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Weighing In On Alteplase Dosing: Is Estimating Weight Harming Our Patients?

When a stroke victim rolls into the emergency department (ED) we know we have a limited time window to administer alteplase (recombinant tissue-type plasminogen activator [r-tPA]). The pressure of this narrow therapeutic window often pressures hospital staff to administer the potentially brain-saving medication as early as possible. Often, administration is hastened by estimating patient weight as a basis for calculating the critical 0.9 mg/kg weight-based dose. However, the question remains if we are appropriately estimating [...]

By |2016-02-24T20:10:00-05:00February 24th, 2016|EM PharmD Blog|0 Comments

Gabapentin Misuse: A Growing Challenge

With the opioid abuse epidemic that we clinicians in the emergency department encounter as part of our daily practice, the movement towards the use of alternative agents continues to evolve for the management of pain in our patients. In taking advantage of traditional and novel mechanisms of action of these agents, acute pain in patients in the emergency department may be managed appropriately without posing the risk of introducing opioid-naive patients to opioids or worse, [...]

By |2016-02-11T11:00:00-05:00February 11th, 2016|EM PharmD Blog|0 Comments

Managing Rate Control in the Face of Borderline Hypotension

Encountering patients in afib with RVR is a daily occurrence in the emergency department. Rate control with AV blocking drugs are standard approaches for stable patients and good ol’ electricity for those who are unstable. But there is a group in-between that presents a different challenge. Those who are in afib but are relatively hypotensive, by which I mean SBPs in the 90’s or low 100’s. In these patients, pharmacologic rate control may improve SBPs [...]

By |2016-02-03T17:00:00-05:00February 3rd, 2016|EM PharmD Blog|0 Comments