Johns Hopkins Medicine’s Post

Working Wednesday Tip ⁉ Surgery or No surgery? That is the question. 💡 The rise in IV drug use is a concerning trend with severe consequences for the heart. Tricuspid valve endocarditis, an infection of the tricuspid valve - the right-sided valve - is particularly prevalent among IV drug abusers. 💡 The tricuspid valve controls blood flow from the heart's upper chamber (atrium) to the lower chamber (ventricle). When this valve malfunctions, allowing blood to ‘leak’ back into the atrium, it strains the heart, leading to potential damage. 💡 Recognizing the Signs and Symptoms: •          Fatigue •          Abdominal and leg swelling •          Irregular heart rhythm/ fast heart beat •          Shortness of breath •          Enlarged liver 💡 Treatment typically involves a combination of antibiotics. However, managing tricuspid valve endocarditis in IV drug abusers requires a multifaceted approach. 🚦 Clinical Pearls: 1.        IV drug abusers should be admitted for substance abuse assistance and receive intense IV antibiotic therapy. 2.        An IV drug abuser shouldn't be discharged with IV access to prevent further drug use. 3.        Tricuspid valve repair or surgery is often recommended; however, the risk of reinfection after surgery is increased, particularly if IV drug use continues. Content Source: Mayo Clinic Photo Source: Mayo Clinic …………………………………………………………………………………………………. Hey y’all, my name is Yvette. I am a cardiology nurse, if you're knee-deep in a cardiology or telemetry medical malpractice cases, know this: I've got your back. With over 25 years of experience under my stethoscope, I'm here to offer expert analysis and support. Let's go on this journey together, with honesty, integrity, and a sprinkle of social fun.

🔍 Clinical Tips! Honesty is key: Discover how transparency builds trust between patients and practitioners in the realm of filler treatments. Plus, unravel strategies for navigating challenging conditions like delusional parasitosis and drug-induced balanitis. Read More: https://okt.to/9ncyap #CosmeticDerm #SkinCare #Derm #Dermatology #Dermatologist #DermInsights #SkincareExperts #DermDiaries #DermatologyExperts #Dermatology101 #DermatologyCare #DermatologyEducation

Ever wondered about the story behind the anesthesia that revolutionized surgeries and improved patient experiences? 🤔 In 1846, ether marked a pivotal moment in medicine. Fast forward 130 years, and Iain Glen, with unwavering determination, transformed 2,6 diisopropylphenol into the game-changing propofol we know today. Here are a few benefits to Propofol: ✅Lightning-Fast Onset: Quick and smooth anesthesia induction. ✅Swift Awakening: Rapid metabolism ensures a clear-headed wake-up. ✅Significantly reduced nausea and vomiting. ✅Innovative Imaging: Enables safe imaging in young children, enhancing diagnosis. ✅Ambulatory Surgery Growth: Paved the way for outpatient procedures. Glen's journey, from a vet student to a groundbreaking researcher, is inspiring. Her persisted even when trials halted in 1980 and he proved propofol's safety. Propofol is now available in 90 countries and millions of patients each year receive propofol anesthesia by continuous infusion. You can read more about him and watch a short video as well here: https://lnkd.in/etcT8nWz #operatingroom #surgery #anesthesia #crna #ornurse #scrubtech

Today I bring an information related to eye drop which is called "Ceflox -D" . The composition and their function is given below : 1️⃣.Ciprofloxacin ➡️ it is used to treat infections of the eye, such as bacterial conjunctivitis. Ciprofloxacin eye drops is also used to treat corneal ulcers of the eye. Ciprofloxacin belongs to a group of medicines called fluoroquinolone antibiotics. It works by killing bacteria that cause conjunctivitis. 2️⃣.Dexamethasone ➡️ it is used to treat inflammation of the eyes caused by allergies and certain conditions, including damage caused by chemical and thermal burns. Dexamethasone eye insert is used to treat eye pain and swelling after eye surgery. It is also used to treat itching of the eye caused by a condition known as allergic conjunctivitis. Dexamethasone belongs to the group of medicines known as corticosteroids (steroids or cortisone-like medicines) that is used to relieve the redness, itching, and swelling caused by eye infections and other conditions or procedures (eg, eye surgery). #pharma #pharmaceutical #medicine #eyecare #conjunctivitis #bioengineering #biotechnology #biochemistry

