Pharmacology Rounds - Tweetorama

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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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c. berg -

One question...re: TMP/SMX + ACE/ARB = bad. The statement was: take a look at local antibiogram to ensure clindamycin will work for complicated SS infections; if not, you may need linezolid. what ever happened to doxycycline, which looks great on most in vivo and in vitro studies to date across populations?

Best,
Cameron

Paul B., M.D. -

Our hospital makes us give mag over 2 hours because it says if given faster that it does not go intracellular. Did not look at study (that is why you make the big bucks...). Do you know how fast they gave it?

Sean G., M.D. -

why in the board review does it say that we should still avoid carbipenums in known PCN allergy when the actual cross reactivity is 0.01%....I mean isn't that pretty much the likelihood of allergic rxn in non pen allergic pts? I thought the point of this segment was NOT to avoid the use of carbipenums if they are indicated simply based on PCN allergy.

Paul J. V., D.O. -

I constantly hear people say to check the allergies listed with the patient to see if they are truly allergic. The most common answers I get from the patient are:
My mother told me I was allergic, or
I got a rash when I was a child and taking penicillin.
Now I know that these might not represent true allergies; but I've never seen a recommendation of what to do with this information. Should I assume the patient is not truly allergic and give them the medicine? Should I recommend they be allergy tested? What are your recommendations?

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