EM Drug Info Geek

@Shuttlecock I’ve come around on Jar Jar, but I couldn’t wrap my head around that at the time (Junior high me thought that was much too over the top and felt there was way too much screen time)

The thing is, a whole generation didn’t hate the Star Wars prequels. I was 18 when Phantom Menace came out, saw it opening night with a few friends from student res, and then rewatched it at least three or four times in the theatre over the next month or so. Pretty much everyone saw this movie (and EpII & III). Guys and girls. Nerds and casuals. Many went multiple times (the box office numbers prove this). The merch sold through the roof, every magazine featured cover stories with the cast, most casual fans thought Jar Jar was funny while the Star Wars nerds were obsessed with the tech behind the character. Girls loved Padme’s fashion while straight guys loved Portman. The online fandom was hyperactive with fan theories, fan art, etc with a very clear even split between the male/female demos. Fan and general public reaction was insanely positive. This particular scene became ICONIC. 98% of the negativity came from the professional film critics. TPM wasn’t perfect by any means but the media definitely tried to push the message that it was a disaster, Jake Lloyd sucked, and that Jar Jar was offensive and racist. This weird gaslighting that it was the fans who were negative and toxic is just current media trying to do damage control for just how negative they were at the time.

@docmartin22 @BradSpellberg @ABsteward @DrToddLee @jasonroberts_pk @PulmCrit The AI-guided PCR will catch it, stop worrying

@BradSpellberg @ABsteward @DrToddLee @jasonroberts_pk @PulmCrit Need to get cultures before antibiotics. But wait, you can give antibiotics prehospital, so cultures schmulters. Then give alot of fluids. And after large volume fluids, you can give more large volume fluids. Or small volume fluids. Because....guidelines.

🔥Just published🔥 Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026 : Critical Care Medicine #IDXposts share.google/VN4AfbchzDiRr7…

@EMNerd_ But they say this hyperCl is from NS, implication that the patient had a Cl ‘within normal limits’ on presentation and then iatrogenesis ran its course. LR FTW! Not exactly related to your post, HCO3 with normal AG (normal AG leading team astray): pubmed.ncbi.nlm.nih.gov/37133440/

This is incorrect. The serum bicarb will be affected by both the AG and chloride but not the AG which is only effected by the anions other than Cl. Sure the bicarb and pH will stay low due to an hyperchloremic acidosis. But as far as I know insulin doesn’t help with chloride.

Okay got in a discussion with Endo at work about the management of DKA on following the AG vs the serum Bicarb to assess for resolution. They cited the following guideline which recommends using the serum bicarb because the AG can be affected by the hyperchloremic acidosis.

@ThommyTox @zacroBID @ABsteward There’s definitely some OB indication that does this empirically, maybe some RMSF cases? I’ll have to take a look not on the phone

I went into an infectious diseases time machine and found this… does anyone out there do doxycycline load dosing or is this a dead duck? @zacroBID @DrugInfoGeek @ABsteward #TwitteRx #MedTwitter #IDXposts #google_vignette" target="_blank" rel="nofollow noopener">jamanetwork.com/journals/jamai…

@thecurioustales @Breedlove22

@phil_c89 @PulmCrit @BradSpellberg Competent graphic designers have become more valuable

@PulmCrit @BradSpellberg called it years ago! and total aside, I can't be the only one turned off by these AI infographics right??

Antibiotics probably aren’t beneficial for patients with cirrhosis & GI bleeding It will take time to change practice on this, but this is probably ripe for some antimicrobial stewardship The idea that a few doses of ceftriaxone improve *mortality* in GI bleed was always sus…

Love this study - down with superfluous/inactionable drug interaction alerts!!!! pmc.ncbi.nlm.nih.gov/articles/PMC12… "Implementation of DDI alerts, without tailoring alerts to clinical context, is unlikely to reduce patient harms from DDIs"

@austincamp Been a long time since I looked into this but I’m pretty sure they were focused on the first week (highest risk) so you *could* count those parenteral UFH/LMWH towards those 7 days. I also don’t really know if that matters - juice worth the squeeze?

