0:01

Emergency Medical Minute presents, Pharmacy

0:03

Fried it were emergency medicine.

0:05

Clinical Pharmacists join us to

0:07

shed light on pharmacological topics.

0:15

Welcome back to Pharmacy Friday! were bringing

0:17

it back! I'm Jeffrey Olson on the

0:19

second year medical student at the University

0:21

of Colorado and I joined in studio

0:24

today by Doctor Travis Bar. Like a

0:26

big contributor on the Pod, we've had

0:28

him on many times and are special

0:31

guest today is Dr. Kelly Olson Farm

0:33

D. She is an emergency medicine pharmacist

0:35

who practices at Denver Health but has

0:38

also worked at Swedish Hospital. Fun fact

0:40

is all three of us went to

0:42

the University of Denver together. Now the.

0:44

Phone fact is, Kelly and I are

0:47

married. No bias there. No, by a

0:49

certain your and Kelly often does help

0:51

out with the summaries for our medical

0:53

minutes. so cows grew to have you

0:55

on how you doing today. Can.

0:57

Thank you. Good and Doctor

0:59

Barley Carrier I'm fantastic! Have excited

1:01

for this! Okay, good, nervous. Okay.

1:04

so we're bringing back Pharmacy Friday

1:06

and I have written a show

1:08

for you to that has five

1:10

segments. And. Each segments

1:13

going to be different. Some of them

1:15

will have you guys collaborating as you

1:17

might do in the emergency room and

1:19

a few of them are going to

1:21

be lately competitive which we know also

1:23

sometimes happens in the emergency room. Wouldn't

1:25

see how this goes, hopefully you out

1:28

there listening. I learned something and enjoy

1:30

this kind of more fun freeform episode.

1:32

Okay, so starting with segment one, I'm

1:34

calling this the get to know You

1:36

questionnaire. This is how we're going to

1:38

get to know our guest Cali as

1:40

was real or. Another more about Doctor

1:43

Bar Lock. Are you ready? Oh

1:45

yeah, Yeah, let's try it again. So question

1:47

number one: this is for you, Cali. What's

1:50

a book you read within the past year

1:52

that you couldn't put down. Ah

1:55

man I read aloud lox last year.

1:57

Most of it is trash that. The

2:00

fourth length Roka fail world

2:02

renowned for failed Travis. for

2:04

me I actually some. Solutions.

2:11

Are it's ah question to.

2:14

Tell you what is the scariest

2:16

thread? Oh ah, potassium.

2:18

Rep. Maybe maybe can give us Navy one

2:21

sentence. Why think that's the scariest drugs. Because

2:23

it can cause of read me as if

2:25

you has two little or too much and

2:27

it does can then files as like burial

2:30

concentrated sassine that you need to dilute out

2:32

of our make in a these self that

2:34

doesn't to the for can be a bad

2:36

safety issue. Interesting art Travis

2:39

much you know of partner

2:41

wants to say Botox snake

2:43

eyes and know of by

2:45

a molecule from all with

2:47

your most dangerous substance on

2:49

the planet. So I'll argue

2:52

with Allan Poe's Malaysia ah

2:54

another medical one Tally: what

2:56

is your favorite medical app

2:58

or website up. A website. I

3:00

think I use Md Talk as

3:02

an app quite often. Far.

3:04

As a probably that is good

3:06

choice. So choice Travis I really

3:08

like which iam think it's as

3:10

can it. Crystallizes.

3:13

Important to com pointers what I

3:15

actually see on the basis new

3:18

insurance I like that one on

3:20

those are guess tally. What

3:22

is one home remedy that you swear

3:25

by? Ah

3:27

I mean I think the. Most.

3:29

Nifty one is probably using duct tape

3:31

on like. Work Sir. I

3:33

think that's I'm trying to say. The only is. Duct

3:35

tape than that. Lawyers had

3:37

enough that eventually it'll just

3:40

totally consistent. Good yeah. On

3:42

to figure that I feel you

3:45

family told me I'd. As

3:47

noticeable such as sorry trials

3:49

one home remedies face whereby

3:51

see and honey yeah I

3:53

mean I would say them

3:55

for Topher suffered I recommend

3:57

that them resulting. In. It.

4:00

Honey is actually like pretty interesting I

4:02

feel as the home remedy is like

4:04

that. reminds me when. Like button batteries

4:06

they tell you I give. it's like

4:08

kid. Give honey in increments until you

4:10

can actually get them to the hospital exit

4:12

over fun like experiments on pigs softly as

4:14

as rain, Sasa guy or analysis. Of suffer

4:16

doc some but as it. Has

4:19

some same area of the pharmacy. Medical minutes

4:22

coming up here sign. On

4:25

hundreds or thousands of years on

4:27

me honey assess assess this as

4:30

Muslims. Guess Calley what is your

4:32

signature dish? Probably. A rubella salad

4:34

with like a lemon and

4:36

apartment on. Was started

4:39

by Luxembourg site out to

4:41

the some braised rack of

4:43

lamb over current status knowledge.

4:45

Real that is real Ira.

4:47

Oh yeah. That. Must make like

4:50

take a lot of time. Did ball the

4:52

hands on times her sort out

4:54

birds in other items from records

4:56

of offloaded in it's it's Britain

4:58

so of the in fact I

5:00

mean button or sally back to

5:02

you which metaphor historical figure do

5:04

you admire the most. Louis.

