You must administer surgical prophylaxis at the time of the first incision or as close as possible. Redose if surgery is longer than four hours. No need for post-op, except in cardiac procedures. Usually use cefazolin 2 g (3 g for patients above 120 kg), ceftriaxone, cefotetan, cefoxitin 2 g, clindamycin 900 mg, vancomycin 15 mg/kg Cefazolin 2g is […]
Gout
Caused by uric acid over-production or underexcretion Factors: DKA, myeloproliferative and lymphoproliferative disease, acute EtOH, hypothyroidism, acromegaly, hypo or hyperparathyroidism, chronic hemolytic anemia, obesity Medications: Decrease uric acid filtration: diuretics (thiazide and loop diuretics), nicotinic acid (Niaspan), salicylates (ASA), alcohol (EtOH), levodopa/carbidopa, ethambutol, pyrazinamide, ticagrelor Acute treatment: Colchicine, NSAIDs, corticosteroids (if NSAIDS contraindicated) Chronic treatment: Allopurinol or […]
Substance Abuse Disorders
Alcohol Withdrawal – Tremors start around 6 hours, seizures around 12 hours, but can occur 3-5 days later. Mortality can be as high as 35%. 3 Ts – Increase temp, tremor and tachycardia Treatment: correct electrolyte imbalances, benzos, can use propofol or barbiturates in refractory cases, magnesium, alpha 2 agonists, Beta blockers, calcium channel blockers Avoid: […]
Study Design
What Statistical Test To Use: I memorized this table and wrote it out on my noteboard during the test. It makes it easy to pick out which test without much mental effort Type of Data 2 Independent Samples“BETWEEN“ Related or Paired Samples“WITHIN“ 3 or More Independent Samples 3 or More Related Samples Measures of Correlation Prediction […]
Stages of Drug Development
Stages of Drug Development: 1 IND Animal tests 2 IND Review by FDA and local IRB Animal tests 3 Phase 1 Healthy volunteers, tests safety 4 Phase 2 Sick volunteers, tests effectiveness 5 Phase 3 Larger scale, test effectiveness and adverse effects 6 Post-marketing Review 7 NDA application 8 FDA Review and decision […]
Sleep Disturbances
Lifestyle Modifications: Maintain sleep schedule Do not go to bed unless tired Sleep long enough, but not too much Optimize bedroom lighting, temp and sound Develop a ritual Do not stay in bed for more than 15 minutes if you can’t sleep Don’t go to bed hungry. Only use the bedroom for sleep Avoid naps Avoid […]
Skeletal Muscle Relaxants
baclofen – seizure in overdose
Research Study Subjects -Informed Consent
Expedited IRB Review: Minimal or no risk Involve data, documents, specimens etc that have been collected for non-research purposes. IRB Exempt: Research in established or commonly accepted educational settings Use of educational tests where subjects cannot be IDed The use of texts and surveys if the subject is a public official under FOIA. Collecting or […]
QT Prolongation
Low Mg, Ca or K can all cause QT prolongation
Pulmonary HTN
Stages: No symptoms Symptoms with strenuous daily activities Symptoms with normal daily activities Symptoms at rest. Treatment: High dose CCBs Inhaled nitric oxide IV epoprostenol and IV adenosine ambrisentan, bosentan, macitentan, riociguat, sildenafil, tadalafil