Sciatica is a condition that causes pain, tingling, or numbness in the lower back, buttock, and leg. It is usually caused by pressure on the sciatic nerve, which is the longest and thickest nerve in the body. - **Medications**: Anti-inflammatory drugs, such as aspirin, celecoxib, or diclofenac, can help reduce inflammation and pain. Muscle relaxants, such as carisoprodol, tizanidine, or thiocolchicoside, can help ease muscle spasms. Antidepressants, such as amoxapine, desipramine, or trimipramine, can help improve mood and regulate pain signals. Narcotics, such as codeine, hydrocodone, or oxycodone, can provide strong pain relief - **Steroid injections**: In some cases, a doctor may inject a corticosteroid medication into the area around the nerve root that is causing pain. This can help reduce inflammation and provide temporary pain relief. However, this treatment has some risks and limitations, such as infection, bleeding, nerve damage, and reduced bone density. It can also only be done up to three times in one year². - **Surgery**:. The most common type of surgery for sciatica is decompression, which involves removing the part of the disc, bone, or tissue that is pressing on the nerve. Surgery can provide immediate and long-term pain relief, but it also has some risks and complications, such as infection, bleeding, nerve damage, and recurrence of symptoms².

Daily Critical Care Pearls #134: Status Epilepticus - Treatment of the Underlying Causes In addition to emergency management with antiepileptics and vitals support, it is essential to address the underlying cause 👇👇 ✅Bacterial infection - antibiotics ✅Viral infection - antivirals ✅Abscess – surgery ✅Increased ICP – neurosurgical decompression ✅Eclampsia – Mg2+ and BP management (early delivery of baby and placenta) ✅Isoniazid OD or pyridoxine-dependent seizures (e.g. neonates) – pyridoxine ✅Cholinergic syndrome – atropine, palidoxime if organophosphate poisoning) ✅Sodium channel blocker overdose – sodium bicarbonate, intralipid #criticalcare #pharmacy #medicine #clinicalpharmacy #pearls

Lets talk about an antidiabetic drug with unique councilling point Drug name Acarbose an antidiabetic Agent,Alpha-Glucosidase Inhibitor Brand name: Glucobay the only product available in Pakistan (Currently out of stock in market also) 🔶 Diabetes mellitus, type 2, treatment ✴️ Initial: 25 mg 3 times daily while maximum maintenance dose of 50 to 100 mg 3 times daily increased after 4-8 weeks. 🔶 Postprandial hyperinsulinemic hypoglycemia after gastric bypass surgery (off label): ✴️ Oral: 25 to 100 mg 3 times daily just prior to the start of each meal, or if more frequent meals may consider 25 to 50 mg up to 6 times daily 👉 Councilling point: Take medication with a first bite of each main meal

Context🛑👉🏻Heparin and warfarin are both anticoagulant medications, but they work in different ways and are used for different purposes in managing blood clotting disorders ⬛HEPARIN:- ➡️Heparin is a fast-acting anticoagulant that works by inhibiting the formation of blood clots. It primarily acts in the blood and prevents the formation of fibrin, a key component of blood clots. ➡️Heparin acts quickly but has a short duration of action, so it's often used in acute situations or during surgery. ⬛ WARFARIN:- ➡️Warfarin is a slower-acting anticoagulant that interferes with the body's ability to use vitamin K to produce clotting factors. It affects the liver's production of clotting proteins and takes a few days to become fully effective. ➡️Warfarin has a delayed onset of action and takes several days to reach its full effect. It is used for long-term prevention of blood clots. #pharmacology #drugsafety #medicine #mechanism #anatomyandphysiology #pathology #pharmacovigilance #icsr

