Real Time Pharmacology

 Cleanse / Irrigate wound with: 1. Normal Saline 2. Soap and Water, 3. Dakin's solution 4. Other Secure with 1. Foam dressing 2. Kerlix 3. Ace bandage 4. Adhesive Optifoam 5. Medigrip elastic 6. Guaze 7. Other Frequency: 1. Daily 2. Twice daily 3. Other

Povidone iodine has broad antimicrobial activity,works against biofilms, and has effect on inflammation. It can be used for management and  treatment of acute and chronic wounds. Betadine is an over the counter (OTC) medication. It has not been tested and approved by the FDA, however, it complies with applicable regulations and policies.   Application: Wounds, burns and scrapes:  Apply a small amount of 5% topical spray or 10% topical solution, or 10% topical swab to the affected area 1 to 3 times daily  Apply 10% topical ointment directly to affected area Vaginal irritation Insert 0.3% intravaginal douche  once daily for 7 days 

Cancer cells tend to turn their extracellular environment acidic, thus helping these rogue cells thrive while creating a hostile environment for normal ones. Acidosis promotes tumor growth, metastasis and drug resistance, while helping tumor cells evade the immune system. But it’s not clear exactly how this occurs.   Using a fluorescently-labeled peptide called pHLIP that only inserts itself into the membranes of cells under acidic conditions, they mapped the acidic regions of mammary tumors produced by human breast cancer cell lines in mice. The pH probe provided striking images, for the first time at cell-level resolution, that confirmed what  previous methods  had suggested: acidosis is not confined to the hypoxic tumor core, but rather extends to the boundary between tumors and healthy tissue.  Called the tumor-stroma interface, this boundary is the advancing edge of a malignant tumor, where cells spread aggressively and break into blood vessels and nearb...

Vitamin D has multiple biological roles in our body. It increases calcium, magnesium and phosphate absorption .  It is very important to correct the low Vitamin D levels by supplementation.  The two major forms  most commonly available are vitamin D 2  (ergocalciferol), and vitamin D 3  (cholecalciferol). Uses:  Vitamin D deficiency; Prophylaxis, Falls Vitamin D deficiency dose: 50,000 international units orally once weekly for 8 weeks (or) 6000 international units once daily for 8 weeks to achieve a 25-hydroxyvitamin D level greater than 30 nanograms/mL; follow with maintenance dose of 1500 to 2000 international units/day (guideline dosage) Cost: $5 to $14 per month  Common Side effects: Gastrointestinal:  Constipation, Loss of appetite, Nausea Serious side effect:  Endocrine metabolic:  Hypervitaminosis D Renal Impairment Vitamin D undergoes activation in renal tissue; higher doses may be required in patients...

A 91- year old patient. Admitted to the hospital from the ED. Patient was seen for altered mental status. Labs, CT of brain head, CXR XR of left Tib/Fib were performed. Presumed meningioma in the left middle cranial fossa was noted. Sodium was critically low at 114. Nephrologist was consulted and hyponatremia is of unknown etiology. Patient also has uncontroled hypertension. Comorbidities: Coronary artery disease, Diabetes, Dementia, hypothyroidism, hyperlipedemia, neuropathy. Patient will need physicain oversight for hyponatremia, normal saline routinely, and medication management for hypertension. Rx: Sodium Chloride USP 1.0 gram Use  1. Hyponatremia 2. Preparation of normal isotonic solution of sodium chloride 3. As an electrolyte replenisher for the prevention of heat cramps, due to excessive  perspiration 4. any alternate use as directed by a physician Each tablet contains: sodium 394mg Hyponatremia  is a common electrolyte disorder encountered i...

*Clinical atherosclerotic cardiovascular disease (ASCVD) includes acute coronary syndrome (ACS), those with history of myocardial infarction (MI), stable or unstable angina or coronary or other arterial revascularization, stroke, transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic origin. Should I initiate statins or not? The 2014 National Lipid Association (NLA) recommendations provides a more comprehensive, patient-centered approach to identifying ASCVD risk.   In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) issued guidelines to use the intensity of statin therapy as the treatment goal instead of LDL-C or non–HDL-C targets, as in previous guidelines, to reduce atherosclerotic cardiovascular disease (ASCVD) risk (  Andrus & Lacaille, 2014  )  The guideline classifies statin therapy as  high-intensity (lowers LD...

Hispanic, 43 year old female Lots of stress in life Diabetes for 2 years Currently on Metformin 1000 mg BY MOUTH twice daily. Clinic ran comprehensive metabolic panel. Blood glucose 216, Hemoglobin A1C is 7.8 (ADA guideline: A1C of 6.5 or greater, confirmed diabetes with repeat) High triglycerides and cholesterol. Diabetes and numbers: American College of Physicians (ACP), in 2018 proposed changing the recommended A1C target guidelines.Based on outcomes and taking side effects and cost in to consideration they recommend patients with t ype 2 diabetes  should aim to achieve an HbA1C between 7 and 8  percent  instead of 6.5 to 7 percent, as previously advised by ADA.  The American Diabetes Association did not like the suggestions  stating the old standard are better, saying that a “reasonable A1C goal for many non pregnant adults with Type 2 diabetes is less than 7 percent. We went with ADA guidelines and added Glyburide 5 mg daily with lar...