Archive for November 2015

Chronic pain is not acute pain: forget the numerical pain scale

November 27, 2015, 11:11 am

Pain_scale

★★★★☆

Intensity of Chronic Pain — The Wrong Metric? Ballantyne JC, Sullivan MD. N Engl J Med 2015 Nov 26;373:2098-9.

Full Text

This short but very important “Perspective” article argues that numerical pain scales are absolutely the wrong way to evaluate and monitor  chronic pain. The authors point out that:

Opioids . . . have good short-term efficacy, but there is

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Kitchen Tox: beware of the durian

November 17, 2015, 10:21 pm

ThamKC/shutterstock.com

ThamKC/shutterstock.com

★★★☆☆

Durian Induced Hyperkalaemia. Leo CLB et al. Med J Malaysia 2011 Mar;66:66-67.

Full Text

Durian, a spiky, coconut-sized fruit native to Malaysia and grown throughout southeast Asia, is known for its distinctive aroma that some have compared to ripe Limburger cheese. The Oxford Companion to Food notes that others have compared the smell of durian to “the civet …

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Must-read: review of single-dose activated charcoal

November 17, 2015, 12:25 am

wikipedia.org

wikipedia.org

★★★★☆

Activated charcoal for acute overdose: a reappraisal. Juurlink D. Br J Clin Pharmacol 2015 Sep 26 [Epub ahead of print]

Abstract

The British Journal of Clinical Pharmacology seems to be publishing a series of articles on basic management of the poisoned patient. Several weeks ago we reviewed (and highly recommended) Marco Sivilotti’s excellent discussion of flumazenil, naloxone and the

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Review: recreational marijuana use

November 10, 2015, 3:21 pm

Stanimir G. Stoev/Shutterstock.com

Stanimir G. Stoev/Shutterstock.com

★★★☆☆

Recreational cannabis use: Pleasures and pitfalls. Rella JG. Cleve Clin J Med 2015 Nov;82:765-72.

Full Text

This somewhat superficial but relatively well done review article gets extra credit for being available via open access. The author covers the history, pharmacology, toxicology, and acute and chronic effects of cannabis use, as well as withdrawal and the cannabinoid hyperemesis

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Therapeutic plasma exchange in poisoned patients

November 7, 2015, 7:08 pm

★☆☆☆☆

Therapeutic plasma exchange in poisoning: 8 years’ experience of a university hospital. Disel NR et al. Am J Emerg Med 2015 Oct;33:1391-1395.

Abstract

In therapeutic plasma exchange (TPE), blood is removed from the body, and plasma is separated from components such as RBCs, WBCs, and platelets. Those components are re-infused along with a replacement fluid such as fresh-frozen plasma or …

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Use of flumazenil and naloxone in poisoned patients

November 2, 2015, 11:08 pm

flumazenil★★★★☆

Flumazenil, naloxone and the ‘coma cocktail’ Sivilotti MLA Br J Clin Pharmacol 2015 Aug 7 [Epub ahead of print]

Abstract

This very smart paper reviews factors affecting the clinical use of two antidotes that reliably reverse  coma caused by two major classes of poisons: flumazenil for benzodiazepines, and naloxone for opiates.

Both these antidotes are specific, rapid-acting, short-lived, and titratable. …

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