More articles from 1-Minute Consult
- Can my patient with a ‘sulfa allergy’ receive celecoxib or other nonantimicrobial sulfonamides?
There is no cross-reactivity between antimicrobial and nonantimicrobial sulfonamides, and patients with a history of immunoglobulin E–mediated reaction to a sulfonamide antibiotic can receive nonantimicrobial sulfonamides.
- Which patients with presumed acute infectious diarrhea in an outpatient setting should undergo gastrointestinal pathogen panel testing?
Use of a gastrointestinal pathogen panel is warranted in certain individuals, such as those with fever, visible blood in the stool, sepsis, or a compromised immune system.
- How can I better recognize and manage delirium in my hospitalized patients?
By knowing common precipitants and mimickers of delirium and considerations for workup, clinicians can implement nonpharmacologic preventive strategies, better identify patients experiencing delirium, and optimize symptom management.
- How do I manage my patients with thyrotoxicosis until they see the endocrinologist?
Primary care physicians can start beta-blockers promptly for symptomatic relief, obtain radioactive iodine uptake and scan, and start methimazole if high uptake is noted.
- What are options for my patients with erectile dysfunction who have an unsatisfactory response to PDE5 inhibitors?
Alternative therapies include intracavernosal injection, vacuum erection devices, and penile prosthesis implantation.
Should my patients with hypertension be referred for renal denervation?Renal denervation may be appropriate as an alternative or adjunct to pharmacotherapy in certain patients. Shared decision-making is crucial before proceeding.
- Should every patient with an unprovoked venous thromboembolism have a hypercoagulable workup?
In the absence of consensus guidelines addressing this question, an individualized approach that considers personal and family history is needed.
- What fluids should I order for my patient with acute pancreatitis?
Recent data show that moderate fluid resuscitation is associated with fewer adverse events and that lactated Ringer’s may be superior to normal saline.
- Does my patient with acute variceal hemorrhage need a transjugular intrahepatic portosystemic shunt?
Placement of a transjugular intrahepatic portosystemic shunt can be used as salvage therapy to control bleeding when endoscopic management fails and as a means of secondary prophylaxis in select patients.
- Do patients with sepsis benefit from intravenous albumin?
Patients with sepsis who do not need vasopressors do not benefit from intravenous albumin compared with intravenous crystalloid therapy alone.