Has anyone ever acquired torsades de pointes by drinking too much tonic water???
There’s no studies on it that I could find and inquiring minds want to know.
So I was wandering through the depths of tumblr and stumbled across this post and oh my god guess who knows the answer to this ancient question
Had a patient with malaria recently and there was no quinine to be had in my city so out of curiosity I calculated the dose in tonic water:
In the US, quinine in tonic water is limited to 83mg/liter, and since the dose per the CDC is 650mg PO TID, the patient would have needed to drink 7.8 liters of tonic water 3 times daily.
If a patient who was drinking a lot of modern tonic water developed torsades, I’d recommend evaluating for hypomagnesia and hypokalemia due to volume status before looking at the quinine as the cause.
I realize that you’re a lot further in your career now and you already realize this about tonic water. I just got excited that I could answer this random drug question from your student era.
Sometimes it feels like there’s too much random trivia in the brain and you’ve gotta let it leak out, which is why we’re on tumblr.
And this is why I give up an call pharmacy half the time when it comes to the crazy stuff. Because you guys always have a way of knowing how much of something is in something else and viola! Magic!
I haven’t thought about this in ages!!! Thanks for the info!!! =-)
I know I dont post many pictures of me on here but here is me ! And my kitty !! And my goldfish! All in one post because why not ! You guys deserve to see what I really look like lol . Some facts about me !
- I am 4 ft 10 (really good at making myself appear tall in pictures)
- I got Wanda from tumbler! (My kitty)
- I do not support petsmart but that is where both my goldfish came from. (And my previous black moore S.I.P momo)
- I work full time at a pharmacy and am taking pre rec classes deciding if I want to presue vet tech education or pharmacy
- I have ADHD and Fetal Alchahol Syndrom
- I love naps
-im allergic to fresh pineapple
- finally , always down to talk or answer questions so dont be shy !! ❤
Book Recommendations: Books that have helped me think and write critically when it comes to scientific literature. I’ve never gotten below a 4.0/1st in a lab report.
This post will be especially helpful for those taking psychology, neuropsychology, neuroscience, cognitive neuroscience, pharmacy etc. All books are written by world leading academic researchers and are very well referenced.
If there is a book on this list that you read, let it be this! Dr Goldacre focuses on the misuse of science by journalists, homeopaths, schools and big pharmaceutical companies. The book has a great segment on understanding “The Placebo Effect”. Other topics include; Brain Gym, misleading cosmetic adverts, issues with vitamin pills and “toxins”. He has a blog he runs Badscience.net that has great free articles! The book is beautifully referenced and really easy to read, definitely worth investing in. If you can’t spend money on the book just yet, there is a similar free talk here.
Prof Nutt incurred the wrath of the UK government when he put forth research papers stating that alcohol and tobacco were more harmful than many illegal drugs, including LSD, ecstasy and cannabis. In “Drugs”, he talks us through the science of what drugs are and how they work, quantifying and comparing the harms caused by different drugs, as well as drug addiction. This book is a great starting point and has educated me on all major drugs better than any textbook has. It’s written in simple English with numerous references and even has a wonderful segment titled “What should I tell my kids about drugs?”. I have had the pleasure of meeting Prof Nutt multiple times and given the slander he has endured, he remains passionate and dedicated to his field. Prof Nutt runs a website aimed at the general public Drugscience.org. There is a similar free talk here.
Another gem by Dr Goldacre, this is a slightly heavier text than the above two books but is a must read for those going into pharmacy or research. Bad Pharma explains where new drugs come from and issues with missing data in clinical trials. Companies run bad trials on their own drugs, which distort and exaggerate the benefits by design. When these trials produce unflattering results, the data is simply buried. Dr Goldacre discusses the issues with design and also the harms of not making the missing trial data available. This book is not ‘anti-drug’, this book highlights issues with publication bias and how this needs to be and can be mended in order for doctors and patients to make better informed decisions on the drugs they are prescribing/prescribed.There is a similar free talk here.
Written by the late Dr Oliver Sacks, this was the first book I purchased at the age of 13 in the field of neurology that made me go nuts for the brain. As a huge fan of Roald Dahl’s style, this book was just perfect. Dr Sacks turned patient case studies into short stories, inviting you into the incredible world of neurological disorders. The following phenomena are covered: visual agnosias, memory loss, Parkinsonion-symptoms, hallucinations etc. Dr Oliver Sacks has multiple books that are worth investing in, have a look at Oliversacks.com. There is a similar free talk here.
