Podcasts about br j clin pharmacol

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-360 Overview: Join us as we examine common medical myths encountered in primary care. Hear what the evidence has to say about grapefruit and statins, vitamin K-rich vegetables and warfarin, and biotin for treating hair loss. Stay informed, challenge assumptions, and enhance your practice with insights on these long-held beliefs. Episode resource links: Grapefruit: Am J Med 2016; Vol 129 (1): 26-29, Br J Clin Pharmacol. 2011 Sep;72(3):434-41.   Warfarin: Medicine (Baltimore). 2016 Mar;95(10):e2895   Biotin: The Journal of Clinical and Aesthetic Dermatology. 2020;13(3):37-40 Guest: Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-360 Overview: Join us as we examine common medical myths encountered in primary care. Hear what the evidence has to say about grapefruit and statins, vitamin K-rich vegetables and warfarin, and biotin for treating hair loss. Stay informed, challenge assumptions, and enhance your practice with insights on these long-held beliefs. Episode resource links: Grapefruit: Am J Med 2016; Vol 129 (1): 26-29, Br J Clin Pharmacol. 2011 Sep;72(3):434-41.   Warfarin: Medicine (Baltimore). 2016 Mar;95(10):e2895 Biotin: The Journal of Clinical and Aesthetic Dermatology. 2020;13(3):37-40 Guest: Jillian Joseph, MPAS, PA-C, Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Richard Onorato

Today's episode doesn't need a whole lot of explanation: I had asparagus one day and couldn't help but wonder about a peculiar scent. If you eat asparagus, you know exactly what I'm talking about. So I dove into the research and learned way more about asparagus than I ever thought I would

Les pharmaciens sont fréquemment confrontés à des interactions qui peuvent faire allonger l'intervalle QT et augmenter le risque de torsades de pointe. Quelle conduite privilégier pour prévenir les torsades de pointe d'origine médicamenteuse? Qui sont les patients les plus susceptibles de développer ce type d'arythmie et quels outils sont disponibles pour évaluer le risque? Quand faut-il intervenir? Pour nous guider à travers ces questions, Trait pharmacien reçoit Geneviève Cyr, pharmacienne à l'Institut de cardiologie de Montréal. NOUVEAUTÉ! Les membres de l'A.P.E.S. peuvent réclamer des UFC en réussissant un questionnaire d'évaluation des apprentissages! https://bit.ly/3PaDAuJ Références : Site Web de CredibleMeds : https://crediblemeds.org/ Vandael E et coll. Development of a risk score for QTc-prolongation: the RISQ-PATH study. Int J Clin Pharm 2017;39(2):424-32. Vandael E et coll. A smart algorithm for the prevention and risk management of QTc prolongation based on the optimized RISQ-PATH model. Br J Clin Pharmacol 2018;84(12):2824-35. Tisdale JE et coll. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes 2013;6(4):479-87. Haugaa KH et coll. Institution-wide QT alert system identifies patients with a high risk of mortality. Mayo Clin Proc 2013;88(4):315-25.

Happy birthday Adam! Join us for this special birthday Pod where we discuss a fascinating new meta-analysis on the association of PPIs and Dementia. Learn about the study's results, methods, a rabbit hole about prediction intervals, and Adam's Tupperware approach to confidence intervals.  Learn more and become a member on https://drjournalclub.com/PPIs and Barrett's Continuing Education Course: https://drjournalclub.com/continuing-education/Ahn N, Nolde M, Krause E, Güntner F, Günter A, Tauscher M, Gerlach R, Meisinger C, Linseisen J, Baumeister SE, Rückert-Eheberg IM. Do proton pump inhibitors increase the risk of dementia? A systematic review, meta-analysis and bias analysis. Br J Clin Pharmacol. 