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.
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!
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 forced to re-evaluate my criteria for what constitutes a seminal paper in the area of critical care medicine.
Although there isn’t an official scoring system or absolute list of must-have criteria, I’ve developed a simple list of ten important factors that help differentiate important trials from paramount, landmark gems in evidence-based medicine.
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: Continue reading
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?
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 riddled with small, conflicting trials and methodological flaws.
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 therapy.
Phenytoin (PHT) and valproic acid (VPA) compete for the same binding sites on albumin. In patients taking both PHT and VPA, the free fraction of phenytoin will be increased, which causes a total PHT level to falsely represent a patient’s active PHT status.
To supplement the recent video on Total vs. Free Phenytoin and the existing correction calculator for hypoalbuminemia, a new correction calculator for concurrent valproic acid has been released.
How should aspiration pneumonia be treated? Is anaerobic coverage required?
The concept of aspiration pneumonia and anaerobic coverage is a complex, controversial topic. Like most controversial topics, there is paucity of evidence, and the literature that does exist is controversial.
