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Old Medics, Old Drugs

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Wasn't it levophed that produced the vomiting seen in the Exorcist? I can't remember the drug we pushed but one night we had a really sick patient, was told to give this drug to this patient, then I gave it, and the patient emptied their stomach contents against the far wall. I do remember that there were small chili beans or some type of bean in the vomit that our housekeeping department was OH SO Happy that they got to clean up.

The patient didn't survive the night.

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Wasn't it levophed that produced the vomiting seen in the Exorcist? I can't remember the drug we pushed but one night we had a really sick patient, was told to give this drug to this patient, then I gave it, and the patient emptied their stomach contents against the far wall. I do remember that there were small chili beans or some type of bean in the vomit that our housekeeping department was OH SO Happy that they got to clean up.

The patient didn't survive the night.

Not sure if it caused emesis, but I did always hear it referred to as "Leave'em dead". LOL

Aminophyline was another one famous for causing projectile vomiting- not a good thing for someone already in respiratory distress. . Sadly, I recall times when aminophylline and epinephrine were the only medications we had on board to treat asthma. Lots of people died because we were so behind the times.

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Yeah, one of my doctors (old school - but he's since passed on) favorite cocktails for CHF was 125 of solumedrol or 100mg solucortef and then a bottle of aminophylline.

Amazingly, we usually brought the patients into the ED better than they were at home with that cocktail. Through in CHF and Emphysema and we usually made em worse or dead.

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Not sure if it caused emesis, but I did always hear it referred to as "Leave'em dead". LOL.

As an aside, levophed is still alive and well, and widely used in the ICU and even ER. It's a decent pressor, and gets a lot of use in sepsis.

Unfortunately I don't have it on my ambulance, but most people I'd likely use it for need a few liters of saline first. Granted, these people are sick and have a high mortality.

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We also have levophed (norepinephrine) as an option for sepsis, and it's my preference over Dopamine because of the MOA.

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The whole "leave'em dead" saying is outdated. It used to be the case that levophed was only used in refractory hypotension and was the last resort pressor before the patient expired. We have gotten much better at selecting pressors and levophed is now used in a wider scope.

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I used Levo a couple weeks ago in Cardiogenic Shock.

I have also used it in Sepsis.

We don't carry it though, gotta consult OLMC then pick it up somewhere.

How about Activated Charcoal?

Edited by mobey

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The whole "leave'em dead" saying is outdated. It used to be the case that levophed was only used in refractory hypotension and was the last resort pressor before the patient expired. We have gotten much better at selecting pressors and levophed is now used in a wider scope.

I thought I posted this before but it seems to have disappeared. The leave 'em dead thing was a JOKE- from years ago. It was not a comment on the drug's efficacy. I haven't been here in awhile and I forgot how flip comments are too often misinterpreted.I thought this was a more lighthearted thread- my bad.

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Ok, here is a useless drug, before we had Albuterol we had...... Trebutaline!!! Give it sub Q and wait for nothing to happen. And who remembers High dose Epi? My highest score was 38mg on a cardiac arrest.

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I would not call terbutaline worthless. If you look at the literature instead of anecdote, you will find that terbutaline is effective. A study in the mid 1990's compared pre-hospital terbutaline to albuterol. Quantatitive measurements of respiratory severity were similar between the two groups and both groups had improvement but the albuterol group reported "feeling" better. You have a case for albuterol being a better agent, but it would be difficult to call terbutaline worthless.

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