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EM Pharmacology

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67 papers 25 to 100 followers
By Terren Trott terren.trott@gmail.com
https://www.readbyqxmd.com/read/28657870/a-placebo-controlled-trial-of-antibiotics-for-smaller-skin-abscesses
#1
RANDOMIZED CONTROLLED TRIAL
Robert S Daum, Loren G Miller, Lilly Immergluck, Stephanie Fritz, C Buddy Creech, David Young, Neha Kumar, Michele Downing, Stephanie Pettibone, Rebecca Hoagland, Samantha J Eells, Mary G Boyle, Trisha Chan Parker, Henry F Chambers
BACKGROUND: Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear. METHODS: We conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection, and the presence of nonpurulent cellulitis...
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/26962903/trimethoprim-sulfamethoxazole-versus-placebo-for-uncomplicated-skin-abscess
#2
RANDOMIZED CONTROLLED TRIAL
David A Talan, William R Mower, Anusha Krishnadasan, Fredrick M Abrahamian, Frank Lovecchio, David J Karras, Mark T Steele, Richard E Rothman, Rebecca Hoagland, Gregory J Moran
BACKGROUND: U.S. emergency department visits for cutaneous abscess have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). The role of antibiotics for patients with a drained abscess is unclear. METHODS: We conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim-sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for 7 days) would be superior to placebo in outpatients older than 12 years of age who had an uncomplicated abscess that was being treated with drainage...
March 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/21612385/no-deaths-associated-with-patient-refusal-of-transport-after-naloxone-reversed-opioid-overdose
#3
David A Wampler, D Kimberley Molina, John McManus, Philip Laws, Craig A Manifold
INTRODUCTION: Naloxone is widely used in the treatment and reversal of opioid overdose. Most emergency medical services (EMS) systems administer naloxone by standing order, and titrate only to reverse respiratory depression without fully reversing sedation. Some EMS systems routinely administer sufficient naloxone to fully reverse the effects of opioid overdose. Frequently patients refuse further medical evaluation or intervention, including transport. OBJECTIVES: The purpose of this study was to evaluate the safety of this practice and determine whether increased mortality is associated with full reversal of opioids...
July 2011: Prehospital Emergency Care
https://www.readbyqxmd.com/read/23000499/is-discharge-on-scene-policy-really-safe-after-naloxone-reversal-of-acute-long-acting-opioid-toxicity
#4
LETTER
Hossein Sanaei-Zadeh
No abstract text is available yet for this article.
January 2013: Resuscitation
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#5
REVIEW
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
February 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/19261367/slow-infusion-of-calcium-channel-blockers-compared-with-intravenous-adenosine-in-the-emergency-treatment-of-supraventricular-tachycardia
#6
RANDOMIZED CONTROLLED TRIAL
S H Lim, V Anantharaman, W S Teo, Y H Chan
INTRODUCTION: The emergency treatment of supraventricular tachycardia (SVT) has, over the last two decades, changed from verapamil to adenosine primarily owing to documented hypotensive episodes occurring with rapid bolus infusions of the calcium channel blocker. Slow infusions of calcium channel blockers have not previously demonstrated hypotension to any significant degree. The aim of this study was to compare the efficacy and safety of bolus intravenous adenosine and slow infusion of the calcium channel blockers verapamil and diltiazem in the emergency treatment of spontaneous SVT...
May 2009: Resuscitation
https://www.readbyqxmd.com/read/28811122/acute-kidney-injury-after-computed-tomography-a-meta-analysis
#7
REVIEW
Ryan D Aycock, Lauren M Westafer, Jennifer L Boxen, Nima Majlesi, Elizabeth M Schoenfeld, Raveendhara R Bannuru
STUDY OBJECTIVE: Computed tomography (CT) is an important imaging modality used in the diagnosis of a variety of disorders. Imaging quality may be improved if intravenous contrast is added, but there is a concern for potential renal injury. Our goal is to perform a meta-analysis to compare the risk of acute kidney injury, need for renal replacement, and total mortality after contrast-enhanced CT versus noncontrast CT. METHODS: We searched MEDLINE (PubMed), the Cochrane Library, CINAHL, Web of Science, ProQuest, and Academic Search Premier for relevant articles...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28829884/effect-of-oral-prednisolone-on-symptom-duration-and-severity-in-nonasthmatic-adults-with-acute-lower-respiratory-tract-infection-a-randomized-clinical-trial
#8
RANDOMIZED CONTROLLED TRIAL
Alastair D Hay, Paul Little, Anthony Harnden, Matthew Thompson, Kay Wang, Denise Kendrick, Elizabeth Orton, Sara T Brookes, Grace J Young, Margaret May, Sandra Hollinghurst, Fran E Carroll, Harriet Downing, David Timmins, Natasher Lafond, Magdy El-Gohary, Michael Moore
Importance: Acute lower respiratory tract infection is common and often treated inappropriately in primary care with antibiotics. Corticosteroids are increasingly used but without sufficient evidence. Objective: To assess the effects of oral corticosteroids for acute lower respiratory tract infection in adults without asthma. Design, Setting, and Participants: Multicenter, placebo-controlled, randomized trial (July 2013 to final follow-up October 2014) conducted in 54 family practices in England among 401 adults with acute cough and at least 1 lower respiratory tract symptom not requiring immediate antibiotic treatment and with no history of chronic pulmonary disease or use of asthma medication in the past 5 years...
