Nebulized Tranexamic Acid for Hemoptysis

Nebulized Tranexamic Acid for Hemoptysis, a guest post by Raniah Aljadeed, PharmD 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 [...]

By |2019-11-24T17:38:23-05:00November 14th, 2018|EM PharmD|0 Comments

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

Nausea and Vomiting in the ED: There’s Something Fishy Going On, guest post by Ruben Santiago, PharmD, BCPS, BCCCP 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 [...]

By |2019-11-24T17:38:24-05:00October 30th, 2018|EM PharmD|0 Comments

Fosfomycin: The Forgotten Treasure

Fosfomycin: The Forgotten Treasure, a guest post by Tony Mixon, PharmD, BCPS We have all been there, a patient with so many complicating factors that it’s difficult to choose the least bad 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 [...]

By |2019-11-24T17:38:24-05:00August 27th, 2018|EM PharmD|0 Comments

BCPS Recertification Follow Up

BCPS Recertification Re-up It's about time to report back on my BCPS recertification follow up. In two previous posts, I outlined my impressions of High-Yield Med Reviews and BCPS recertification 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 [...]

By |2019-11-24T17:38:24-05:00July 25th, 2018|EM PharmD|0 Comments

Choosing DOACs in the emergency department

Choosing DOACs in the emergency department is a critical piece of any emergency medicine pharmacist's knowledge. In this post, we dive deep into which DOAC wins the day (for now). Patient Case: A 62-year-old female presents to the ED with left lower extremity pain and swelling and is diagnosed with a LLE deep vein thrombosis (DVT) on ultrasound. The patient’s past medical history is significant for hypertension and she takes amlodipine at home. Laboratory values, [...]

By |2019-11-24T17:38:24-05:00June 29th, 2018|EM PharmD|0 Comments

Changing Paradigms in Stress Ulcer Prophylaxis

Obviously any patient that requires mechanical ventilation for 48 hours or has "coagulopathy" should get stress ulcer prophylaxis (SUP) right? maybe not....when the above risk factors where identified in 1994 by Deborah Cook (N Engl J Med. 1994;330(6):377-81.) and studies validating SUP as an effective means of preventing GI bleeding in critically ill patients were published (Crit Care Med.1993;21:1844-9. and Crit Care Med. 1993;21:19-30 - btw, cimetidine continuous infusion, really?) critical care was quite different [...]

By |2019-11-24T17:38:24-05:00May 25th, 2018|EM PharmD|0 Comments

What is the INR of FFP

What is the INR of FFP is a guest post by Jerry Altshuler, PharmD, BCCCP So fresh and so clean I frequently encounter people touting that "The INR of FFP is like 1.6 or something". Indeed I learned something similar myself at some point. It turns out however that the mean INR of FFP is actually 1.1 (Transfusion 2005;45:1234-5.). So why does it seem like no matter how much FFP you tend to give, it [...]

By |2019-11-24T17:38:24-05:00May 21st, 2018|EM PharmD|0 Comments
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