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SGEM#46: Don’t Pass the Dutchie (Cannabinoid Hyperemesis Syndrome)

Posted by on Sep 30, 2013 in Featured, GastroIntestinal, Podcasts, Psychiatric | 0 comments

Podcast Link:SGEM#46 Date:  September 27, 2013 Title: Don’t Pass the Dutchie from the Left Hand Side Case Scenario: 22yo man presents for the third time in a week with vomiting. He was worked up extensively in the previous two visits and no cause was found. Nothing seems to stop the vomiting. He has a similar bout of cyclical vomiting a few months ago. You go to assess him and he is very anxious and all he want to do is take a hot shower. Question:  How do you diagnose cannabinoid hyperemesis syndrome? Background: Marijuana is the number one illegal drug used in the USA and the world with psychoactive and physiologic effects. This podcast will not discuss the legality of marijuana or former presidents who apparently did not inhale. The title song “Pass the Dutchie” was a huge reggae song by British band Musical...

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SGEM#45: Vitamin H (Haloperidol for Psychosis)

Posted by on Sep 22, 2013 in Featured, Podcasts, Psychiatric | 3 comments

Podcast Link:SGEM45 Date:  September 20, 2013 Title: Vitamin H – Haloperidol Guest Skeptic: Dr. Anthony (Tony) Seupaul, Chair of EM, University of Arkansas Case Scenario: 23 yr man with schizophrenia presents with police after being picked up for violent outburst at a coffee shop. He is clearly agitated and you need to chemically restrain him. Question:  Is haloeridol the safest and most effective method of tranquilization for patients with psychosis induced aggression or agitation? Serious Reactions (from Epocrates) and delivered by Dr. Michael del Castillo-Hegyi (Chief Resident AUMS): Neurologic (extrapyramidal, tardive dyskinesia, akithisia, dystonia and seizure) Hyperpyrexia or heat stroke Neuroleptic Malignant Syndrome Pneumonia Hypotension or hypertension Cardiac (see Keener Kontest) Sudden Death Hyponatremia Hepatic impairment Hematologic (leukopenia, neutropenia and agranulocytosis) Ocular (cataracts and retinopathy) Reference: Powney MJ et al. Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). Cochrane Database of Systematic Reviews  2012,...

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