2023 Feb;89(2):602-616. doi: 10.1111/bcp.15583. Epub 2022 Nov 23. PMID: 36331350.Kumar R, Kumar A, Nordberg A, Långström B, Darreh-Shori T. Proton pump inhibitors act with unprecedented potencies as inhibitors of the acetylcholine biosynthesizing enzyme-A plausible missing link for their association with incidence of dementia. Alzheimers Dement. 2020 Jul;16(7):1031-1042. doi: 10.1002/alz.12113. Epub 2020 May 8. PMID: 32383816.Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta-analyses. BMJ. 2011 Feb 10;342:d549. doi: 10.1136/bmj.d549. PMID: 21310794.IntHout J, Ioannidis JP, Rovers MM, Goeman JJ. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open. 2016 Jul 12;6(7):e010247. doi: 10.1136/bmjopen-2015-010247. PMID: 27406637; PMCID: PMC4947751.Learn more and become a member at www.DrJournalClub.comCheck out our complete offerings of NANCEAC-approved Continuing Education Courses.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Things you need to know about the way antiepileptic drugs affect each other, all in one podcast. Take a few minutes here to familiarize yourself with these common and critical complications of seizure management. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Danielle Becker. REFERENCES Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology 2004;62(2):292-5. PMID 14745072 Pennell PB, Peng L, Newport DJ, et al. Lamotrigine in pregnancy: clearance, therapeutic drug monitoring, and seizure frequency. Neurology 2008;70(22 Pt 2):2130-6. PMID 18046009 Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol 2006;61(3):246-55. PMID 16487217 Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res 2005;65(3):185-8. PMID 16084694 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

ORAL MINOXIDIL IN PEDIATRICS   Jerjen R et al (starts at 12:33). Low-dose oral minoxidil improves global hair density and length in children with loose anagen hair syndrome. Br J Dermatol. 2021;184(5):977-978. Nicolas-Ruanes et al (starts at 15:33). Low-dose oral minoxidil for treatment of androgenetic alopecia and telogen effluvium in a pediatric population: A descriptive study. J Am Acad Dermatol. 2022 Apr 26; John JM et al (starts at 17:24). Safety and tolerability of low-dose oral minoxidil in adolescents: A retrospective review. J Am Acad Dermatol . 2022 Jul 5;S0190-9622(22)02245-9.   HAIR FIBERS AND CAMOUFLAGE Ring and Keller (starts at 25:13). Effect of camouflaging agents on psychologic well-being: A cross-sectional survey of hair loss patients. J Am Acad Dermatol. 2017 Jun;76(6):1186-1189 Babadjouni A et al (starts at 28:15). Patient Satisfaction and Adverse Effects Following the use of Topical Hair Fiber Fillers. Int J Trichology. 2022 May-Jun; 14(3): 97–102   HYDROXYCHLOROQUINE IN PREGNANCY Reynolds JA et al (starts at 34:38). Outcomes of children born to mothers with systemic lupus erythematosus exposed to hydroxychloroquine or azathioprine. Rheumatology (Oxford). 2022 Jun 29: Sperber K et al (starts at 38:25). Systematic review of hydroxychloroquine use in pregnant patients with autoimmune diseases. Pediatr Rheumatol Online J 2009;7:9. Kaplan Y et al (starts at 39:17). Reproductive outcomes following hydroxychloroquine use for autoimmune diseases: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016 May;81(5):835-48. Clowse MEB et al (starts at 40:27). Hydroxychloroquine in the pregnancies of women with lupus: a meta-analysis of individual participant data. Lupus Sci Med. 2022 Mar;9(1):e000651. Huybrechts K et al (starts at 42:37). Hydroxychloroquine early in pregnancy and risk of birth defects. Am J Obstet Gynecol 2021 Mar;224(3):290.e1-290.e22 Huybrechts K et al (starts at 45:20). Hydroxychloroquine early in pregnancy and risk of birth defects: absence of evidence is not the same as evidence of absence. Am J Obstet Gynecol. 