Tuesday, April 15, 2014

The Z-drugs: zolpidem, zopiclone, and zaleplon

From a recent review:

The Z-drugs zolpidem, zopiclone, and zaleplon were hailed as the innovative hypnotics of the new millennium, an improvement to traditional benzodiazepines in the management of insomnia. Increasing reports of adverse events including bizarre behavior and falls in the elderly have prompted calls for caution and regulation..Z-drugs exert their effects through increased γ-aminobutyric acid (GABA) transmission at the same GABA-type A receptor as benzodiazepines..Poisoning with Z-drugs involves predominantly sedation and coma with supportive management being adequate in the majority. Flumazenil has been reported to reverse sedation from all three Z-drugs. Deaths from Z-drugs are rare and more likely to occur with polydrug overdose.

Monday, April 14, 2014

The Magic Eye method of ECG rhythm assessment

Magic Eye posters were quite the rage a couple of decades ago. I got pretty good at stereoviewing so I'll have to try this. It might come in handy if there are no calipers around.

Via RESUS ME

Saturday, April 12, 2014

A simple clinical prediction rule for the presence of CAD in patients presenting with heart failure

Published here in AJC. This may help in selecting those patients who need coronary angiography. The new ACC heart failure guidelines do not make a strong statement on coronary angiography or non invasive imaging indications, leaving it to clinical assessment.

Friday, April 11, 2014

Chlorine gas inhalation

Here is a post at The Poison Review on this topic focusing on important management questions including the use of steroids and nebulized sodium bicarb. There is a link to an Emedicine article.

Thursday, April 10, 2014

Acute LAD occlusion

Some nuances on the electrocardiographic findings along with a discussion of the relevant coronary anatomy can be found in this post at the blog ECG interpretation.