#Tramadol, a game of analgesic roulette, will it work or won’t it? Will your patient obtain analgesic effects or will they have a seizure, respiratory depression, or various other side effects...🤷🏼‍♀️that’s why it’s been nicknamed #Tramadont! Its variable effects are (1/3)

JUST RELEASED: 2019 #ESGuidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases - what's new? what has changed? what are the main 2019 recommendations? bit.ly/329WGXE #ESCCongress #cardiotwitter

A link to write to Congress about getting more/releasing stockpile of PPE lead by American College of Emergenxy Physicians. Takes <1 minute! p2a.co/LPxXH7j

Toxicologist here. Chloroquine and hydroxychloroquine are not yet proven to treat or prevent #COVID19. They may have a role; we just don’t know yet. Too much (or from drug interactions) can cause hypotension, hypokalemia, seizures, and fatal cardiac dysrhythmias. 1/3

.@EricMeyerowitz and my talk about #COVID-19 literature update today - Slides: docs.google.com/presentation/d… Recording: dropbox.com/s/bj0bbvggh1jr… Key points with slides, links to papers below 👇

Finally it's here! Caravaggio trial for apixaban in malignancy-associated VTE: apixaban noninferior to dalteparin in 1,055 patients ✔️No difference in VTE recurrence (HR 0.63; 0.37-1.07) ✔️No difference in bleeding events (EMA criteria) #ACC20 nejm.org/doi/full/10.10…

Update on convalescent plasma for COVID19. Red Cross seeks COVID19 survivors to donate plasma to help other victims of the virus. redcrossblood.org/donate-blood/d…

TL;DR: Lymphopenia occurs via direct viral invasion due to ACE2 expression on lymphocytes Also cytokine and/or lactic-acid excess → apoptosis B-cells are most affected → loss of humoral immunity may worsen infection Lymphocyte count <20% = worse prognosis / survival

In non #COVID19 news, our white paper on Management of Opioid Use Disorder in the ED is now in print bit.ly/3e2t5pW A monumental effort led by reuben strayer Open-access version here: bit.ly/2JS4bet

So many different potential therapeutic options for #COVID19... unknown which is the most effective at this point but here are the mechanisms for a few on part 2 of the #pharmacyeducationboard, COVID-19 edition!🦠🧬 Thanks Em! TILEmergencyPharmacist 🙌🏼 #twitterx #medtwitter #nursetwitter

🦄PHARMACY MYTHBUSTERS👻 Myth: Ketamine or Succinylcholine can ⬆️ ICP TILEmergencyPharmacist PGY1 Emily researched the origin of these myths and busted them with evidence on this week’s #pharmacyeducationboard! #twitterx #medtwitter #nursetwitter

Management of Opioid Use Disorder in the Emergency Department Open-access/free downloads through June 18, 2020 with this link: authors.elsevier.com/c/1a~kS2dT1Cno…

Alright #MedTwitter & #MedStudentTwitter, I’m going to interrupt your regularly scheduled #COVID19 programming to talk about Blood Pressure, Shock & Using the Force (#MayTheFourthBeWithYou) to assess it! So, Where would a measured blood pressure be highest? 1/

#Procalcitonin pub in AJHP issue 📲 academic.oup.com/ajhp/article-a…

3/ CRP is made in the liver and has a 1/2 life of about 19 hrs. It is better at trending acute inflammation than ESR which rises and falls slowly. Additionally,CRP is more accurate in elderly pts.

I have a pharmacist joke for you, but it is on shortage.

Stop hurting patients with liver disease by giving them blood products they DON’T need: Things We Do for No Reason™: Routine Correction of Elevated INR and Thrombocytopenia Prior to Paracentesis in Patients with Cirrhosis journalofhospitalmedicine.com/jhospmed/artic…

Happy National Penicillin Allergy Day! 🧫🦠💊 On this day in 1928, Alexander Fleming discovered penicillin. Today 1 in 10 pts report a PCN allergy & out of those pts 90% do NOT have a true allergy. So go educate & de-label a PCN allergy today! 🥳

Can you use a MRSA swab from 60 days ago to avoid vanco? Even if critically ill with pneumonia? 98% NPV (10.3% prev). bit.ly/3wcjKnO Love seeing our residents hard work published! :) Gary D Peksa 💊 🌱 Giles Rush Pharmacy ACCP EMED PRN ACCP CRIT PRN