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Digital PharmD

Informatics in Pharmacy

Neurology

Dementia

August 13, 2018 By Dr. G, PharmD

Cognitive Screening Mini – Mental Status Exam – MMSE Montreal Cognitive Assessment – MOCA St Louis University Mental Scale – SLUMS Mood screening:  Geriatric Depression.ScaleIADL: Instrumental Activities Of Daily Living Diagnosing Dementia: Rule out delirium and drug-related causes. Other causes: vitamin B12 deficiency, hypothyroidism, depression, NPH, opioids, sedative-hypnotics, antidepressants, anticholinergics, antiparkinson’s drugs Treatment: Initiate a cholinesterase inhibitor in […]

Anxiety, OCD and PTSD

August 13, 2018 By Dr. G, PharmD

Generalized Anxiety Disorder (GAD): 6 months or more of excessive worry or anxiety. OCD – intrusive thoughts that can not be controlled PTSD: trauma related to avoidance of stimuli. Benzos are the first line therapy in anxiety.  Can cause tolerance or dependence.  Abrupt discontinuation can lead to withdrawal.   Treat for 3-4 weeks until trial for […]

Seizures: Emergent and Codes

August 13, 2018 By Dr. G, PharmD

*See the seizure medication table for quick reference. Seizure overview. Head trauma: Early seizure – within first 7 days, prevent with 5/mg/kg day phenytoin (valproate has higher mortality) No prophylaxis for late seizures. Emergent: For emergent seizures, benzos are the drug of choice to stop seizing. Lorazepam – onset 2-3 minutes, 0.1 mg/kg up to 4 […]

Seizure Medication Table

August 13, 2018 By Dr. G, PharmD

Table: 1 – first line drug, 2 – second line drug, 3 – some effect, 4 – adjunctive therapy, 5 – used only when benefits outweigh risks Drug Focal Tonic-Clonic Absence Atypical Absence Atonic Myoclonic Infantile Spasms Status Epilepticus Lennox Gastaut Acetazolamide 4 4 3 3           Brivaracetam 3     […]

Ischemic Stroke

August 13, 2018 By Dr. G, PharmD

Risk factors: Age: risks double every decade over 55 Race: more risk in native Americans, second highest risk in African Americans then whites. Sex: risk higher in men Low birth weight Family History Diabetes Hypertension Oral contraceptive use Post-menopausal hormone use Atrial fibrillation Coronary artery disease Asymptomatic carotid stenosis Dyslipidemia Obesity Physical inactivity Sickle Cell Disease […]

Parkinson’s Disease

August 13, 2018 By Dr. G, PharmD

In patients who need to be initiation on dopaminergic agents, either levodopa or dopamine agonists can be used. Levodopa is better at improving motor functions, dopamine agonists are better at lessening motor complications.  May also use a MAOI (rasagiline or selegiline only, they increase extracellular dopamine). Carbidopa/Levodopa is the mainstay of therapy, but often clinicians will use […]

Headache

August 13, 2018 By Dr. G, PharmD

Acute: Treat with NSAIDS, APAP, 5-HT receptor antagonists (triptans). Prophylaxis: Avoid precipitants, TCAs, propranolol, topiramate, verapamil, valproic acid, NSAIDs, Botox, Magnesium, Vitamin B12, CoQ10, feverfew Migraine: If they are recurrent, interfere with daily activities or patient prefers prophylactic therapy, prophylaxis should be considered. Use lowest effective dose, give 2 – 3-month trial, consider a choice that also […]

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020