Now that we’re talking about apixaban, I can re-ask a question I’ve never gotten a clear answer on: If you transition from heparin to apixaban for VTE, do you always do the full 7 days of 10 mg BID, or can you shorten that duration by how many days the patient received heparin?

@ThommyTox pmc.ncbi.nlm.nih.gov/articles/PMC78…

@ThommyTox Oh I know - man I miss that. Since it’s patient safety awareness week we were saying we need a few more publications showing med errors (plenty to show heart attack, stroke, etc)

Does anyone out there use “Sepsis Bags” ➡️ cefepime 2g + vanc 1g in 1L of IV fluid? Place where I did my residency used this to improve time to ABX & Fluid. They’d batch them and keep them in the fridge (stable/sterile 9 days). #MedTwitter #TwitteRx #IDXposts

@phlegmfighter Is this gonna be the next Jeff Foxworthy spinoff, "you might be a redneck if..." You might work in an AMC if ...

Finish the joke in a reply: If you work in an "academic medical center" and you have to fight tooth and nail to get a Virchow's node biopsied in a young patient with probably lymphoma....

@ThommyTox Can't believe I missed the obvious converse clinical phenomenon, "Vancomycin Neurotoxicity". Daylight Savings strikes again

@DrugInfoGeek Hahahahahahah, yessssssss

@rudy_betrayed @TwinkTheory Obligatory onion article theonion.com/pretty-cute-wa…

@TwinkTheory Boston being the national example and Chicago being the regional example is hilarious

Look I’m not going to make fun of this person who seems very lonely but all the “why don’t you move to a small town work as a mechanic and buy a 95,000 dollar house and settle down w the local tasty freeze girl and have kids” posters don’t tell you this is what those towns are like 🤷‍♂️ they’ve been utterly destroyed by factory closures, the opioid epidemic and generations of disability checks. Say what you will about coastal “elite” cities but there’s a reason anyone reasonably intelligent claws their way the fuck out of these places and moves to Miami/nyc/la/sanfran/Boston or the regional variant of these places (Chicago, Denver, Austin) etc etc

@grepmeded @alessandrorisk @KrownCryptoCave @RiskTakers000 @crypto_banter @Banter_Clips One of the “few [who] understand”

@DrugInfoGeek @alessandrorisk @KrownCryptoCave @RiskTakers000 @crypto_banter @Banter_Clips

He was making more than enough from trading. Then inflation hit, cash sat in dollars, and real purchasing power collapsed. That’s when he realised he understood markets, but not money. @KrownCryptoCave @RiskTakers000 @crypto_banter @Banter_Clips

@grepmeded @alessandrorisk @KrownCryptoCave @RiskTakers000 @crypto_banter @Banter_Clips See, you get it

@alessandrorisk @KrownCryptoCave @RiskTakers000 @crypto_banter @Banter_Clips this is why I bought BTC with my cash and now it’s worth half as much as it did in October 👌

@PulmCrit Had a pharm student ask how to keep up. Read the methods section and if it can’t answer the question by design - move on.

major life hack: don't bother reading any article whose title includes the word "associated" there are ~1 million medical publications per year, don't spend your time reading retrospective associative studies

Hoping to redirect some of this regulatory energy we've got going on atm. I've only heard the legendary power of Vioxx, but many HCPs/patients would gladly sign the waiver for it...

@austincamp Team turnover and convince them the vanco-penia has been sufficiently addressed and prior team must’ve forgot to pass that along

How did we ever get Vanc d/c’d before the MRSA PCR??

@hasantoxr Bummed it timed out but excited to try it

🚨BREAKING: Google just dropped another hit! It's called PaperBanana and it generates publication-ready academic illustrations from just your methodology text. No Figma. No manual design. No illustration skills needed. Here's how it works: A team of AI agents runs behind the scenes → One finds good diagram examples → One plans the structure → One styles the layout → One generates the image → One critiques and improves it Here's the wildest part: Random reference examples work nearly as well as perfectly matched ones. What matters is showing the model what good diagrams look like, not finding the topically perfect reference. In blind evaluations, humans preferred PaperBanana outputs 75% of the time. This is the recursion we've been waiting for AI systems that can fully document themselves visually. Waitlist’s open, Link in the first comment.