Pharmacology Pitfalls and Pearls in Urgent Care Medicine
Abstract
Adverse drug events account for 17 million emergency department visits in the United States annually. Nonsteroidal anti-inflammatory drugs (NSAIDs) work by inhibiting one or both cyclooxygenase enzymes. There are variable safety profiles among NSAIDs. More than 200 medication combinations contain acetaminophen as a component. Disparities in opioid prescribing practices are persistent despite documentation of race-based and gender-based disparities in analgesia administration for decades. Overdose or intravascular injection of local anesthetics can cause severe side effects including seizures and arrhythmias. The potential risk for allergic cross-reactivity with cephalosporins in a penicillin-allergic patient is estimated at less than 1%. Insulin comes in several formulations, ranging from long-acting to rapid-acting and mixed formulations. When prescriptions/refills are necessary to provide in an urgent care setting, close coordination with a pharmacist, review of the patient record, and verification of current doses are highly recommended to ensure safety.
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