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Methotrexate and Thrombocytopenia Case
The following case on methotrexate and thrombocytopenia was donated by Kirk Seale, M.S., PharmD, BCGP. Kirk received his Master’s degree in Drug regulatory affairs from the University of Florida and...
Can You Use a TCA With an SNRI? Case Review
A 66-year-old female has a past medical history of diabetes, neuropathy, depression, and hypertension. In this case scenario, I discuss the use of a TCA with an SNRI. Her current medication list...
Comparing Lorazepam and Diazepam
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...
Cumulative Risk of Medications and Renal Failure
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,...
CYP2D6 – Comparing Paroxetine and Tamoxifen
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...
Clopidogrel Failure: Why Did I Have Another Heart Attack?
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...
Glucagon Clinical Pearls
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...
Top 5 Enzyme Inducers You’ll Be Tested On
Enzyme inducers most frequently reduce the concentrations of other drugs. This can ultimately lead to treatment failure. In rare situations (i.e. prodrugs), starting an enzyme inducer can...
My Favorite Deprescribing Resource
In geriatrics, deprescribing has become a very popular term. Deprescribing is simply reducing a patient's medication burden by reducing and discontinuing medications. This is often done as the...
Polypharmacy Case Study
In this polypharmacy case study, I pick out some medications that we may be able to discontinue. An 88-year-old male is looking to reduce his medication burden. Current medications include: Aspirin...