Wardround 11xi05

This weeks two minute tutorials were themed around common drugs.

We heard about:
Furosemide (Dr Kidder)
Coamoxiclav (Dr Tuck)
Salbutamol (Dr Johnstone)
Paracetamol (Dr Szulakowski)
Morphine (Dr Jones)
Warfarin (MJM)

I award this week's prize to Dr Kidder. It is useful to review drugs we use commonly as it is easy to begin thinking that something we use often is something we know all about. Confidence can breed mistaken assessments of competence. Coincidentally, our friendly renal doc had, earlier in the week been asking me if I knew how furosemide got into the renal tubules...I must own up that I foolishly thought it was filtered...he put me right on that one and Dr Kidder I see began his talk by mentioning that Furosemide is highly protein bound and is not therefore filtered, but actively transported into the tubules. This is important since in a setting of glomerular protein leakage the tubular furosemide can become bound to albumin and its activity reduced.

A question for you. Did you learn anything from the talks? If so...why not read up on common drugs every now and then.

The week's reading was in house so to speak: How to report an ETT... from our own wiki (http://mjms.pbwiki.com). I will draw up a pro-forma for ward staff to use.

Since there has been a request for discussion of p values I have set next weeks reading as "The Medical Effects of Kissing Booboos" by Hansen GL. Originally published as "The Palliative Effects of Osculation on the Prognosis of Pediatric Wounds" in the Annals of Improbable Research 1995 Volume 1: Number 5. This is not available online without paying a subscription, so I will bring a copy in to the ward on Monday. The paper contains more than one methodological flaw. I would like you to draw up a list for Friday's discussion.

Interesting topics this week:

Diagnosing Endocarditis

Hypernatraemia


Next weeks two minute tutorials are themed around palliative care: I have misplaced my academic diary where the assignments were listed but you all know what you must do. (I will update the post when I can -done)

Pain (AS)
Nausea/vomiting (CT)
Fatigue (BA)
Hiccoughs (MJM)
Constipation (HG)
Dyspnoea (PS)
Dysphagia (NJ)
Itching (GAJ)

Make the two minutes unhurried and informative.

Podcast to follow.

MJM