Ramachandran, through his research into brain damage, has discovered that the brain is continually organising itself in response to change. Phantoms in the Brain explores case studies and experiments invented by Dr Ramachandran like the Mirror Box to help understand the underlying issues. Examples of the case studies involve a woman who persists that her left arm is not paralysed (albeit her entire leftside is paralysed) and a young man loses his right arm in a motorcycle accident, yet he continues to feel a phantom arm with vivid sensation of movement. In a series of experiments using nothing more than Q-tips and dribbles of warm water the young man helped Dr Ramachandran discover how the brain is remapped after injury. This book is really enjoyable and is a slightly more in-depth read than The Man who Mistook his Wife for a Hat. There is a similar free talk here.
Prof Zimbardo provides an in-depth analysis of his classic Stanford Prison Experiment, and his personal experiences as an expert witness for one of the Abu Ghraib prison guards, raising fundamental questions about the nature of good and evil. This book has really interesting commentaries on The Columbine Shooting, People’s Temple Mass Suicide, Prison Abuse in Afghanistan etc. I enjoyed the book but it does get really repetitive (it definitely could have been made shorter by 100 pages), the publishers also use a really small font. There is a similar free talk here.
Ages have been mentioned not as restrictions but as guidelines in terms of the writing style and sensitivity of the literature. Every book mentioned above doesn’t need to be read chronologically, from cover-to-cover. They have been compiled in such a way that you can dip in and out of the chapters without confusion. Lovely! All free talks are given by the authors and they cover the same topics that are mentioned in the books.
If you ever wish to discuss the literature, do get in touch with me! Twitter|Instagram
Preparing for my case presentation tomorrow. This is mostly what my first rotation of clerkship has consisted of, along with journal club and another presentation. Pretty nervous that I will get grilled but prepared to back myself up with my reasoning. Eep.
I have to write my PEBCs (Canadian Pharmacist licensing exam) in May. It consists of two days of 3 hourish multiple choice tests and a day of practical stations. There is so much to study before then but I have no idea where to start. Just wondering if anyone has some tips on how to study for such a big exam that covers so many topics?
Learning so much on this placement that I had to start writing it all down in one place. Hopefully this will come in handy when studying for PEBCs and ultimately as a practicing pharmacist someday!
Clerkship began last week. I am on the general surgery unit with the clinical pharmacists for that specialty. Today while I was going through the patient records I discovered that one of the patients I interviewed during my 2nd year hospital placement is currently in on the unit. His case is so unique that I knew it was him the moment I read the file. I honestly can’t get over the coincidence.
First studyblr post in forever! Up late writing over Therapeutics notes for my midterm on Monday. Kinda disappointed that I don’t think I’ll have time to write them all over. Going to finish up Acute Kidney injury tonight before bed and then start reviewing everything tomorrow.
Zzzz. So tired! I’m in bed now thankfully. Just finished up my night of school work. After not getting to study this afternoon, I feel like I accomplished a lot tonight. I started studying around 7:30pm and managed to get through my therapeutics notes for seizures and MS by 10. By then I wasn’t really focusing so I took a break and watched House. Started studying again around 11:30 and finished around 1ish after getting through headaches and migraines. Since then I was finishing up my final critical appraisal assignment for research and JUST finished it. I’m pretty sure I feel like I’m ready to submit it now, I love that feeling.
So I’m really happy with my productivity tonight. Time to get some sleep so I can work on some more therapeutics and edit my final ethics paper. I’m pooped.
Some late night exam prep. Exams start on April 11th and I want to get a head start on preparing for them because there’s a bunch of material to cover for therapeutics. So I’m doing up my own study guides to get started. I’m doing headache now and watching Friends. I’ll try to keep my studyblr more updated during finals!
Listen if it’s a doctor of pharmacy and a pharmacy student that answer is totally valid.
The other day we had a mock code blue outside of the pharmacy and the closest physician was a poor infectious disease specialist. She named the rhythm incorrectly and her backup was a team of pharmacists. None of us were going to correct her because it seemed close enough to us. The nurse educator finally had to do a discreet cough too steer us down the right path.
I’ve worked in units where the nurses had a little too much faith in my skills and would alert me to absolutely everything before calling the doctor. I have definitely called an attending physician before with, “I just looked at an EKG and it looks ugly. I need someone who went to actual medical school to look at this instead.”
Today I delivered a prescription to a physician who, due to a weird hospital policy, had to them dispense the drugs to the patient’s family himself. This almost never happens and I always feel self-inflicted pressure to give the physician a few brief tips on how to do this well.
Me: now remember you’ve written for oral solutions with two different dosing volumes, and these oral syringes aren’t large enough, so make sure the parents are able to teach you how they understand to give it.
MD: I’m sure they’re smart enough to figure it out. No worries.
I glanced up and looked the doctor in the eye. I thought my expression was neutral, but his eyes immediately widened.
MD: …OR, I’ll make sure these parents are very comfortable with these drugs before they leave.
Me: Awesome. You’ll be a great pharmacist. Make me proud.
I need to go look in the mirror and figure out what look I gave him. I should patent that shit.