2021 May;224(5):549-550. Bérard et al (starts at 46:58). Chloroquine and Hydroxychloroquine Use During Pregnancy and the Risk of Adverse Pregnancy Outcomes Using Real-World Evidence. Front Pharmacol. 2021 Aug 2;12:722511. Howley et al (starts at 47:17). Maternal exposure to hydroxychloroquine and birth defects. Birth Defects Res. 2021 Oct 15;113(17):1245-1256. Andersson et al (starts at 47:34). Fetal safety of chloroquine and hydroxychloroquine use during pregnancy: a nationwide cohort study. Rheumatology (Oxford). 2021 May 14;60(5):2317-2326.   TERIFLUNOMIDE INDUCED HAIR LOSS IN MULTIPLE SCLEROSIS Travis LH et al (starts at 53:28). Real-World Observational Evaluation of Hair Thinning in Patients with Multiple Sclerosis Receiving Teriflunomide: Is It an Issue in Clinical Practice? Neurol Ther. 2018 Dec; 7(2): 341–347. Porwal MH et al (starts at 55:41). Alopecia in Multiple Sclerosis Patients Treated with Disease Modifying Therapies. J Cent Nerv Syst Dis. 2022 Jun 23;14:11795735221109674.   DO IT YOURSELF LOW-ALLERGEN PRODUCTS Xiong M and Warshaw EM. (starts at 1:05:45) Hair Care Product Hacks: Do It Yourself Alternatives. Dermatitis. 2022 Jun 29. Zirwas M and Moennich J (starts at 1:00:25). Shampoos. Dermatitis. 2009 Mar-Apr;20(2):106-10 Tawfik M, Rodriguez-Homs LG, Alexander T, et al (starts at 1:01:10). Allergen content of  best-selling ethnic versus nonethnic shampoos, conditioners, and styling products. Dermatitis 2021;32(2):101–110 https://donovanmedical.com/diy   PREMATURE GREYING (EARLY CANITIES) Anggraini et al (starts at 1:08:50). Risk Factors Associated with Premature Hair Greying of Young Adult. Open Access Maced J Med Sci . 2019 Nov 14;7(22):3762-3764. Dawber RP (starts at 1:09:12). Integumentary associations of pernicious anaemia. Br J Dermatol . 1970 Mar;82(3):221-3. Mosley JG and Gibbs AC (starts at 1:09:50). Premature grey hair and hair loss among smokers: a new opportunity for health education? British Medical Journal 1996; 313: 1616. Bhat RM et al (starts at 1:10:21). Epidemiological and investigative study of premature graying of hair in higher secondary and pre-university school children. Int J Trichology. 2013;5:17–21. Chang H-C and Sung C-W (starts at 1:10:35). Association between serum levels of minerals and premature hair graying: a systematic review and meta-analysis. Int J Dermatol. 2020 Oct;59(10):e378-e380. Schnohr P et al (starts at 1:12:35). Longevity and gray hair, baldness, facial wrinkles, and arcus senilis in 13,000 men and women: The Copenhagen city heart study. J Gerontol A Biol Sci Med Sci. 1998;53:M347–50. Schnohr P et al. Gray hair, baldness, and wrinkles in relation to myocardial infarction: the Copenhagen City Heart Study. Am Heart J  1995 Nov;130(5):1003-10.   Kocaman SA et al (starts at 1:14:10) . The degree of premature hair graying as an independent risk marker for coronary artery disease: A predictor of biological age rather than chronological age. Anadolu Kardiyol Derg 2012;12:457-63.  Paik S et al (starts at 1:14:25). Association Between Premature Hair Greying and Metabolic Risk Factors: A Cross-sectional Study. Acta Derm Venereo. 2018 Aug 29;98(8):748-752. Mahendiratta S et al (starts at 1:15:09). Premature graying of hair: Risk factors, co-morbid conditions, pharmacotherapy and reversal-A systematic review and meta-analysis. Dermatol Ther. 2020 Nov;33(6):e13990. Das S et al (starts at 1:15:51) Cardiovascular risk markers in premature canities. Indian J Dermatol Venereol Leprol. 2022 Jun 30;1-5.

