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Zlatan Coralic
Emergency Medicine Clinical Pharmacist. Views expressed here are my own.
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Zlatan Coralic Jul 9
Replying to @PharmD_intheED
If there are EM residents, go to their teaching conference (usually one day per week). Whenever theres a drug question all eyes will be on you. You become the go to person for anything drug related (and non-related too).
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Zlatan Coralic May 26
50s yo pt w/hx of liver failure p/w AMS A&Ox0. Ammonia off the charts. About giving lactulose:
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Zlatan Coralic Dec 24
Replying to @DGlaucomflecken
Angel Trumpet. Literally,
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Zlatan Coralic Dec 19
Replying to @coreysdavis
1.glad fda is talking about the move; 2.super small med error risk outweighed by benefit, 3. Anti arguments always failed thru history (seatbelts, condoms, BCPs, prep), 4. Not OTC anywhere, still stigma w/asking RPH/HCP; 5. Agree w/tx disease, increase access to MATs
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Zlatan Coralic Dec 13
To increase naloxone access: Reclassify med as OTC (non-Rx) on fed level. Removes stigma of talking to doc/pharm, drives prices down thru competition, saturates community w/nalox. I reached out to and @NancyPelosi (sf reps). Pelosi no ans x3 Harris generic lettr
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Zlatan Coralic Dec 6
Exp: June 30, 2019 or June 19, 2030?
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Zlatan Coralic Dec 5
Replying to @emergencypharm
Starting too as well. Clonidine and other ‘sx management’ does nothing. MAT in ED has potential and signals to pt there is an effective tx.
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Zlatan Coralic Nov 25
New Afib + RVR. No CHF. Super stable. Choice IV dilt -> HR good control, SBP 130s. How do you transition? Dilt 30 mg po q6h? Dilt XR 120 mg po qday? (metop 25 mg po BID?)
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Zlatan Coralic Nov 12
Replying to @TarakTrivedi
If you only have access to EC tabs, instrct pt to “suck, crush, or chew,” do not swallow whole. Check out original ASA trial methods in Lancet.
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Zlatan Coralic Nov 4
As the post was in 2014, I think we should definitely update with more recent evidence. Of note, the review did find benefit with dph+bolus, which is a common practice in EM.
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Zlatan Coralic Nov 4
Replying to @M_Lin @ania_bilski
Hate to be the bearer of bad news, but current shortage of IV diphenhydramine(). Practical point: reserve IV for acute dystonia (rare). Acute akathisia=IV bzd. PO dph at times hard to give to n/v migraine pt. We can make it through these shortages!!!
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Zlatan Coralic Oct 27
An 80s yo DNR/DNI woman with baseline dementia p/w worsening AMS over 2 days(A&O=0). Multiple comorbidities and home meds (anticoagulated). ABCs intact and pt is restless, gently combative, and non-cooperative. Recs for non-con CT-scan?
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Zlatan Coralic 28 Aug 18
Anyone experiencing difficulties getting patients Epipens due to shortage?
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Zlatan Coralic 8 Aug 18
Replying to @ASHP_EMPharm
Attend weekly conferences with residents and attendings. You have to learn the EM lingo, how ED docs approach a problem, what are ED priorities. Also attend RN shift reports. Learn what is important to your RNs and why. EM RNs will teach you tons about drugs in EM.
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Zlatan Coralic 28 Jul 18
>70kg? 81mg of ASA not enough to prevent vascular events according to this study.
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Zlatan Coralic 14 Jun 18
*Neither 0.9% or 0.45% NaCl...NEJM conclusion makes it sound like 3% would be ok too.
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Zlatan Coralic 2 Jun 18
In Safeway accross the street. :)
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Zlatan Coralic 21 May 18
Replying to @lald6103
*within US
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Zlatan Coralic 21 May 18
Acutely agitated 40s year old male (~90 kg) with unknown PMH arriving in 4 point restraints & spit mask, jumping off bed. (911 called for erratic behavior on street) What would you rec for IM sedation?
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Zlatan Coralic 21 May 18
NEJM: TNK > TPA in AIS pts w/subsequent thrombectomy. TNK would simplify code stroke med admin protocols quite a bit.
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