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Single Dose Aminoglycoside For Urinary Tract Infections

Looking for a single dose, no compliance issues, inexpensive, safe, and effective option to treat urinary tract infections? An older therapeutic option might be the answer. A recent systematic review by Goodlet et al. looks into the utility of single dose aminoglycosides (AGs) to treat cysitis.1 Article A Systematic Review of Single-Dose Aminoglycoside Therapy for Urinary Tract Infection: Is It Time To Resurrect an Old Strategy?Kellie J. Goodlet, PharmD , Fatima Z. Benhalima, and Michael [...]

By |2019-06-06T08:00:53-05:00June 6th, 2019|Classic EM PharmD, EM PharmD Blog|0 Comments

I Have Andexanet Issues, 2: A Formulary Toolkit

Zahra Nasrazadani, PharmD, BCPS Emergency Medicine Clinical Pharmacist Salina Regional Health Center A few months ago, Kristina Kipp wrote her inaugural EMCrit article enumerating her (extremely justified) concerns with the data we had available at the time regarding andexanet alfa…or should I say “coagulation factor Xa (recombinant), inactivated-zhzo”(1)? Since then—and in a somewhat perverse order of operations—the drug has been rolled out in a second-generation release and later, the New England Journal of Medicine published [...]

By |2019-04-09T08:10:53-05:00April 9th, 2019|Classic EM PharmD, EM PharmD Blog|0 Comments

A Breath of Fresh Air: Nebulized TXA for Hemoptysis

An 80-year-old male arrived at the Emergency Department (ED) in a serious condition: he was coughing up blood. Although he coughed up about three tablespoons (50cc/hr), he was hemodynamically stable. A physician approached me with an unfamiliar question: “Could we give him nebulized TXA?” I looked at him for a moment, nonplussed. “What?!” I exclaimed, “Hold on—let me look it up and get back to you.” Questions flooded my mind: Is it effective? Is it [...]

By |2018-11-14T11:00:00-05:00November 14th, 2018|EM PharmD Blog|0 Comments

Nausea and Vomiting in the ED: There’s Something Fishy Going On

Nausea and vomiting is a common chief complaint in the ED, one I never really paid much attention to unless prompted (appropriate agent to use in pregnancy, which medication to use for a patient with a prolonged QTc, etc.) - at least, that was my practice before I began practicing in Miami. In one of the many unforgettable cases I have had in the ED, there was a young patient who presented with nausea and vomiting. [...]

By |2018-10-30T10:00:00-05:00October 30th, 2018|EM PharmD Blog|0 Comments

Fosfomycin: The Forgotten Treasure

We have all been there, a patient with so many complicating factors that it’s difficult to choose the least worst option to treat a urinary tract infection. For example: a patient with a CrCl ~22 ml/min, a prolonged QTc, sulfa allergy (described as immediate death), and amoxicillin allergy (also somehow described as immediate death) who absolutely refuses to try a cephalosporin. How is it this difficult to treat a simple urinary tract infection?!?!?! There is [...]

By |2018-08-27T11:11:00-05:00August 27th, 2018|EM PharmD Blog|0 Comments

BCPS Recertification: Follow Up

In two previous post, I outlined my impressions of High-Yield Med Reviews based on my experience going through the modules and webinar. While I still stand behind my evaluation of HYMR, my assessment was somewhat limited because it was all before the exam. Now that I have my scores, I feel I can give a more complete assessment of HYMR. In a nutshell: I passed, and highly recommend HYMR. In the final days before the exam, [...]

By |2018-07-25T14:41:00-05:00July 25th, 2018|EM PharmD Blog|0 Comments