Drs. Tom Dilworth and Stephanie Shealy May (@stephshealymay) join Dr. Rachel Britt (@RachelBPharmD) in the first episode of Breakpoints Dosing Consults to discuss questions and debates around ceftriaxone dosing. When should we use 1g over 2g? How does critical illness affect what dose to use? Is ceftriaxone the most approachable antibiotic? Tune in for answers to these questions and more!   Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ References Ettestad PJ, Campbell GL, Welbel SF, Genese CA, Spitalny KC, Marchetti CM, Dennis DT. Biliary complications in the treatment of unsubstantiated Lyme disease. J Infect Dis. 1995 Feb;171(2):356-61. doi: 10.1093/infdis/171.2.356. PMID: 7844372. Hasegawa S, Sada R, Yaegashi M, Morimoto K, Mori T; Adult Pneumonia Study Group-Japan. 1g versus 2 g daily intravenous ceftriaxone in the treatment of community onset pneumonia - a propensity score analysis of data from a Japanese multicenter registry. BMC Infect Dis. 2019 Dec 26;19(1):1079. doi: 10.1186/s12879-019-4552-8. PMID: 31878894; PMCID: PMC6933656. Barber KE, Loper JT, Morrison AR, Stover KR, Wagner JL. Impact of Obesity on Ceftriaxone Efficacy. Diseases. 2020 Jul 9;8(3):27. doi: 10.3390/diseases8030027. PMID: 32660113; PMCID: PMC7563366. Herrera-Hidalgo L, de Alarcón A, López-Cortes LE, Luque-Márquez R, López-Cortes LF, Gutiérrez-Valencia A, Gil-Navarro MV. Is Once-Daily High-Dose Ceftriaxone plus Ampicillin an Alternative for Enterococcus faecalis Infective Endocarditis in Outpatient Parenteral Antibiotic Therapy Programs? Antimicrob Agents Chemother. 2020 Dec 16;65(1):e02099-20. doi: 10.1128/AAC.02099-20. Erratum in: Antimicrob Agents Chemother. 2021 May 18;65(6): PMID: 33046488; PMCID: PMC7927845. Herrera-Hidalgo L, Lomas-Cabezas JM, López-Cortés LE, Luque-Márquez R, López-Cortés LF, Martínez-Marcos FJ, de la Torre-Lima J, Plata-Ciézar A, Hidalgo-Tenorio C, García-López MV, Vinuesa D, Gutiérrez-Valencia A, Gil-Navarro MV, De Alarcón A. Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT. J Clin Med. 2021 Dec 21;11(1):7. doi: 10.3390/jcm11010007. PMID: 35011748; PMCID: PMC8745305. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1. PMID: 34292926; PMCID: PMC8344968. Whittles LK, White PJ, Paul J, Didelot X. Epidemiological Trends of Antibiotic Resistant Gonorrhoea in the United Kingdom. Antibiotics (Basel). 2018 Jul 13;7(3):60. doi: 10.3390/antibiotics7030060. PMID: 30011825; PMCID: PMC6165062. Ackerman A, Zook NR, Siegrist JF, Brummitt CF, Cook MM, Dilworth TJ. Comparison of Clinical Outcomes among Intensive Care Unit Patients Receiving One or Two Grams of Ceftriaxone Daily. Antimicrob Agents Chemother. 2020 May 21;64(6):e00066-20. doi: 10.1128/AAC.00066-20. PMID: 32205348; PMCID: PMC7269488. Ulldemolins M, Roberts JA, Rello J, Paterson DL, Lipman J. The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin Pharmacokinet. 2011 Feb;50(2):99-110. doi: 10.2165/11539220-000000000-00000. PMID: 21142293. Dailly E, Arnould JF, Fraissinet F, Naux E, Letard de la Bouralière MA, Bouquié R, Deslandes G, Jolliet P, Le Floch R. Pharmacokinetics of ertapenem in burns patients. Int J Antimicrob Agents. 2013 Jul;42(1):48-52. doi: 10.1016/j.ijantimicag.2013.02.021. Epub 2013 Apr 8. PMID: 23578794. Pai MP. Treatment of bacterial infections in obese adult patients: how to appropriately manage antimicrobial dosage. Curr Opin Pharmacol. 2015 Oct;24:12-7. doi: 10.1016/j.coph.2015.06.004. Epub 2015 Jun 25. PMID: 26119488. Mahmood I. Theoretical versus empirical allometry: Facts behind theories and application to pharmacokinetics. J Pharm Sci. 2010 Jul;99(7):2927-33. doi: 10.1002/jps.22073. PMID: 20127826. Kang N, Housman ST, Nicolau DP. Assessing the Surrogate Susceptibility of Oxacillin and Cefoxitin for Commonly Utilized Parenteral Agents against Methicillin-Susceptible Staphylococcus aureus: Focus on Ceftriaxone Discordance between Predictive Susceptibility and in Vivo Exposures. Pathogens. 