Anthony Lau, PharmD BCPS
@alaurx.bsky.social
EM Pharmacist & Hockey Goalie & Travelist | Living & appreciating life to the fullest | Sharing what I learn everyday. Opinions are my own, RTs not endorsements #MedSky #EMsky #PharmSky
Experience Lasting Moments, a #fundraising event with stunning #photography & limited-edition prints supporting TWCC’s #palliative care work in South Asia
📅 Oct 25: Join us in Abbotsford, BC! lnkd.in/gZB98e8T
🌐 Everywhere else? Our online Square-Print Sale Oct 15–30 twoworldscancer.ca/cart
📅 Oct 25: Join us in Abbotsford, BC! lnkd.in/gZB98e8T
🌐 Everywhere else? Our online Square-Print Sale Oct 15–30 twoworldscancer.ca/cart
September 28, 2025 at 8:20 PM
Experience Lasting Moments, a #fundraising event with stunning #photography & limited-edition prints supporting TWCC’s #palliative care work in South Asia
📅 Oct 25: Join us in Abbotsford, BC! lnkd.in/gZB98e8T
🌐 Everywhere else? Our online Square-Print Sale Oct 15–30 twoworldscancer.ca/cart
📅 Oct 25: Join us in Abbotsford, BC! lnkd.in/gZB98e8T
🌐 Everywhere else? Our online Square-Print Sale Oct 15–30 twoworldscancer.ca/cart
Great decision! Switching to remi would help reduce serotonergic load and risk since fentanyl is more serotonergic 😊
July 4, 2025 at 4:01 PM
Great decision! Switching to remi would help reduce serotonergic load and risk since fentanyl is more serotonergic 😊
Finished another day @ #EMPRx25 w/ an amazing grp of passionate EM pharmacists! I feel incredibly privileged to be here w/ my brothers & sisters in EMP. Exciting news about SEMP & direction this new society is heading. I’d love to join & support its vision, truly inspiring!! 🙌 #EMSky #Pharmsky #EMRx
April 6, 2025 at 1:38 AM
Finished another day @ #EMPRx25 w/ an amazing grp of passionate EM pharmacists! I feel incredibly privileged to be here w/ my brothers & sisters in EMP. Exciting news about SEMP & direction this new society is heading. I’d love to join & support its vision, truly inspiring!! 🙌 #EMSky #Pharmsky #EMRx
Thrombosis Canada: "If used subcutaneously, UFH dosed at 333 units/kg SC for the initial dose and then 250 units/kg SC twice daily is an alternative that does not require aPTT monitoring."
Copied and pasted screenshot of lexicomp dosing recommendation...suggests the same.
Copied and pasted screenshot of lexicomp dosing recommendation...suggests the same.
February 25, 2025 at 4:40 AM
Thrombosis Canada: "If used subcutaneously, UFH dosed at 333 units/kg SC for the initial dose and then 250 units/kg SC twice daily is an alternative that does not require aPTT monitoring."
Copied and pasted screenshot of lexicomp dosing recommendation...suggests the same.
Copied and pasted screenshot of lexicomp dosing recommendation...suggests the same.
To put the finishing touch on this discussion...even more data on this... Table 1 is quite nice, response diff between 3.375 g IV q6H and 4.5 g IV q6H are quite similar. Table 2...lorente 2009 also shows NSS for clinical cure.
February 14, 2025 at 5:02 PM
To put the finishing touch on this discussion...even more data on this... Table 1 is quite nice, response diff between 3.375 g IV q6H and 4.5 g IV q6H are quite similar. Table 2...lorente 2009 also shows NSS for clinical cure.
How about the data on PTZ 3.375 g IV q6h vs 4.5 g IV q6h? (which I find interesting!)
Gill & Nicolau 2023:
- 3.375g Q6H over 0.5h had adequate PTA at MIC 8 mg/L
- 4.5g Q6H over 3h or 4.5g Q8H over 4h = >90% PTA at MIC 16 mg/L
Attached fig here for our reference, but we can visually see the PTAs
Gill & Nicolau 2023:
- 3.375g Q6H over 0.5h had adequate PTA at MIC 8 mg/L
- 4.5g Q6H over 3h or 4.5g Q8H over 4h = >90% PTA at MIC 16 mg/L
Attached fig here for our reference, but we can visually see the PTAs
February 14, 2025 at 5:02 PM
How about the data on PTZ 3.375 g IV q6h vs 4.5 g IV q6h? (which I find interesting!)
