Dantrolene (RYANODEX) is an intravenous nanosuspension of dantrolene sodium used as a prophylactic and therapeutic agent to treat malignant hyperthermia (MH) – a life-threatening condition triggered by succinylcholine and halogenated volatile anesthetic gases creating sustained skeletal muscle contraction due to a defect in the release/reuptake of calcium. Dantrolene works by…
Ceftriaxone (Rocephin) is an intravenous/intramuscular third generation cephalosporin that provides decent aerobic gram positive coverage (ie, pneumococcus although bacterial resistance is growing) but wonderful gram negative coverage against organisms like E. coli, Klebsiella, H. flu, and Proteus. Anaerobic bacteria and Pseudomonas are NOT covered by ceftriaxone.
Over a dozen different aortic arch great vessel configurations have been described in humans. I’ve illustrated the two most common types in this diagram. The “normal” aortic arch gives rise to three “great vessels.” From proximal to distal, these arteries are the innominate (which, in turn, gives rise to the…
Levetiracetam (Keppra) is an oral and intravenous antiepileptic drug (AED) indicated as adjunctive therapy for partial onset seizures, myoclonic seizures, and generalized tonic-clonic (“grand mal”) seizures in adults. The medication is used in the pediatric population as well for various reasons beyond my scope of practice. Most AEDs either enhance…
Vecuronium (Norcuron) is a nondepolarizing, aminosteroid neuromuscular junction blocker that, like rocuronium, works at the level of neuromuscular end plate’s nicotinic acetylcholine receptors (AChR) as a competitive antagonist. Because it competes with acetylcholine for a similar binding site, vecuronium’s effects can be overcome to increasing the amount of “normal” substrate…
Meropenem (Merrem) is a broad spectrum intravenous antibiotic and member of the carbapenem β-lactam drug class. These antibiotics are often reserved for multidrug resistant organisms (MDR) causing a wide variety of serious infections like hospital acquired pneumonia, intraabdominal infections, neutropenic fever, complicated soft tissue infections, and gram negative sepsis.
Zosyn (pipercillin-tazobactam or “pip-tazo”) is an intravenous combination of a β-lactam antibiotic with a β-lactamase inhibitor. β-lactamase is an enzyme implicated in antibiotic resistance that breaks down penicillins, cephalosporins, etc., so inhibiting it may make the antibiotic more efficacious in settings where it would be rendered inactive. Zosyn has gram…
Cyanokit (hydroxocobalamin, a form of vitamin B12) is an injectable therapy most often used to treat cyanide toxicity. This medication readily combines with cyanide to form cyanocobalamin thereby freeing cytochrome c oxidase to proceed with aerobic respiration in the electron transport chain.
Cefepime (Maxipime) is a broad-spectrum intravenous antibiotic commonly used to treat infections in inpatient and intensive care settings. Cefepime exerts its antibacterial effect by inhibiting bacterial cell wall synthesis. Specifically, it binds to penicillin-binding proteins (PBPs), essential for cell wall synthesis’s final stages. This results in the inhibition of bacterial…