2015 Jul 30;4(3):599-605. doi: 10.3390/pathogens4030599. PMID: 26264030; PMCID: PMC4584275. Gern BH, Greninger AL, Weissman SJ, Stapp JR, Tao Y, Qin X. Continued in vitro cefazolin susceptibility in methicillin-susceptible Staphylococcus aureus. Ann Clin Microbiol Antimicrob. 2018 Feb 20;17(1):5. doi: 10.1186/s12941-018-0257-x. PMID: 29463249; PMCID: PMC5819674. Bremmer DN, Balada-Llasat JM, Goff DA, Bauer KA. Ceftriaxone Etest non-susceptible methicillin susceptible Staphylococcus aureus time-kill responses. Diagn Microbiol Infect Dis. 2017 Jun;88(2):192-194. doi: 10.1016/j.diagmicrobio.2017.02.019. Epub 2017 Mar 2. PMID: 28291629. Kosowska-Shick K, McGhee PL, Appelbaum PC. Affinity of ceftaroline and other beta-lactams for penicillin-binding proteins from Staphylococcus aureus and Streptococcus pneumoniae. Antimicrob Agents Chemother. 2010 May;54(5):1670-7. doi: 10.1128/AAC.00019-10. Epub 2010 Mar 1. PMID: 20194704; PMCID: PMC2863635. Palmer SM, Kang SL, Cappelletty DM, Rybak MJ. Bactericidal killing activities of cefepime, ceftazidime, cefotaxime, and ceftriaxone against Staphylococcus aureus and beta-lactamase-producing strains of Enterobacter aerogenes and Klebsiella pneumoniae in an in vitro infection model. Antimicrob Agents Chemother. 1995 Aug;39(8):1764-71. doi: 10.1128/AAC.39.8.1764. PMID: 7486916; PMCID: PMC162823. Craig WA. Interrelationship between pharmacokinetics and pharmacodynamics in determining dosage regimens for broad-spectrum cephalosporins. Diagn Microbiol Infect Dis. 1995 May-Jun;22(1-2):89-96. doi: 10.1016/0732-8893(95)00053-d. PMID: 7587056. Garot D, Respaud R, Lanotte P, Simon N, Mercier E, Ehrmann S, Perrotin D, Dequin PF, Le Guellec C. Population pharmacokinetics of ceftriaxone in critically ill septic patients: a reappraisal. Br J Clin Pharmacol. 2011 Nov;72(5):758-67. doi: 10.1111/j.1365-2125.2011.04005.x. PMID: 21545483; PMCID: PMC3243010. Joynt GM, Lipman J, Gomersall CD, Young RJ, Wong EL, Gin T. The pharmacokinetics of once-daily dosing of ceftriaxone in critically ill patients. J Antimicrob Chemother. 2001 Apr;47(4):421-9. doi: 10.1093/jac/47.4.421. PMID: 11266414. Van Wart SA et al., ICAAC 2009, poster # A1-010 Housman ST, Sutherland CA, Nicolau DP. Pharmacodynamic profile of commonly utilised parenteral therapies against meticillin-susceptible and meticillin-resistant Staphylococcus aureus collected from US hospitals. Int J Antimicrob Agents. 2014 Sep;44(3):235-41. doi: 10.1016/j.ijantimicag.2014.05.012. Epub 2014 Jun 24. PMID: 25052866. Zelenitsky SA, Beahm NP, Iacovides H, Ariano RE, Zhanel G. Limitations of ceftriaxone compared with cefazolin against MSSA: an integrated pharmacodynamic analysis. J Antimicrob Chemother. 2018 Jul 1;73(7):1888-1894. doi: 10.1093/jac/dky120. PMID: 29635472. Paul M, Zemer-Wassercug N, Talker O, Lishtzinsky Y, Lev B, Samra Z, Leibovici L, Bishara J. Are all beta-lactams similarly effective in the treatment of methicillin-sensitive Staphylococcus aureus bacteraemia? Clin Microbiol Infect. 2011 Oct;17(10):1581-6. doi: 10.1111/j.1469-0691.2010.03425.x. Epub 2010 Dec 14. PMID: 21073629. Carr DR, Stiefel U, Bonomo RA, Burant CJ, Sims SV. A Comparison of Cefazolin Versus Ceftriaxone for the Treatment of Methicillin-Susceptible Staphylococcus aureus Bacteremia in a Tertiary Care VA Medical Center. Open Forum Infect Dis. 2018 May 18;5(5):ofy089. doi: 10.1093/ofid/ofy089. PMID: 30568987; PMCID: PMC5961173. Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Video version of episode: https://www.youtube.com/watch?v=elzijduKNS8 Chubbyemu case: https://youtu.be/UrbylXMU8Mw Most snowglobes are just made of water, but some can contain ethylene glycol. Most of those usually don't contain enough ethylene glycol to cause damage, but keep the word "usually" in mind. A homemade snowglobe can contain concentrations of anything, which is what happened in this case. Ethylene glycol can cause a profound high anion gap metabolic acidosis, and we'll explain the science, chemistry and physiology behind that in this episode. References: Delayed ethylene glycol presenting with abdominal pain and multiple cranial and peripheral neuropathies: a case report. Journal of Medical Case Reports volume 4, Article number: 220 (2010). Multiple Cranial Nerve Deficits After Ethylene Glycol. Ann Emerg Med. 1991 Feb;20(2):208-10. https://pubmed.ncbi.nlm.nih.gov/1996809/ Antidotes OH that form toxic metabolites. Br J Clin Pharmacol. 