Gill & Nicolau 2023:
- 3.375g Q6H over 0.5h had adequate PTA at MIC 8 mg/L
- 4.5g Q6H over 3h or 4.5g Q8H over 4h = >90% PTA at MIC 16 mg/L
Attached fig here for our reference, but we can visually see the PTAs
Gill & Nicolau 2023:
- 3.375g Q6H over 0.5h had adequate PTA at MIC 8 mg/L
- 4.5g Q6H over 3h or 4.5g Q8H over 4h = >90% PTA at MIC 16 mg/L
Attached fig here for our reference, but we can visually see the PTAs
Where does the PTZ 4.5g IV q6h dosing come from tho?
Here is FDA's 4.5g IV Q6H evidence… www.sciencedirect.com/science/arti...
This study used PTZ 4.5 g IV q6h & it found "similar number of mean hospital days, readmission rates, and frequency of AEs vs imipenem"
Here is FDA's 4.5g IV Q6H evidence… www.sciencedirect.com/science/arti...
This study used PTZ 4.5 g IV q6h & it found "similar number of mean hospital days, readmission rates, and frequency of AEs vs imipenem"
February 14, 2025 at 5:02 PM
Where does the PTZ 4.5g IV q6h dosing come from tho?
Here is FDA's 4.5g IV Q6H evidence… www.sciencedirect.com/science/arti...
This study used PTZ 4.5 g IV q6h & it found "similar number of mean hospital days, readmission rates, and frequency of AEs vs imipenem"
Here is FDA's 4.5g IV Q6H evidence… www.sciencedirect.com/science/arti...
This study used PTZ 4.5 g IV q6h & it found "similar number of mean hospital days, readmission rates, and frequency of AEs vs imipenem"
Here's a snapshot of the handbook's TOC & some of the palliative care topics covered :)
February 1, 2025 at 3:12 AM
Here's a snapshot of the handbook's TOC & some of the palliative care topics covered :)
In fact, mirtazapine has fewer reported w/d symptoms in the data...further supporting stopping it cold turkey in these pts🚫
but, be mindful of potential reporting bias!
if dose is >30mg/day, w/d becomes more relevant since it's more adrenergic at higher doses
pubmed.ncbi.nlm.nih.gov/16797080/ 8/
but, be mindful of potential reporting bias!
if dose is >30mg/day, w/d becomes more relevant since it's more adrenergic at higher doses
pubmed.ncbi.nlm.nih.gov/16797080/ 8/
January 24, 2025 at 8:24 PM
In fact, mirtazapine has fewer reported w/d symptoms in the data...further supporting stopping it cold turkey in these pts🚫
but, be mindful of potential reporting bias!
if dose is >30mg/day, w/d becomes more relevant since it's more adrenergic at higher doses
pubmed.ncbi.nlm.nih.gov/16797080/ 8/
but, be mindful of potential reporting bias!
if dose is >30mg/day, w/d becomes more relevant since it's more adrenergic at higher doses
pubmed.ncbi.nlm.nih.gov/16797080/ 8/
2/ Sodium bicarb Y-site incompatibility: “dopamine, noradrenaline”: NHS trust CC IV drug admin guide: www.gicu.sgul.ac.uk/teaching/res...
4/ Trissel LA. Epi/norepi compatibility w/ common parenteral medications. 2007. TriPharma...attached some📸 for us.
4/ Trissel LA. Epi/norepi compatibility w/ common parenteral medications. 2007. TriPharma...attached some📸 for us.
January 10, 2025 at 6:48 PM
2/ Sodium bicarb Y-site incompatibility: “dopamine, noradrenaline”: NHS trust CC IV drug admin guide: www.gicu.sgul.ac.uk/teaching/res...
4/ Trissel LA. Epi/norepi compatibility w/ common parenteral medications. 2007. TriPharma...attached some📸 for us.
4/ Trissel LA. Epi/norepi compatibility w/ common parenteral medications. 2007. TriPharma...attached some📸 for us.
My favourite…Trauma-llama!! 🩼🦙😎
January 4, 2025 at 7:57 PM
My favourite…Trauma-llama!! 🩼🦙😎
Happy New Year! Wishing everyone a year filled with new adventures, growth, and endless possibilities. Cheers to 2025! 🥳🎉✨ #HappyNewYear #NewBeginnings
January 1, 2025 at 5:07 AM
Happy New Year! Wishing everyone a year filled with new adventures, growth, and endless possibilities. Cheers to 2025! 🥳🎉✨ #HappyNewYear #NewBeginnings
Day 24 of Pharmacy Advent!! One day away from Christmas Day! Reporting live from the airport so I might be a bit more brief. Let’s chat pharmacokinetics…tricks of the trade! I’m going to split this PK chat into 3-4 parts & cover 1 important concept each day. Let’s dive in! 👇
#medsky #pharmsky #MedEd
#medsky #pharmsky #MedEd
December 24, 2024 at 7:00 PM
4/ 🚨 Giving glucose before thiamine can theoretically worsen Wernicke’s. Thiamine-dependent enzymes needed for glucose metabolism. Without thiamine, glucose breakdown might stall, causing less ATP synthesis & rapid buildup of lactic acid.
