Medical
Neostigmine
Neostigmine is a polar acetylcholinesterase inhibitor (does NOT cross the blood-brain barrier) that is routinely used to reverse non-depolarizing neuromuscular blocking agents (NMBA) like rocuronium, vecuronium, and cisatracurium. These NMBAs are competitive inhibitors at...
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Medical
Calcium Chloride
Calcium chloride (CaCl2) is an ionic form of intravenous calcium repletion with roughly three times more bioavailable calcium than its organic counterpart - calcium gluconate.
The teaching that one needs a functional liver to metabolize...
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Medical
Glycopyrrolate
Glycopyrrolate (Robinul) is an anticholinergic (specifically an anti-muscarinic) that works on peripheral acetylcholine receptors in the heart (SA node, AV node), exocrine glands, and smooth muscle. Because of its polar, quaternary amine structure, it...
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Medical
Dexamethasone
Dexamethasone (Decadron) is synthetic adrenocortical steroid roughly 25 times more potent than hydrocortisone and devoid of mineralcorticoid (“sodium retaining”) properties. Therefore, it's primarily used for long acting, anti-inflammatory effects.
In the ICU, I most commonly...
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Medical
Flumazenil
Flumazenil (Romazicon) is a reversal agent for benzodiazepines ("benzos") through competitive inhibition at the GABA(A)/benzo receptor complex. Since it serves as an antidote for benzos, we have to consider the effects of acute withdrawal...
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Medical
Potassium Chloride
Potassium chloride (KCl) is a form of intravenous electrolyte repletion in hypokalemia - the most common electrolyte disorder in hospitalized patients often caused by diarrhea, vomiting, loop/thiazide diuretics, steroids, and poor intake among many...
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