nicotine-prevEMS brings in a two-year-old with vomiting and decreased mental status. According to their report, he had been doing well until he suddenly got sick en route to the hospital. He became sleepier, and, as they wheeled him in, he began to seize. His parents say he was at a relative’s house when he was found drinking from a container of some colorful liquid, which he accidently spilled on himself. Then he began to vomit. The culprit: the liquid was used to refill electronic cigarettes.

colchicine-90After a recent study of colchicine use for gout, the FDA approved its use and granted 3-year exclusive marketing rights to the company that performed the study, leading to a huge jump in the price.

rx-pad-90In this new regular series, we’ll take a closer look at some of the drugs we use frequently in the ED. We aim to capture new indications for old standbys, or risks and dosing adjustments you should know, plus some unusual facts you might enjoy.

kroc-90Case: A 41-year-old male with rheumatoid arthritis, depression and polysubstance abuse is brought to an urban emergency department after being found unresponsive at home.  In the field, paramedics administered 2mg of nebulized naloxone and the patient became more alert. Per the patient’s spouse, they had been injecting “crocodile” all week.

Paramedics present to an urban emergency department with a middle aged man found unresponsive in a nearby alley. The paramedics were unable to obtain IV access due to years of drug abuse and overall poor venous access.

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