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Emerging Trends in Pain Medication Management: Back to the Future: A Focus on Ketamine

  Providers face many challenges when faced with pain management. Pain is complex, difficult to understand and diagnose, and especially enigmatic to manage. The discovery of nonopioid agents for pain management has become particularly important considering the ongoing opioid epidemic. This review is focused on revisiting ketamine, an agent that has historically been used for […]

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Backstories on the US Opioid Epidemic. Good Intentions Gone Bad, an Industry Gone Rogue, and Watch Dogs Gone to Sleep

Epidemics of opioid use are old news in the United States, but an epidemic that kills over 200,000 Americans is not. A multiplicity of intertwined factors have brought us to this place. From 30,000 feet, it is the story of good intentions gone bad, a drug industry gone rogue, and government watch dog agencies gone […]

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Cardiac Rupture in a Young Male Cocaine User

To the Editor: A 25-year-old man was found unconscious by his wife in the bathroom of his apartment. She called emergency services and cardiopulmonary resuscitation was promptly initiated within a few minutes. The patient was intubated, transferred to the Emergency Department (ED) of a local hospital, and after 1 hour of advanced cardiac life support […]

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patient's view of surgery looking up at doctors

Appropriate Use of Proton Pump Inhibitors: A Double-Edged Sword

We read with great interest the article published by Wombell et al in the current issue of The American Journal of Medicine. The authors summarize the evidence linking proton pump inhibitors (PPIs) to hospital-acquired Clostridium difficile infection.1 They also provide a description of the possible mechanisms responsible for this association. We commend the authors for their timely contribution to the […]

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Antidepressants and Hyponatremia

It is well known that antidepressants can cause hyponatremia, particularly in elderly patients. This complication can be serious, with delirium, seizure, or even death. In the classic study by Fabian et al,1 paroxetine, a selective serotonin reuptake inhibitors (SSRI), was found to induce hyponatremia in 12% of elderly patients within a mean duration of 9 days. […]

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