PCN Allergy
From January 2020, Mainlining MadnessBryan and Mike discuss the incidence and repercussions of penicillin and cephalosporin allergy histories, the true nature of cross-reactivity, and the approach to evaluation and management in the urgent care setting.
15min 43Bryan Hayes, PharmD and Mike Weinstock, MD
No Antibiotics for You!
From December 2019, Medication MishapsBeing pressured to provide antibiotics when its not indicated is a common phenomenon. Miz chats with EM-Over-Easy guys Andy Little and Drew Kalnow on ways to approach this ask, and ways to educate our patients in a constructive way.
17min 29Andy Little, DO, Drew Kalnow, DO, and Mizuho Morrison, DO
Legal Lessons: Risks of Medications
From December 2019, Medication MishapsPatients who have cellulitis should have antibiotics selected based on potential for treatment of the cellulitis as well as risks of side effects of the antibiotic.
19min 5Matthew DeLaney, MD and Mike Weinstock, MD
Excellence In Physical Exam Series | ACE Inhibitor Angioedema
From October 2019, SVT?! REVERT Me!ACE inhibitor angioedema has a range of presentations from mild lip swelling to airway closure – an exam starts with observing the patient for signs of respiratory distress and then obtaining a good view of the posterior pharynx looking for glottal edema and posterior pharyngeal edema.
11min 20Jesse Nichos, DO and Mike Weinstock, MD
What Do I Do Next? - Local Anesthetic Systemic Toxicity
From October 2019, SVT?! REVERT Me!Local anesthetics are widely used and generally have a favorable safety profile. Despite their widespread use clinicians need to understand the safe dosage range of these medications for every patient.
16min 6Charles Khoury, MD, Matthew DeLaney, MD, and Doug Wallace, MD
Medical management of ADHD
From August 2019, Disabilities MatterPatients with ADHD are often prescribed medications, but there is a high potential for abuse and diversion as well as weight loss, insomnia, and rebound. Management should be monitored by a health care provider with experience in prescribing these medications and parents should supervise adherence …
16min 50Bryan Hayes, PharmD and Mike Weinstock, MD
Pharyngitis
From June 2019, ID KillersRick and Matt tackle the surprisingly complex topic of pharyngitis and take a deep dive on the microbiology and considerations of antibiotic treatment.
18min 17Matthew DeLaney, MD and Rick Pescatore, DO
Gout Management
From May 2019, Difficult patient vs. personality disorder?Bryan and Mike discuss the pathophysiology of gout, what chronic gout medications patients might be taking, and acute pain management strategies with a focus on NSAIDS, glucocorticoids, and colchicine. They also present a pathway for when to refer the patient for outpatient follow up and possible …
18min 7Bryan Hayes, PharmD and Mike Weinstock, MD
Opiate Prescribing In The Urgent Care
From April 2019, April Showers, Syncope & SprainsThe opioid crisis is the most catastrophic and enduring public health crisis of our time. Recent legislative advances have provided more tools for clinicians to fight the epidemic.
14min 57Mike Weinstock, MD and Rick Pescatore, DO
Listener Feedback & Questions
From March 2019, Bun (Not) In The OvenPatients with compressive lesions in the lumbosacral spine below the level of the conus medullaris may present with signs and symptoms of cauda equina syndrome. Symptoms are due to compression of multiple nerve roots of the cauda equina and may include pain radiating into one or both legs …
15min 17Mike Weinstock, MD and Matthieu DeClerck, MD
Hyperkalemia
From February 2019, No...You Aren't Gonna Die!Bryan and Mike discuss the the presentation of acute hyperkalemia with a focus on ECG changes, medications available in urgent care to treat severe cases, and when to recommend outpatient follow up or arrange transfer to an emergency department.
16min 1Bryan Hayes, PharmD and Mike Weinstock, MD
DOAC Reversal
From February 2019, No...You Aren't Gonna Die!Continuing the recent discussion between Matt DeClerck and Dr. Tom Deloughery on the direct oral anticoagulants (DOACs), this month we bring you a segment on reversing these DOACs with Matt, Neda, and Dr. Tarlan Hedayati. What are the agents currently on the market, including the newest kid on the …
20min 27Tarlan Hedayati, MD, Neda Frayha, MD, and Matthieu DeClerck, MD
Medication Adherence
From January 2019, Can't We All Just Get Along?There are many barriers to patients compliance with prescriptions. Mike sits down with Bryan Hayes to discuss what are the issues, and also practical solutions to increase patient adherence to medications.
15min 34Mike Weinstock, MD
Gastroesophageal Reflux Disease
From December 2018, Head, Shoulders, Knees and ToesMiz and Jenny discuss current diagnosis, workup and management of GERD. Jenny highlights the step-up approach to treatment when lifestyle modifications alone are insufficient.
19min 28Mizuho Morrison, DO and Jenny Beck-Esmay, MD
Listener Questions
From December 2018, Head, Shoulders, Knees and ToesWhile steroids are not usually first line treatment for odontogenic pain they have been shown to be efficacious in treating post-endodontic pain in multiple studies in the dental literature. Steroids may play a role in pts that can not tolerate, are allergic too, or have contraindications to our …
12min 13Matthieu DeClerck, MD and Mike Weinstock, MD
Opioid Withdrawal
From November 2018, Breaking Bad - Insulin Pumps and MandiblesOpioid withdrawal is becoming more and more prevalent. Treatment for opioid withdrawal should be much like treating any other disease. Zachary Repanshek MD discusses use of common medications to treat withdrawal symptoms.
22min 57Neda Frayha, MD, Matthieu DeClerck, MD, and Zack Repanshek, MD
Nitrofurantoin in Pregnancy
From November 2018, Breaking Bad - Insulin Pumps and MandiblesRick does a deep dive on the literature surrounding the use of nitrofurantoin (macrobid) in the first trimester of pregnancy, and finds that the literature does not support ACOG recommendations. When risks of resistant organisms are high, Rick advocates for the routine use of nitrofurantoin for …
10min 17Rick Pescatore, DO and Jessica Pescatore, DO
Dystonic Reactions and Akathisias
From October 2018, You'll Shoot Your Eye Out!Acute extrapyramidal syndrome aka: drug-induced dystonias and akathisia are known side effects to commonly used medications that patients may be taking at home or that we may prescribe in the urgent care setting. The most commonly used medications that can lead to acute dystonia or akathisia …
22min 17Dave Diller, MD and Matthieu DeClerck, MD
What Would I Do Next? | Lactic Acidosis From Glucophage
From October 2018, You'll Shoot Your Eye Out!Patients who are taking metformin and present with weakness should have metformin associated lactic acidosis (MALA) considered in their differential.
14min 59Mike Weinstock, MD, Brent Arnold, DO, and Mike Pallaci, DO
Antibiotic Prescribing In the Urgent Care
From October 2018, You'll Shoot Your Eye Out!A study recently published in JAMA Internal Medicine by Palms et al, demonstrated that urgent cares are overprescribing antibiotics more than any other clinical setting. We need to do a better job of antibiotic stewardship, and Mike and Miz tackle HOW.
14min 13Mizuho Morrison, DO and Mike Weinstock, MD
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