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 Total Parenteral Nutrition (TPN)

“If the gut works, use it!” but when it doesn’t…⁠

✨ Check out this post to learn more!⁠

💉 Total parenteral nutrition (TPN), also known as parenteral nutrition (PN) is a form of nutritional support given completely via the bloodstream, intravenously with an IV pump. ⁠

🍞 TPN administers proteins, carbohydrates, fats, vitamins, and minerals.⁠



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ACE inhibitors vs. ARBs.

                                                               What’s the difference?⁠

💊Angiotensin converting enzymes (ACE) inhibitors and angiotensin receptor blockers (ARBs) are antihypertensive medications used to treat high blood pressure and other comorbid conditions.⁠

💊While the enzyme inhibitors work by reducing the level of angiotensin II in the body, the receptor blockers inhibit the function of angiotensin II by directly blocking the specific receptor. ⁠

⭐️Key Takeaways⭐️⁠

-ACE inhibitors and ARBs have similar benefits, and both work equally well in the body though ARBs are thought to have less side effects. ⁠
-ACE inhibitors and ARBs are both considered first line for the treatment of hypertension. ⁠
-ACE inhibitors remain first line for HFrEF with ARBs as an alternative. ⁠
-For those who cannot tolerate an ACE inhibitor, ARBs are reasonable substitutes (ex: dry cough)⁠
-It is NOT recommended to treat hypertension patients with both ACE inhibitor and ARB as it can increase adverse effects. ⁠

ACE inhibitors vs. ARBs. Read More »

Inhaled Corticosteroid Combinations

🧠Memory tips for inhaled corticosteroid combinations!⁠

🌬️Inhaled corticosteroids are first-line options for treating patients with asthma. But many of these inhalers are brand-name only and some come in combination with long-acting beta 2 agonists or inhaled anticholinergics. ⁠

🫁Inhaled corticosteroids work by reducing inflammation and swelling in the airways. Reducing inflammation makes it easier to breathe, which minimizes asthma attacks. But these medications have to be taken daily, and it may take several weeks before they’re fully effective.⁠

🧠Some of these brands are often used on exams and it is helpful to know what their combinations are: ⁠

TIP – we would never put two corticosteroids together so for example if the question asks about Symbicort – the answer should be ✅️budesonide with formoterol (ICS + LABA) NOT ❌️budesonide with fluticasone (ICS + ICS). ⁠

⁠👉🏻Quiz yourself on how well you know the combinations and some of my memory tips on remembering them!

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😳 Since one of sertraline’s common side effect is diarrhea 💩, I called this piece ‘Squirtraline’. 💦 🤣⁠

💊 Sertraline belongs to the class selective serotonin reuptake inhibitors. SSRIs are like the traffic controllers of your brain’s serotonin levels. They help ensure that serotonin sticks around longer, improving symptoms of depression and anxiety. ⁠

🧠TIP: Serotonin is your ‘feel-good’ neurotransmitter. It is responsible for regulating mood, emotions, and even appetite. Sertraline’s role is to increase the amount of serotonin available in the brain by inhibiting its reuptake. Notice how SERtraline looks similar to SERotonin. ⁠

🌟Common side effects to know: ⁠

-Changes in sleep pattern⁠
-Decreased libido and erectile dysfunction⁠

👉🏻Other than sexual side effects, symptoms often improve or resolve with time. ⁠

🗒️ Note: Sertraline is the most likely of the SSRIs to cause diarrhea. Research shows it may occur in up to 20% of people. Don’t fret – educate your patients that it will usually get better within a few weeks and to use antidiarrheal medications (ex: loperamide) in the short term. ⁠

💊 Starting doses: 12.5-25 mg daily and may increase to 25-50 mg increments⁠

Sertraline Read More »