Why FDA says "Stop SGLT2 Inhibitors for Diabetes Prior to Surgery…?" >Sodium-glucose co-transporter 2 (SGLT2)-inhibitors are increasingly being prescribed by cardiovascular clinical teams for patients with heart failure with and without diabetes mellitus. >The cardiovascular teams should be aware of recent Food and Drug Administration (FDA) advisory warnings for increased incidence of euglycemic diabetic ketoacidosis when SGLT2-inhibitors medications are continued prior to cardiac and non-cardiac surgeries. >These warnings have stated that continuing SLGT2-inhibitors preoperatively can lead to poor patient outcomes and increased hospital length of stay. >When caring for patients being referred for surgery it is important to advise patients to stop their SGLT2-inhibitors 3-4 days prior to surgery to minimize the risk of postoperative ketoacidosis and urinary tract infections. #medicationsafety #patientsafety #evidencebasedmedicine

💊𝗔𝗽𝗶𝘅𝗮𝗯𝗮𝗻 Apixaban is a novel oral anticoagulant, approved by FDA in 2012. ✨𝐌𝐞𝐜𝐡𝐚𝐧𝐢𝐬𝐦 𝐨𝐟 𝐚𝐜𝐭𝐢𝐨𝐧: Apixaban is an oral inhibitor of factor Xa. It binds to the active site of factor Xa and inhibits conversion of prothrombin to thrombin. ⚕️𝐓𝐡𝐞𝐫𝐚𝐩𝐞𝐮𝐭𝐢𝐜 𝐮𝐬𝐞: It is used for stroke prevention in non-valvular atrial fibrillation. It is also approved for treating deep venous thrombosis and pulmonary embolism. 🚫𝐀𝐝𝐯𝐞𝐫𝐬𝐞 𝐞𝐟𝐟𝐞𝐜𝐭𝐬: Bleeding is the most serious adverse effect for factor Xa inhibitors as there is no antidote available to reverse the bleeding caused by apixaban. Declining renal function can prolong the effect of the drug and increase the risk of bleeding. ⚠️𝐂𝐚𝐮𝐭𝐢𝐨𝐧: Don't stop apixaban abruptly. It increases the risk of stroke. Doctor may prescribe another anti coagulant to prevent clot formation. There is a risk of epidural or spinal hematoma, when apixaban is used with neuraxial anesthesia. 💊𝐃𝐨𝐬𝐞: 👉𝐒𝐭𝐫𝐨𝐤𝐞 𝐏𝐫𝐨𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 𝐰𝐢𝐭𝐡 𝐀𝐭𝐫𝐢𝐚𝐥 𝐅𝐢𝐛𝐫𝐢𝐥𝐥𝐚𝐭𝐢𝐨𝐧: 5mg PO BID 𝘙𝘦𝘯𝘢𝘭 𝘢𝘥𝘫𝘶𝘴𝘵𝘮𝘦𝘯𝘵: 2.5 mg BID if patient has serum creatinine ≥1.5 mg/dL, age ≥80 years or weight ≤60 kg. (If any 2 characteristics are present) 👉𝐃𝐞𝐞𝐩 𝐯𝐞𝐧𝐨𝐮𝐬 𝐭𝐡𝐫𝐨𝐦𝐛𝐨𝐬𝐢𝐬 𝐚𝐧𝐝 𝐩𝐮𝐥𝐦𝐨𝐧𝐚𝐫𝐲 𝐞𝐦𝐛𝐨𝐥𝐢𝐬𝐦: 10 mg PO BID x 7 days, then 5 mg BID 👉𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐏𝐫𝐨𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 𝐨𝐟 𝐃𝐕𝐓/𝐏𝐄: Indicated following hip or knee replacement surgery Initial: Give 2.5 mg PO 12-24 hr after surgery. Then 2.5 mg BID for 35 days for hip replacement surgery and for 12 days for knee replacement surgery. 🔴Discontinue at least 24 hours before surgery with low risk of bleeding and at least 48 hours before surgery with high risk of bleeding. 📍𝐑𝐞𝐟𝐞𝐫𝐞𝐧𝐜𝐞𝐬: Medline plus medscape #apixaban #healthcare #pharmacist #medication #FDA