Pharmacology

Gamechanger? Can Pioglitazone Reduce Cardiovascular Events After a Stroke? An Analysis of the IRIS Trial

January 19, 2017
Gamechanger?  Can Pioglitazone Reduce Cardiovascular Events After a Stroke?  An Analysis of the IRIS Trial

By Johanna Hase, MD

Peer Reviewed

Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my practice? Featuring thorough evidence-based review as well as expert commentary, our aim is for this series to help you decide if the results of a given study are, in fact, a gamechanger

A 64 year old woman with pre-diabetes, hyperlipidemia, and hypertension on aspirin, losartan and simvastatin, recently was diagnosed …

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From The Archives: They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

April 3, 2014
From The Archives: They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

Please enjoy this post from the archives dated September 23, 2011

By Santosh Vardhana, MD

A 36-year-old obese male with hypertension and hyperlipidemia presents to the ER with new knee pain, swelling, and erythema. Joint aspiration reveals negatively birefringent crystals. He is started on oral prednisone.

A 26-year-old woman with lupus presents to ER with edema, hematuria, and fevers. On exam she hypertensive, febrile to 100.4C, and has periorbital and lower extremity edema. Urine dipstick reveals 2+blood and protein. She is started on IV methylprednisolone.…

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An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

February 21, 2014
An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

By Gabriel Schneider, MD

Peer Reviewed

The new oral anticoagulants (NOACs) are an appealing alternative to the burdensome vitamin K antagonists such as warfarin. These novel agents include direct thrombin inhibitors such as dabigatran (which inhibits thrombin) and factor Xa inhibitors such as rivaroxaban and apixaban (which prevent thrombin generation). Compared to warfarin, NOACs have fewer food and drug interactions, as well as a more predictable pharmacodynamic profile that serves to obviate the need for the frequent outpatient monitoring in most patients. In addition …

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What Physicians Should Know About MDMA (Ecstasy)

February 20, 2014
What Physicians Should Know About MDMA (Ecstasy)

By Loren Gorcey

Peer Reviewed

With the recent resurgence of techno music and raves in the United States, the drug MDMA, known worldwide by the name “ecstasy,” has experienced a comeback. In light of a New Year’s Eve rave in Los Angeles in 2010, where 18 MDMA-related emergency room visits and 1 death occurred, MDMA is once again becoming a problem . Locally, 4 MDMA-related emergency room visits and 2 MDMA-related deaths occurred this past summer at Electric Zoo, an annual electronic music festival in …

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From The Archives: The Polymyxins: Why am I using them all the time, and what are they?

November 21, 2013
From The Archives: The Polymyxins: Why am I using them all the time, and what are they?

Please enjoy this post from the archives dated December 8, 2010

By Jon-Emile S Kenny

Faculty Peer Reviewed

A 65-year-old female with locally advanced rectal cancer is admitted to the ICU, hypotensive and febrile. Her PICC line is removed and blood cultures drawn. Fourty-eight hours later all cultures return ESBL Klebsiella with susceptibility only to polymyxin.

I sat on the venerable call-room couch staring mindlessly at the cluttered, nauseating walls repeating the word ‘polymyxin’ like an endless antimicrobial mantra. What strange dosing it has, and …

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FROM THE ARCHIVES – Kayexalate: What is it and does it work?

November 7, 2013
FROM THE ARCHIVES – Kayexalate: What is it and does it work?

Please enjoy this post from the archives dated December 1, 2010

By Todd Cutler, MD

Faculty Peer Reviewed

A 62-year-old male is hospitalized with an acute congestive heart failure exacerbation. On hospital day three, the patient’s symptoms have significantly improved with twice daily furosemide 80mg IV. He is continued on IV diuretics and aggressive electrolyte repletion. On day five of his admission, his basic metabolic panel is significant for a creatinine of 2.3 mg/dL (increased from 1.3 on admission) and a potassium concentration of 5.9

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Corticosteroids and Prophylaxis. What complications should you try to prevent in patients on chronic corticosteroids?

October 30, 2013
Corticosteroids and Prophylaxis.  What complications should you try to prevent in patients on chronic corticosteroids?

By Robert Joseph Fakheri, MD

Faculty Peer Reviewed

A 55 year-old male is recently diagnosed with systemic sarcoidosis. The patient is started on prednisone 40mg with the plan to decrease the dose after remission of symptoms, which may take a number of months. What kind of prophylaxis should the patient receive?

Corticosteroids are an effective treatment option for a number of diseases spanning many specialties. However, long-term corticosteroid treatment is marred with a number of side effects including hypertension, hyperglycemia, weight gain, adrenal suppression, osteoporosis, …

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Clinical Misinformation: The Case of Benadryl Causing Dementia

May 22, 2013
Clinical Misinformation: The Case of Benadryl Causing Dementia

By Natalie Smith, MD

Faculty Peer Reviewed

A few weeks ago I received an email from a friend I grew up with containing a link to an article she had seen online and a question as to its implications. The email was directed to me, the medical student, but was also sent to eight of our other closest friends. I clicked on the link and found a short article titled, “What drugs are known to cause memory loss?” My friend’s particular concern was based on …

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