AIS – post TPA after 24 hours
24 hr Post TPA CT or MRI – no bleed Start aspirin 300 mg suppository of 325 mg daily po or Plavix 325 mg qd Start High intensity Statin, such as Atorvastatin 40-80 mg qd Continue on heart monitor, watch for atrial fibrillation Consider Echocardiogram Cardiogenic emboli suspected Keep...
Lower extremity nerve injury
Lower extremity injuries are very common. It is important to recognize the nerve injured and the possible cause....
Bipolar disorder
Bipolar is also known as manic depressive disorder. Patients have periods of depression, alternate with manic periods. The following video is a very nice graphic ways to explain the disorder. Bipolar a graphical review: Serotonin syndrome & neuroleptic malignant syndrome....
Panic and anxiety disorder
Panic and anxiety disorder are very common. The follow review will help medical professionals to understand more about them. Patients tend to have symptoms suggesting of cardiac, neurological and rheumatologic diseases. They end up receiving numerous testing and treatments from different specialists without benefit. Other topics Illness anxiety disorder...
AIS No Tpa or Post TPA after 24 hours
Plan Get CTA head and neck if not done, Creat has to be normal. If large artery thrombosis, if Last known normal < 24 hours, consider intervention therapy. Give Aspirin po 325 mg or 300 mg suppository or other antiplatelet agent document reason for no tpa, such as past...
COVID-19 Reopen started
A gradual reopening is on its way. Remember: the virus is highly contagious. Best way to deal with the epidemic The epidemic is not going away any time soon. No magic pill for the prevention or treatment for the virus. Do not waste your money. Vaccine will not be...
Seizure, and pregnancy
Woman who are in child bearing age or desire to get pregnant needs special consideration in using anticonvulsant (antiepileptic drug = AED). The following is a very short synopsis, please refer to numerous full review for information. Before getting pregnant AED interfere with birth control pills, may result in...
COVID-19 Looking forward
What’s going to happen in the next 12 months? The government and each one of us have to decide what we want to do in the next few months. How to protect our self, how to modify our daily contact, work. and travel. We have to Continue social distancing,...
Antidepressants
A quick reference of the commonly used “antidepressants”. More appropriately, these medications should be called Serotonin agonist....
Depression
Treatment of Unipolar depression Depression is a very common medical problem, prevalence is over 10% of the population. When patient has other medical symptoms such as headache, chest pain, shortness of breath, soft tissue pain, low energy, poor sleep, weakness, numbness, they will be seen by a variety of...