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Benzodiazepines are on the Beers criteria. They can have significant adverse effects like sedation, confusion, the risk for dependence, and increased fall risk. We like to avoid benzodiazepines if we can, but what if we do feel that it is necessary (i.e. hospice or other situation)? I have been asked this question before and will […]
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Medications and renal failure can go hand in hand. This is of course if we are talking about the right medications. There are numerous medications that can cause an acute renal failure situation, but many times in practice, it is due to a cumulative risk. Here’s a case scenario to ponder… An 88-year-old female is […]
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As I’m working on 2020 updates for all of our board certification study material, I couldn’t help but recognize that I did not have a dedicated lecture on pharmacogenomics. Below I discuss how genetic alterations in CYP2D6 activity can affect two commonly used medications. CYP2D6 is a well known metabolic enzyme that causes structural changes […]
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A 62-year-old male had a heart attack about 9 months ago. He was stented and placed on both aspirin 81 mg daily and clopidogrel 75 mg daily. He presents today to the emergency department and is diagnosed with a STEMI. His wife is wondering why the medications used to prevent this from happening didn’t work. […]
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Glucagon can be a lifesaver, literally. Glucagon’s primary use is in the setting of severe hypoglycemia. Glucagon works by increasing cyclic AMP which causes glycogenolysis and gluconeogenesis. This ultimately leads to an increase in glucose in the blood and helps manage a hypoglycemic state. Here are some clinical pearls that are important to glucagon’s use. […]
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