2016 Mar; 81(3): 505–515. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767193/ Toxic Alcohols. N Engl J Med 2018; 378:270-280. https://www.nejm.org/doi/full/10.1056/NEJMra1615295 Ethylene glycol ingestion masked by concomitant ethanol ingestion. Case Reports 2012;2012:bcr1220115326. https://casereports.bmj.com/content/2012/bcr.12.2011.5326 Challenges in the Diagnosis of Ethylene Glycol Poisoning. Ann Clin Biochem. 2014 Mar;51(pt2):167-78. https://pubmed.ncbi.nlm.nih.gov/24215789/ Emmett M, Narins RG. Clinical use of the anion gap. Medicine (Baltimore) 1977;56:38-54. Uribarri J, Oh MS, Carroll HJ. D-lactic acidosis: a review of clinical presentation, biochemical features, and pathophysiologic mechanisms. Medicine (Baltimore) 1998;77:73-82. Judge BS. Metabolic acidosis: differentiating the causes in the poisoned patient. Med Clin North Am 2005;89:1107-1124. Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786-1795. https://www.nejm.org/doi/full/10.1056/NEJMra020617 A 49 Year Old Man With Obtundation Followed By Agitation And Acidosis. N Engl J Med 2015; 372:465-473. https://www.nejm.org/doi/full/10.1056/NEJMcpc1410940 Integration of Acid-Base And Electrolyte Disorders. N Engl J Med 2014; 371:1821-1831. https://www.nejm.org/doi/full/10.1056/NEJMra1215672 Calcium Kidney Stones. N Engl J Med 2010; 363:954-963. https://www.nejm.org/doi/full/10.1056/NEJMcp1001011 --- Support this podcast: https://anchor.fm/chubbyemu/support

In the past two weeks, warnings, questions, and misinformation concerning COVID-19 and NSAID use have been spreading...no pun intended..virally. The pace of this evolving pandemic and the equally quick pace of the news and social media news cycle have meant that information and misinformation travel equally fast. Today we bring to you the story of how a letter in The Lancet led to a world of confusion. Host: Elizabeth Esty, MD Research By: Elizabeth Esty & Nathan Novotny Sound Editing By: Stephen Bahmani Time Stamps: 0:00 - COVID-19 Statistics 2:55 - The Lancet Letter: What Started the Rumor 4:10 - ACE Inhibitors & ARB's 5:00 - What The Lancet Letter Got Wrong 6:25 - Treatment of HTN and DM in China vs. the U.S. 9:13 - Do ACE Inhibitors Actually Increase ACE-2 Expression? 11:00 - The French Ministry of Health and Their Warning About NSAIDs 14:09 - Misinformation in the Age of COVID-19 15:09 - Potential Harms of Tylenol Use 16:11 - The Need for High-Quality Science to Overcome COVID-19 References: Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. March 2020:S2213260020301168. doi:10.1016/S2213-2600(20)30116-8 Kane S. Ibuprofen - Drug Usage Statistics, ClinCalc DrugStats Database. ClinCalc DrugStats Database. https://clincalc.com/DrugStats/Drugs/Ibuprofen. Published December 23, 2019. Accessed March 30, 2020. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. March 2020. doi:10.1016/j.cell.2020.02.052 Lu J, Lu Y, Wang X, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project). The Lancet. 2017;390(10112):2549-2558. doi:10.1016/S0140-6736(17)32478-9 Wang Zengwu, Chen Zuo, Zhang Linfeng, et al. Status of Hypertension in China. Circulation. 2018;137(22):2344-2356. doi:10.1161/CIRCULATIONAHA.117.032380 Hu C, Jia W. Diabetes in China: Epidemiology and Genetic Risk Factors and Their Clinical Utility in Personalized Medication. Diabetes. 2018;67(1):3-11. doi:10.2337/dbi17-0013 Yuan H, Li X, Wan G, et al. Type 2 diabetes epidemic in East Asia: a 35-year systematic trend analysis. Oncotarget. 2018;9(6). doi:10.18632/oncotarget.22961 Woo KS, Nicholls MG. High prevalence of persistent cough with angiotensin converting enzyme inhibitors in Chinese. Br J Clin Pharmacol. 1995;40(2):141-144. Chen X, Hu W, Ling J, et al. Hypertension and Diabetes Delay the Viral Clearance in COVID-19 Patients. medRxiv. March 2020:2020.03.22.20040774. doi:10.1101/2020.03.22.20040774 Perico L, Benigni A, Remuzzi G. Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade. NEF. March 2020:1-9. doi:10.1159/000507305 Qiao Y, Shin J-I, Chen TK, et al. Association Between Renin-Angiotensin System Blockade Discontinuation and All-Cause Mortality Among Persons With Low Estimated Glomerular Filtration Rate. JAMA Intern Med. March 2020. doi:10.1001/jamainternmed.2020.0193 The Local. UPDATE - Coronavirus: French health minister and WHO issue warning over taking anti-inflammatories. https://www.thelocal.fr/20200314/coronavirus-french-health-minister-issues-warning-over-anti-flammatories. Published March 14, 2020. Accessed March 30, 2020. ScienceAlert. Updated: WHO Now Doesn’t Recommend Avoiding Ibuprofen For COVID-19 Symptoms. https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms. Accessed March 30, 2020. European Medicines Agency. Coronavirus disease (COVID-19). https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19#advice-on-using-non-steroidal-anti-inflammatory-medicines-such-as-ibuprofen--section. Published March 18, 2020. U.S. Food and Drug Administration. FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19. https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19. Published March 19, 2020. BBC Reality Check team and BBC Monitoring. Coronavirus and ibuprofen: Separating fact from fiction. BBC News. https://www.bbc.com/news/51929628. Published March 17, 2020. Mosbergen D. Tylenol Overdose Risk Is Staggering; Acetaminophen Safeguards Remain Insufficient: Report. HuffPost. https://www.huffpost.com/entry/tylenol-overdose_n_3976991. Published September 24, 2013.    

Contributor: Dylan Luyten, MD Educational Pearls: Insulin related hypoglycemia can vary from a brief transient effect from short-acting forms (i.e. insulin lispro) to prolonged from long acting (i.e. insulin glargine), and will require different treatment and/or observation Of oral glycemic agents, sulfonylureas are a common culprit while metformin is rarely a cause Sulfonylureas also deserve attention because in pediatric patients, they can be lethal even with a single ingestion, but also can cause severe hypoglycemia in adults Hypoglycemia in non-diabetics usually occurs in the malnourished, or in those with liver or adrenal disease References Klein-Schwartz W, Stassinos GL, Isbister GK. Treatment of sulfonylurea and insulin overdose. Br J Clin Pharmacol. 2016;81(3):496–504. doi:10.1111/bcp.12822 Tourkmani AM, Alharbi TJ, Rsheed AMB, AlRasheed AN, AlBattal SM, Abdelhay O, Hassali MA, Alrasheedy AA, Al Harbi NG, Alqahtani A. Hypoglycemia in Type 2 Diabetes Mellitus patients: A review article. Diabetes Metab Syndr. 2018 Sep;12(5):791-794. doi: 10.1016/j.dsx.2018.04.004. Epub 2018 Apr 12. Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

  Episode 278 is an all inclusive guide to kidney anatomy, health, bloodwork, and MORE for physique and performance based athletes! First I dig into some basics on kidney anatomy and function before moving into some considerations for athletes looking to get bloodwork done to track kidney health, and all before ending with practical application on how to maintain kidney health while pushing for your goals! Also, theres a few references I'll provide below for those looking to take things further!   REFERENCES Adelstein RS, Sellers JR. Effects of calcium on vascular smooth muscle contraction. The American journal of cardiology. Jan 30 1987;59(3):4b-10b.   Agre P, King LS, Yasui M, Guggino WB, Ottersen OP, Fujiyoshi Y, . . . Nielsen S. Aquaporin water channels--from atomic structure to clinical medicine. The Journal of physiology. Jul 1 2002;542(Pt 1):3-16.   AHA. American Heart Association. Kidney Damage and High Blood Pressure. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Kidney-Damage-and-High-Blood-Pressure_UCM_301825_Article.jsp. Last updated 9/11/2014a. Accessed 8/10/2014.     Akinwusi PO, Oluyombo R, Ogunro PS, Adeniji AO, Okunola OO, Ayodele OE. Low dose aspirin therapy and renal function in elderly patients. International journal of general medicine. 2013;6:19-24.   