Inhaled isopropyl alcohol for nausea

An elderly male presents to the emergency department with complaints of nausea, vomiting, and diarrhea starting a day and a half ago.  The diarrhea started abruptly, has occurred almost 10 times, and is non-bloody.  His abdomen is soft but has mild diffuse tenderness.  Vital signs and basic laboratory results are normal except for a potassium of 2.9 mEq/L and an EKG with a QTc interval of 490 msec. 

"How it works" series: Midodrine

Midodrine is a peripherally-acting selective alpha1 receptor agonist.  Let's take that sentence apart to see what we should expect from this medication.  Being an alpha1 agonist, this means that it binds to the alpha1 receptor and activates it, causing it to perform the function that it would usually perform if its endogenous catecholamine (ie. norepinephrine) were to bind to it. 

Nitrofurantoin in renal impairment

A 74 year old female patient presents to clinic describing dysuria and urinary frequency that started within the last few days.  She has no vaginal discharge or irritation and has no CVA tenderness, fevers, chills, flank pain, nausea, or vomiting.  The diagnosis of uncomplicated UTI is made based on clinical suspicion and you decide to prescribe some antibiotics.  She weighs 72 kg and her SCr is 1.4 mg/dL.  Using the Cockcroft-Gault equation,

Pneumococcal vaccine: Which, when, and why?

The pneumococcal vaccine was developed to reduce the disease burden of streptococcus pneumoniae, a gram-postive bacteria that has more than 90 serotypes that can cause diseases in humans.  Some of these infections include pneumonia, meningitis, bacteremia, otitis media, and sinusitis.  There are currently two vaccines on the market to raise immunity against pneumococcal infections - PCV13 (Prevnar 13 - which covers 13 serotypes) and PPSV23 (Pneumovax 23 - which covers 23 serotypes).  The 23-valent vaccine covers all of the serotypes in the

"How it works" series: Daptomycin

Daptomycin (Cubicin) is the first antibiotic in a class known as lipopeptides and has a unique mechanism of action.  Daptomycin is a large molecule with a high molecular weight and has two distinct sections.  One section is a 10 member amino acid ring (illustrated as the big red circle) and the other is the attached lipophilic tail (illustrated as the curvy red line).  The lipophilic tail is capable of direct insertion through the

Linezolid-induced thrombocytopenia

Thrombocytopenia is a notable adverse effect of linezolid.  Some of the evidence behind the onset, duration, and the extent of platelet decrease will briefly be described here and summarized in bullets at the bottom of the discussion.  For a discussion of linezolid's mechanism of action and some other notable features, see a prior post here.