August 22, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/9258787/midazolam-a-review-of-therapeutic-uses-and-toxicity
#9
REVIEW
S P Nordt, R F Clark
Midazolam is a familiar agent commonly used in the emergency department to provide sedation prior to procedures such as laceration repair and reduction of dislocations. Midazolam is also effective in the treatment of generalized seizures, status epilepticus, and behavioral emergencies, particularly when intravenous access is not available. Midazolam is often employed as an induction agent for rapid sequence endotracheal intubation. Midazolam has a rapid onset of action following intravenous, intramuscular, oral, nasal, and rectal administration...
May 1997: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/9952166/a-review-of-the-use-of-fentanyl-analgesia-in-the-management-of-acute-pain-in-adults
#10
REVIEW
P W Peng, A N Sandler
No abstract text is available yet for this article.
February 1999: Anesthesiology
https://www.readbyqxmd.com/read/16859529/the-incidence-of-relative-adrenal-insufficiency-in-patients-with-septic-shock-after-the-administration-of-etomidate
#11
COMPARATIVE STUDY
Zulfiqar Mohammad, Bekele Afessa, Javier D Finkielman
INTRODUCTION: Etomidate blocks adrenocortical synthesis when it is administered intravenously as a continuous infusion or a single bolus. The influence of etomidate administration on the incidence of relative adrenal insufficiency in patients with septic shock has not been formally investigated. The objective of this study was to determine the incidence of relative adrenal insufficiency in patients with septic shock after etomidate administration compared with patients with septic shock who did not receive etomidate...
2006: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/18565378/clinical-controversies-etomidate-as-an-induction-agent-for-endotracheal-intubation-in-patients-with-sepsis-continue-to-use-etomidate-for-intubation-of-patients-with-septic-shock
#12
https://www.readbyqxmd.com/read/28135357/hypertension-in-2017-what-is-the-right-target
#13
Aram V Chobanian
No abstract text is available yet for this article.
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#14
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
June 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28187918/diazepam-is-no-better-than-placebo-when-added-to-naproxen-for-acute-low-back-pain
#15
Benjamin W Friedman, Eddie Irizarry, Clemencia Solorzano, Nauman Khankel, Jennifer Zapata, Eleftheria Zias, E John Gallagher
STUDY OBJECTIVE: Low back pain causes more than 2.5 million visits to US emergency departments (EDs) annually. Low back pain patients are often treated with nonsteroidal anti-inflammatory drugs and benzodiazepines. The former is an evidence-based intervention, whereas the efficacy of the latter has not been established. We compare pain and functional outcomes 1 week and 3 months after ED discharge among patients randomized to a 1-week course of naproxen+diazepam versus naproxen+placebo...
August 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/25568981/single-induction-dose-of-etomidate-versus-other-induction-agents-for-endotracheal-intubation-in-critically-ill-patients
#16
REVIEW
Eric A Bruder, Ian M Ball, Stacy Ridi, William Pickett, Corinne Hohl
BACKGROUND: The use of etomidate for emergency airway interventions in critically ill patients is very common. In one large registry trial, etomidate was the most commonly used agent for this indication. Etomidate is known to suppress adrenal gland function, but it remains unclear whether or not this adrenal gland dysfunction affects mortality. OBJECTIVES: The primary objective was to assess, in populations of critically ill patients, whether a single induction dose of etomidate for emergency airway intervention affects mortality...
January 8, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#17
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/22250698/laryngospasm-and-hypoxia-after-intramuscular-administration-of-ketamine-to-a-patient-in-excited-delirium
#18
Aaron M Burnett, Benjamin J Watters, Kelly W Barringer, Kent R Griffith, Ralph J Frascone
An advanced life support emergency medical services (EMS) unit was dispatched with law enforcement to a report of a male patient with a possible overdose and psychiatric emergency. Police restrained the patient and cleared EMS into the scene. The patient was identified as having excited delirium, and ketamine was administered intramuscularly. Sedation was achieved and the patient was transported to the closest hospital. While in the emergency department, the patient developed laryngospasm and hypoxia. The airway obstruction was overcome with bag-valve-mask ventilation...
July 2012: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26799349/succinylcholine-is-associated-with-increased-mortality-when-used-for-rapid-sequence-intubation-of-severely-brain-injured-patients-in-the-emergency-department
#19
Asad E Patanwala, Brian L Erstad, Denise J Roe, John C Sakles
OBJECTIVE: To compare succinylcholine and rocuronium regarding mortality in patients with traumatic brain injury (TBI) who are intubated in the emergency department (ED). METHODS: This was a retrospective cohort study conducted in an academic ED in the United States. Adult patients with TBI who underwent rapid sequence intubation (RSI) in the ED with rocuronium or succinylcholine between October 2010 and October 2014 were included. The main outcome of interest was in-hospital mortality...
January 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/20237045/rapid-sequence-induction-and-intubation-current-controversy
#20
REVIEW
Mohammad El-Orbany, Lois A Connolly
The changing opinion regarding some of the traditional components of rapid sequence induction and intubation (RSII) creates wide practice variations that impede attempts to establish a standard RSII protocol. There is controversy regarding the choice of induction drug, the dose, and the method of administration. Whereas some prefer the traditional rapid injection of a predetermined dose, others use the titration to loss of consciousness technique. The timing of neuromuscular blocking drug (NMBD) administration is different in both techniques...
May 1, 2010: Anesthesia and Analgesia
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