Al-Awqati Q, Barasch J, Goldman L (ed.), SchaferAI (ed.). Goldman's Cecil Medicine, Twenty-Fourth Edition. Chapter 117: Structure and Function of the Kidneys; 716-720. Copyright 2012 Saunders, an imprint of Elsevier, Inc. Available at: www.clinicalkey.com Accessed: 6/9/2014.   Alpern RJ, Sakhaee K. The clinical spectrum of chronic metabolic acidosis: homeostatic mechanisms produce significant morbidity. American journal of kidney diseases : the official journal of the National Kidney Foundation. Feb 1997;29(2):291-302.   Amodu A, Abramowitz MK. 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Unfortunately, many patients with epilepsy fail their first trial of an anti-seizure medication. A large proportion of these patients are put on a second agent...or a third. But is more necessarily better? Produced by James E. Siegler. Music by Justin Warren and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol. 2006;61:246-255 Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology. 2004;62:292-295 Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res. 2005;65:185-188 Pennell PB, Peng L, Newport DJ, Ritchie JC, Koganti A, Holley DK, et al. Lamotrigine in pregnancy: Clearance, therapeutic drug monitoring, and seizure frequency. Neurology. 2008;70:2130-2136

Things you need to know about the way anti-epileptic drugs affect each other, all in one podcast. Take a few minutes here to familiarize yourself with these common and critical complications of seizure management. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health identifying information. The content in this episode was vetted and approved by Danielle Becker. REFERENCES 1. Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol. 2006;61:246-255 2. Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology. 2004;62:292-295 3. Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res. 2005;65:185-188 4. Pennell PB, Peng L, Newport DJ, Ritchie JC, Koganti A, Holley DK, et al. Lamotrigine in pregnancy: Clearance, therapeutic drug monitoring, and seizure frequency. Neurology. 2008;70:2130-2136

For the Show Notes, see the gemcast website: http://gempodcast.com/2015/11/11/high-risk-medications-and-adverse-drug-events/ Adverse drug events (ADEs) are a major problem among older adults who present to the Emergency Department. ADEs come in 5 types. 1 in 6 hospitalizations among older adults involves an ADE, and half of the hospitalizations for ADEs are deemed preventable. What medications should be used with caution or avoided in older adults? What are safer alternatives? In this podcast we discuss the types of ADEs, which patients are at greatest risk, the highest risk medications, alternatives to the high-risk medications, and ways to prevent ADEs. Leah Hatfield, an ED pharmacist, shares her wisdom. References: 1. By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American geriatrics society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015. 2. Hanlon JT, Semla TP, Schmader KE. Alternative medications for medications in the use of high-risk medications in the elderly and potentially harmful drug-disease interactions in the elderly quality measures. J Am Geriatr Soc. 2015. 3. Alhawassi TM, Krass I, Bajorek BV, Pont LG. A systematic review of the prevalence and risk factors for adverse drug reactions in the elderly in the acute care setting. Clin Interv Aging. 2014;9:2079-2086. 4. Pretorius RW, Gataric G, Swedlund SK, Miller JR. Reducing the risk of adverse drug events in older adults. Am Fam Physician. 2013;87(5):331-336. 5. Passarelli MC, Jacob-Filho W, Figueras A. Adverse drug reactions in an elderly hospitalised population: Inappropriate prescription is a leading cause. Drugs Aging. 2005;22(9):767-777. 6. Saedder EA, Lisby M, Nielsen LP, Bonnerup DK, Brock B. Number of drugs most frequently found to be independent risk factors for serious adverse reactions: A systematic literature review. Br J Clin Pharmacol. 2015;80(4):808-817. Image credit: https://pixabay.com/en/pill-capsule-medicine-medical-1884775/ Sound credits: sounds from freesound.org by Jobro and HerbertBoland