As it turns out, patients with ARDS should be belly sleepers.  The PROSEVA trial, freshly published in NEJM, examined the role of prone positioning in patients with early, severe acute respiratory distress syndrome (ARDS). Background Prior to PROSEVA, trials examining prone positioning in ... [More]

Voluven (hydroxyethyl starch 130/0.4) was heralded to the hospital community as a cheaper alternative to albumin, but safer than previous hydroxyethyl starch (HES) products that were shown to cause bleeding and renal failure. Although Voluven is likely "safer" than older HES products, it still is NO... [More]

Magnesium repletion is very common in hospitalized patients.  Is there any difference between PO and IV magnesium in patients without symptoms of hypomagnesemia? Dosage Forms There are a lot of magnesium-based dosage forms approved in the United States.  Two of the most common are magnesi... [More]

Amlodipine (Norvasc) is a great drug -- but it takes 8 hours for the drug to reach its peak drug concentration, and about a week to reach steady-state full antihypertensive effect. Delayed Onset of First Dose Most dihydropyridine calcium channel blockers (eg, not diltiazem or verapamil) can cause re... [More]

We've got some exciting news regarding updates over the past month on ClinCalc.  We've posted two new clinical calculators, released a new iPhone/Android mobile app, and even did some guest posting! Two New Calculators HAS-BLED Calculator for Assessing Bleeding Risk in Atrial Fibrillation To co... [More]

I receive quite a bit of feedback regarding one of my more popular mobile applications, ICU Trials by ClinCalc.  Often, these emails involve a request to add a particular "landmark" trial with the next application update.  With 10-20 recent requests for new trial additions, I've been force... [More]

We've been busy at ClinCalc -- we've officially released four new features on the website, a number of small features, and we're finishing development on a new mobile application targeted at pharmacy and medical students!  Below is an overview of the four newest pages on ClinCalc: Printable Ami... [More]

Ciprofloxacin binds to divalent and trivalent cations (calcium, magnesium, etc).  Are there any recommendations regarding giving crushed ciprofloxacin via an enteral feeding tube, such as holding nutrition or increasing the dose? The package insert for ciprofloxacin tablets states that the med... [More]

Is there a preferred agent for VTE prophylaxis in trauma patients?  Is there a superior dosing strategy for these high-risk patients? The selection and dosing of pharmacologic VTE prophylaxis in trauma patients has a troubled, controversial past.  The literature surrounding the topic is r... [More]

The ASPIRE trial, recently published in the NEJM, examined the role of aspirin after patients with VTE's had completed at least 6 weeks of full anticoagulation (although most completed 6+ months).  This is the sister trial to the WARFASA trial, which required 6-18 months of warfarin therap... [More]