Gentamicin is an intravenous, intramuscular, and topical aminoglycoside bactericidal antibiotic that works by interfering with bacterial protein synthesis. By binding the 30S subunit of the bacterial ribosome, proteins are improperly translated leading to bacterial death.
Promethazine (Phenergan) is an oral, intramuscular (IM), rectal, and intravenous (albeit with caution!) phenothiazine derivative that is both a first-generation antihistamine (H1 receptor antagonism) and a weak typical antipsychotic (D2 receptor antagonism). It also demonstrates antagonism of muscarinic acetylcholine receptors (anticholinergic) and NMDA receptors (similar to ketamine), conferring some degree…
Loop diuretics like furosemide (Lasix) and bumetanide (Bumex) block the reabsorption of sodium, potassium, and chloride in the thick ascending limb of the loop of Henle. This interferes with concentrating the renal medulla, and in turn, disrupts the osmotic gradient that typically moves water from within the tubules to the…
Polymyxin B is a “last-line” antibiotic primarily used to treat hospital-acquired gram-negative infections that are resistant to essentially all other conventional antibiotics. As an intensivist, I’ve had to use polymyxin B for two very resistant nosocomial bugs: Acinetobacter and Stenotrophomonas. It can also be used for resistant Enterobacteriaceae, Pseudomonas, Salmonella,…
Ceftazidime-avibactam (Avycaz) is an intravenous antibiotic combining a third-generation cephalosporin (inhibits cross-linking of peptidoglycan used to form the bacterial cell wall) with a β-lactamase inhibitor (inhibits a bacterial enzyme which degrades β-lactam antibiotics). Avycaz is used to treat complicated intra-abdominal infections (often with metronidazole), complicated urinary tract infections, and hospital-acquired pneumonia.…
Intravenous (IV) fluids are ubiquitous in medicine. Crystalloid fluids consist of electrolytes and/or dextrose. They are traditionally used to replace ongoing fluid losses, hydrate patients who cannot tolerate enteral intake, reconstitute medications, etc. Colloids contain larger molecular-weight substances, such as albumin and starch, to reduce oncotic pressure (although their clinical…
Aorta-esophageal fistula is an abnormal communication between the aorta and esophagus leading to life-threatening exsanguination via the GI tract. This can be caused by procedures (e.g., weeks following cardiac arrhythmia ablation), malignancy, foreign body, aortic aneurysm, etc. Patients typically present with massive bright red GI bleeding that can be intermittent…
As part of a quick point-of-care ultrasound (POCUS) examination, ocular ultrasound can help determine increased intracranial pressure (ICP), retinal detachment, lens dislocation, vitreous hemorrhage, etc. in conjunction with the patient’s history and physical exam.
As a follow-up to my labeled anatomical heart emoji, I give you the lungs! Also from the Emoji 13.0 list.
