pharmacology

With the growing usage of β-blocker therapy to control everything from atrial fibrillation and congestive heart failure to migraine prophylaxis and essential tremor, we need to be more aware of potential pitfalls due to drug interactions. A…

For the last several months, multiple manufacturing delays have led to a nationwide shortage of injectable, intravenous (IV) opioid medications like morphine, hydromorphone, and fentanyl. These medications are routinely utilized in the…

Ibutilide is easily one of my favorite drugs in critical care and perioperative medicine. It's a short-acting "pure" class III antiarrhythmic (potassium channel blocker). Amiodarone is traditionally classified as a class III, but it…

Neuromuscular blocking agents (NMBAs or "paralytics") are categorized as depolarizing (classically succinylcholine) and nondepolarizing. They're important drugs to know because we routinely use them in the operating room, intensive care…

Patients with bacteremia/fungemia can pose a real challenge, especially when discussing if, how, and when to exchange out existing access catheters. In other words, if I have a patient in my ICU with new gram negative rods in their blood,…

Malignant hyperthermia (MH) is a rare, autosomal dominant condition involving mutations in the ryanodine receptor type 1 (RYR-1) causing an aberrant calcium-induced calcium release (CICR) mechanism. With normal skeletal muscle contraction,…

A simple overview of acetaminophen (Tylenol) toxicity:

In any basic pharmacology course, we're taught the concept of an "elimination half-life", or the time it takes to reach 50% of a drug's initial concentration. With more advanced multi-compartmental models of pharmacokinetics, the concept of…