December 24, 2024 at 4:23 AM
4/ 🚨 Giving glucose before thiamine can theoretically worsen Wernicke’s. Thiamine-dependent enzymes needed for glucose metabolism. Without thiamine, glucose breakdown might stall, causing less ATP synthesis & rapid buildup of lactic acid.
7/ Here’s a SRMA for NAC in non-APAP DILI. It showed ↑transplant-free survival & ↓hospital stays, though no significant impact on overall mortality.
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
December 22, 2024 at 8:46 PM
7/ Here’s a SRMA for NAC in non-APAP DILI. It showed ↑transplant-free survival & ↓hospital stays, though no significant impact on overall mortality.
pmc.ncbi.nlm.nih.gov/articles/PMC...
pmc.ncbi.nlm.nih.gov/articles/PMC...
2/ Acetylcysteine replenishes glutathione, restoring capacity to detoxify highly reactive hepatotoxic metabolite NAPQI. Earlier treatment confers ↓ risk of liver injury. Risk of hepatotoxicity lowest when treated within 10 hours of APAP ingestion
December 22, 2024 at 8:46 PM
2/ Acetylcysteine replenishes glutathione, restoring capacity to detoxify highly reactive hepatotoxic metabolite NAPQI. Earlier treatment confers ↓ risk of liver injury. Risk of hepatotoxicity lowest when treated within 10 hours of APAP ingestion
Day 21 of Pharmacy Advent: beta-lactam allergy & cross-sensitivity!
With 4 days to Christmas, let’s unwrap this topic...I feel like this comes up occasionally, thus deserves its own post. Whether it’s a refresher or new knowledge, let’s dive in!👇
#medsky #pharmsky #EMsky #nursesky #MedEd #GPsky
With 4 days to Christmas, let’s unwrap this topic...I feel like this comes up occasionally, thus deserves its own post. Whether it’s a refresher or new knowledge, let’s dive in!👇
#medsky #pharmsky #EMsky #nursesky #MedEd #GPsky
December 21, 2024 at 7:10 PM
2/ How does warfarin come in?
Warfarin may increase calciphylaxis risk by inhibiting matrix Gla protein—a vitamin-K-dependent protein that prevents vascular calcification. In its absence, arterial calcium deposition can accelerate (enzyme no longer breaking down Ca!)👇
Warfarin may increase calciphylaxis risk by inhibiting matrix Gla protein—a vitamin-K-dependent protein that prevents vascular calcification. In its absence, arterial calcium deposition can accelerate (enzyme no longer breaking down Ca!)👇
December 20, 2024 at 9:53 PM
2/ How does warfarin come in?
Warfarin may increase calciphylaxis risk by inhibiting matrix Gla protein—a vitamin-K-dependent protein that prevents vascular calcification. In its absence, arterial calcium deposition can accelerate (enzyme no longer breaking down Ca!)👇
Warfarin may increase calciphylaxis risk by inhibiting matrix Gla protein—a vitamin-K-dependent protein that prevents vascular calcification. In its absence, arterial calcium deposition can accelerate (enzyme no longer breaking down Ca!)👇
Day 20 of Pharmacy Advent:
Let’s continue from our chat about anticoagulation in ESLD—today we’ll focus on warfarin in ESRD.
What are some considerations for warfarin use in dialysis patients? Is it completely safe? Let’s dive in! 👇
#medsky #pharmsky #nephrosky #hemesky #MedEd
Let’s continue from our chat about anticoagulation in ESLD—today we’ll focus on warfarin in ESRD.
What are some considerations for warfarin use in dialysis patients? Is it completely safe? Let’s dive in! 👇
#medsky #pharmsky #nephrosky #hemesky #MedEd
December 20, 2024 at 9:53 PM
Day 20 of Pharmacy Advent:
Let’s continue from our chat about anticoagulation in ESLD—today we’ll focus on warfarin in ESRD.
What are some considerations for warfarin use in dialysis patients? Is it completely safe? Let’s dive in! 👇
#medsky #pharmsky #nephrosky #hemesky #MedEd
Let’s continue from our chat about anticoagulation in ESLD—today we’ll focus on warfarin in ESRD.
What are some considerations for warfarin use in dialysis patients? Is it completely safe? Let’s dive in! 👇
#medsky #pharmsky #nephrosky #hemesky #MedEd