abby

30 posts

abby

abby

@amhtpharmd

opinions are my own

เข้าร่วม Ağustos 2021
71 กำลังติดตาม20 ผู้ติดตาม
abby รีทวีตแล้ว
Jordan Bloom
Jordan Bloom@JordanBloomMD·
One year outcomes of TAVR in young low risk patients make it into @NEJM boasting great outcomes and driving massive change in practice. @JoChikweMD and colleagues show a 220% increase in 6 year mortality for matched patients undergoing TAVR compared to SAVR. #DontDrinktheKoolAid jtcvs.org/article/S0022-…
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abby@amhtpharmd·
I love conversations with my docs that start with “hey you ever heard of ______”
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Anil Makam
Anil Makam@AnilMakam·
"weak recommendation based on low quality evidence" may be one of the most harmful things in medicine
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abby@amhtpharmd·
Building relationships is the end all be all to affect change in the workplace. Doesn’t matter how smart a person is if they can’t build trust & relationships they won’t be effective.
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abby รีทวีตแล้ว
𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊
@drjohnm interventions more resistant than cooling: - IABP - PCI in stable asymptomatic CAD - 48 hour heparin gtts for medical management of NSTEMI
GIF
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abby
abby@amhtpharmd·
@austincamp It’s that PharmD we’ve been “given” 😂🙄
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Austin Camp
Austin Camp@austincamp·
For a second I was sympathetic with this DO’s situation. Then I read the comments and her bio. I’m now confident she must have been in the wrong.
Dr Mollie James@molsjames

A pharmacist at @Walgreens blocked my prescription today. A person with a significant alcohol problem decided to go sober (with much support and encouragement) and I @james_clinic have been managing the withdrawal at home--saving an expensive inpatient admission and rehab stay. After 2 weeks on meds, the pharmacist refused to fill the ativan refill today because "the dose is only supposed to be X". The patient has been taking the meds properly and perfectly tapering them. Said patient had WALKED into the pharmacy to pick up the rx--so the pharmacist could see that said patient was awake, coherent and functioning well. I asked if the pharmacist evaluated the patient, and he said NO. I clarified I wanted the rx filled as ordered and he refused, stating it was 'his right to refuse to fill a script'. This places a vulnerable patient at risk for an ER visit, admission, regression and relapse based on a pharmacist with a big ego and very little clinical experience. THIS HAS GOT TO STOP!!!!!!!!!!!

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abby@amhtpharmd·
@propofolpapi661 We learn more when we are humble enough to admit when we don’t know or when we are wrong. It’s liberating & I wish it were more normalized. Constantly reminding my learners (& myself) of this
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The propofol guru
The propofol guru@EMResusPharmD·
@amhtpharmd Pt is post arrest x 1 hour, vitals are stable. Has a run of V-tach. The RN (who is alone in the room) comes out and calls for the ED MD. MD gets up to walk over - nurse has Zoll charged & shocks unsynchronized without MD…but pt. was already back to NSR.
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The propofol guru
The propofol guru@EMResusPharmD·
Fill in the blank: there is nothing more dangerous than… I’ll go first. A nurse/MD/DO/PharmD who doesn’t know what they don’t know, yet won’t admit they’re wrong, but continues to flaunt themselves as knowing everything. #EMRx #TwitterX
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abby@amhtpharmd·
@gaialect Healing from Hidden Abuse 🫶🏻
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gaia
gaia@gaialect·
what book helped you heal from the narcissist that was in your life?
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abby@amhtpharmd·
I light of ANNEXa-I, I am even more excited for a [possible] TEG DOAC cartridge as I think/hope it could help us personalize whichever reversal agent we use in order to achieve max hemostasis without tipping scales to the hypercoagulable side
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abby@amhtpharmd·
@ralphadelta I appreciate the dialogue & different points of view. 💪🏼
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abby@amhtpharmd·
@ralphadelta Thx for context. Difficult to choose given pages and pages of amendments. Typically excludes more patients & ⬇️ external validity. Not saying the drug doesn’t work, it does. Inc risk of MI & isc CVA is concerning & I typically don’t view VTE ppx as effective for most MI/CVA
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abby@amhtpharmd·
ANNEXA-1 (nearly) direct comparison of andexanet alfa (AA) & 4FPCC Quick 💭 🚩multiple protocol changes 🚩 AA NNH 21 for thrombotic events (driven by MI & ischemic stroke) at 30 days (replicated effect) 🙅🏼‍♀️No difference in mRS at 30d It’s gonna be a no from me dawg. PCC4me.
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NEJM
NEJM@NEJM·
Presented today at #ACC24: In the DanGer Shock trial involving patients with STEMI and cardiogenic shock, mortality at 6 months was lower with mechanical circulatory support with a microaxial flow pump than with standard care alone. Full trial results: nej.md/3xyXU3t
NEJM tweet media
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abby รีทวีตแล้ว
IMCrit
IMCrit@IM_Crit_·
ICU Pharmacology Secrets - Etoh withdrawal: I heard today from a resident (when I asked if a pt had received phenobarbital): "my attending prefers Precedex (dexmedetomidine) for etoh withdrawal" Friendly reminder: Dexme is not etiologic treatment for etoh withdrawal. The real
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abby@amhtpharmd·
6/ Lessons learned: 🩸PV pts are at ⬆️ risk of bleeding events from acquired vWD and also at ⬆️ risk of thrombosis d/t high blood viscosity 🧪TEG was not able to detect vWD, however the TEG Platelet Map did show significant PLT inhibition & aided w treatment 👩🏼‍⚕️🧪🩸
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abby@amhtpharmd·
5/ Which product(s) contains vWF? - FFP - cryo Didn’t want to give FFP with shortened R time. Cryo it was! Patient received two units & bleeding slowed. Starting post operative aspirin today for graft patency 🤞🏻
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abby@amhtpharmd·
1/ Interesting recent cardiac surgery case. Pt w/ hx of polycythemia vera controlled on Jakafi. Other meds were ASA 81 mg & protonix daily (hx of GIB) Baseline Global TEG normal, however the PLT map showed ~ 30% inhibition of ADP pathway.
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