The PharmERToxGuy

Today’s pearl is about the dose ceiling effect of NSAIDs (the idea that increasing doses does not lead to further pain relief)

Are we giving to much without benefit?

More isn’t always better.

Continue reading “The ‘Ceiling’ Effect of NSAIDs”

Today’s pearl is about the potential benefits of administering basal subcutaneous insulin early for patients with diabetic ketoacidosis (DKA) requiring an insulin infusion

Is earlier better? 

Continue reading “Timing of Basal Insulin Administration in Patients with DKA”

Today’s pearl is about an efficient yet (nearly) comprehensive method to assessing an anion gap metabolic acidosis.

Not all anion gaps are created equal

Continue reading “A Nuanced Approach to an Anion Gap Metabolic Acidosis”

Today’s pearl is about the safety of physostigmine.

Physostigmine – a drug whose bark is worse than its bite. 

Continue reading “Don’t Fear Physostigmine”

Today’s pearl is about how a salicylate overdose may present similarly to sepsis.

Since time of the essence in a salicylate overdose, early identification may be life-saving.

Continue reading “Salicylate Toxicity as a Sepsis-Mimic”

Today’s pearl is about how much sodium is contained in each dose of the commonly used antibiotics in the emergency department.

Many of the antibiotics we use on a daily basis in the emergency department contain a surprisingly high sodium load that may be clinically significant for some patients.

Continue reading “Sodium Content of ED Antibiotics”

Today’s pearl is about an alternative diltiazem dosing method.

Weight-based diltiazem doses may be too high for some patients and fixed doses may offer similar efficacy with decreased risk of hypotension.

Continue reading “IV Diltiazem Dosing in Atrial Fibrillation”

Today’s pearl is about the unpredictable and potentially dangerous risks with tramadol.

Tramadol has a reputation for being a safe, non-opioid alternative to opioids. Nothing could be further from the truth.

Continue reading “Be Cautious with Tramadol”

Today’s pearl is about an alternative to sodium bicarbonate for tricyclic antidepressant poisoning.

Sodium bicarbonate has been on and off shortage for the past few years.

Continue reading “Alternative to Sodium Bicarbonate for TCA Poisoning”

Today’s pearl is about management of calcium channel blocker poisoning .

Glucagon was an option in the past, but is no longer recommended due to lack of supporting data and risk of adverse effects.

Continue reading “Glucagon is Out for Calcium Channel Blocker Overdose”