugs and Medical Technology Featured Quality generic drugs medication adherence Prescription Drugs Source Type: blogs
Don’t Smoke ’Em if You Got ’Em
A 22-year-old man with no past medical history presented to the emergency department with altered mental status. He was brought in by police who reported using a TASER on him three times after he became violent with them. His friends report he smoked K2. His initial vital signs included a temperature of 99.9°F, a heart rate of 137 bpm, blood pressure of 151/76 mm Hg, a respiratory rate of 22 bpm, and pulse oximetry of 98% on room air. The patient was agitated and combative, and was placed in four-point restraints.
K2 is a synthetic cannabinoid. Other commonly used synthetic cannabinoids include spice, moon rocks, comat...
Source: The Tox Cave - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Don’t Smoke ’Em if You Got ’Em
A 22-year-old man with no past medical history presented to the emergency department with altered mental status. He was brought in by police who reported using a TASER on him three times after he became violent with them. His friends report he smoked K2. His initial vital signs included a temperature of 99.9°F, a heart rate of 137 bpm, blood pressure of 151/76 mm Hg, a respiratory rate of 22 bpm, and pulse oximetry of 98% on room air. The patient was agitated and combative, and was placed in four-point restraints.
K2 is a synthetic cannabinoid. Other commonly used synthetic cannabinoids include spice, moon rocks, com...
Source: The Tox Cave - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Read it and weep - then get angry!
The Deadly Corruption of Clinical TrialsUpdate (4/3/2015): After nearly 11 years of obfuscation and denial surrounding the tragic death of Dan Markingson, the University of Minnesota has suspended enrollment in psychiatric drug trials. This comes in response to a blistering report issued by the Minnesota State Legislative Auditor that cites "serious ethical issues" and vindicates much of the reporting in the story below. Read more from Carl Elliott about the fallout from the report here.IT'S NOT EASY TO WORK UP a good feeling about the institution that destroyed your life, which may be why Mary Weiss i...
Source: PharmaGossip - April 4, 2015 Category: Pharmaceuticals Authors: insider Source Type: blogs
Read it and weep - then get angry!
The Deadly Corruption of Clinical TrialsUpdate (4/3/2015): After nearly 11 years of obfuscation and denial surrounding the tragic death of Dan Markingson, the University of Minnesota has suspended enrollment in psychiatric drug trials. This comes in response to a blistering report issued by the Minnesota State Legislative Auditor that cites "serious ethical issues" and vindicates much of the reporting in the story below. Read more from Carl Elliott about the fallout from the report here.IT'S NOT EASY TO WORK UP a good feeling about the institution that destroyed your life, which may be why Mary Weiss i...
Source: PharmaGossip - April 3, 2015 Category: Pharmaceuticals Authors: insider Source Type: blogs
Cases: Benign Prostatic Hypertrophy (BPH) as a hospice diagnosis?
Conclusion: In this case, a simple condition that is easily treatable in most men became one that we expected to lead to Mr. K’s death. However, the diagnosis that led it to become life-limiting was Mr. K’s dementia, and the heavy burden which BPH treatments would have placed on him. Mr. K’s daughter based her decision on Mr. K’s values, saying that if the father she was raised by was able to see himself in his current condition, he would have wanted both to stay in place and to be allowed to die with dignity. Forced catheterization and antipsychotic treatment might have prolonged his life by years but would have ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 6, 2015 Category: Palliative Carer Workers Tags: cases childers emergency care hospice medications POLST urology Source Type: blogs
Cases: Second-Line Anti-emetic Therapies for Refractory Chemotherapy-Induced Nausea and Vomiting (CINV)
Discussion:Nausea and vomiting (NV) are commonly reported side effects with chemotherapy.1 The primary pathway for NV involves the chemotherapy drugs directly stimulating the chemoreceptor trigger zone (CTZ), in the area postrema at the base of the fourth ventricle. Activated receptors in the CTZ transmit signals to the vomiting center in the brainstem to produce NV. Receptors in the CTZ include serotonergic receptor 5-hydroxytryptamine type 3 (5-HT3), dopaminergic (D2) and neurokinin type 1 (NK-1) receptors. In addition, chemotherapy can damage GI mucosa causing local release of 5-HT3 neurotransmitters by gut enteroch...
Source: Pallimed: A Hospice and Palliative Medicine Blog - August 25, 2014 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs
A Hot Topic
A 58-year-old man presented unresponsive following a seizure at home. His brother stated that he became progressively confused over the course of a few hours and then started shaking. EMS reports tonic-clonic seizures that resolved following administration of 5 mg of midazolam IM.
The patient was unresponsive and hyperthermic on arrival. He was intubated for airway protection, covered with ice packs, and administered normal saline intravenously. His rectal temperature is 41.9˚C (107.4˚F), blood pressure is 94/45 mm Hg, heart rate is 160 beats/minute, and the respiratory rate is 16 breaths/minute with an oxygen saturatio...
Source: The Tox Cave - June 23, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
A Hot Topic
A 58-year-old man presented unresponsive following a seizure at home. His brother stated that he became progressively confused over the course of a few hours and then started shaking. EMS reports tonic-clonic seizures that resolved following administration of 5 mg of midazolam IM.
The patient was unresponsive and hyperthermic on arrival. He was intubated for airway protection, covered with ice packs, and administered normal saline intravenously. His rectal temperature is 41.9˚C (107.4˚F), blood pressure is 94/45 mm Hg, heart rate is 160 beats/minute, and the respiratory rate is 16 breaths/minute with an oxygen saturat...
Source: The Tox Cave - June 23, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