5:07

Calm. And he created the Poison Control

5:09

Center And he was a pharmacist and

5:11

that's very. Proud moment for

5:13

pharmacy or a dartboard? oh

5:16

I'm from me I just

5:18

the percentage of is a

5:20

she's several vice seizes since

5:23

he was Austrian bus he

5:25

was this Er physicians who

5:27

started noticing that there is

5:30

a wide disparity in mortality

5:32

in the obstetrics units of

5:34

the hostages out between the

5:37

patience of urging taking care

5:39

of by physicians and those

5:41

are. Taking care of by the

5:43

used by the woods and by the

5:46

nurses and that the ones being taken

5:48

care of as a physician's were dying

5:50

and like a way higher rates and

5:52

he concluded that there was some substance

5:55

of the doctors were communicating to the

5:57

patience from dead bodies they were handling.

6:00

And basically can I came up with

6:02

the idea of like hand washing and

6:04

it's a really ice sheets on a

6:06

sad story of him publishing his like

6:09

evidence for it's and then getting kind

6:11

of harassed and son from the community

6:13

and ended up a sham. You're really

6:15

really sad tennis ending racing team until

6:18

it's a mental institution and was like

6:20

abuse their and and he's in a

6:22

diner very sad way but he actually

6:24

did ten of change the world after

6:27

after that so's Isis as nuts I

6:29

should really. Really? Admirable. Nice. I

6:31

knew you're gonna have a good

6:33

answer for that to answer your

6:35

always perfect in various medical historical

6:38

figures. Next question Tally: Which Drugs

6:40

is the biggest prima donna in

6:42

the hospital. Okay, so

6:44

you clarify that like prima donna

6:46

isn't what's the most annoying one

6:49

to deal with. Are.

6:51

The. One that's the most exciting to work

6:53

with. Now I was our

6:55

citizens you may temperamental fluorosis question.

6:58

But but also exciting I'm in a

7:00

free Madonna can be exciting. I. Mean I

7:02

guess is he would say probably the this

7:04

prima donna the one that's like. The.

7:07

Worst the deal as is probably I the

7:09

I g to because it's a protein say

7:11

you have to be careful handling it. can't

7:13

be too they were. It's like thousands of

7:15

dollars and like I've had seen nurses actually

7:17

drop it in fashion on the floor which

7:20

is not their fault for nine also be

7:22

tight race and for to be really difficult

7:24

for nurses and it's not that they can

7:26

see the mass, it's just that it's really

7:28

tricky sometimes and you have to monitor it

7:30

so frequently and so I think it's just

7:32

a lot of work on everybody's side especially

7:34

nursing. said do ideology and it's the thought

7:36

of money. So it's high stakes. Bears

7:39

are Travis. I

7:42

don't have enough really good answers.

7:44

That thing that I was thinking

7:46

of as the drugs. I swear

7:48

between people message mess up all

7:50

the time and requires ago the

7:52

attention and that's Abby. were just

7:54

says you yeah handling as it's

7:56

just you know the one that

7:58

we screw up. The dosing, the

8:00

route, the everything all the time. There's

8:03

way too. Many forms of that be enough why

8:05

they took out the like ratios for Athena. It's

8:07

not like one in one thousand one hundred thousand

8:09

anymore, so they just have less the oil exam

8:11

her whenever I'm all sectors and I just made

8:13

it. Way harder with the ratio says yeah

8:15

that out. The snow and on packaging is

8:17

to look for Isaiah. Sufferers of he

8:19

was really good answers or it's. Kelly

8:22

turned six or waffles waffles.

8:26

Waffles Yeah, I'm

8:28

sure there's plenty

8:30

of assist assist

8:32

samples. Are like objectively better the

8:34

really Christie on the outside and soft on

8:36

the inside. It's just that they just demands.

8:39

A whole other. And

8:41

sire cooking unit. Make

8:44

them. But. That's. What makes

8:46

them so special and delicious? The

8:48

prima donna of Fructose. Or

8:51

last one what is something from the

8:54

hospital but you always need help with.

8:56

Yet so I think that the he

8:59

are is a team base and group

9:01

and I'm a lot of what I

9:03

rely on as a pharmacist is answering.

9:05

Not like nurses and doctors are giving

9:08

me the information I need to help

9:10

them make medical decisions and so I

9:12

really rely on their assessments to help

9:14

me help Some essentially. Price.

9:17

Or.warlock were I mean my him

9:19

in Iraq This piggyback off as

9:21

added mean that other see the

9:23

world of emergency medicine. The medicines

9:25

know a large as snowed are

9:28

a team be sports and I'd

9:30

say serves him right. Back to

9:32

that particularly with with pharmacies when

9:34

I've got a p cents to

9:36

one that the dosing is complicated

9:38

for for is there was one.

9:40

Pieds is very clear. Also there's

9:42

patients who are. And. Extremes of

9:44

I B M I for example

9:46

and you're trying to figure out what

9:49

what site actually the right dosing of

9:51

a meditation to give here and

9:53

them as these other see escalating complexity

9:55

once you get allergies involved and other

9:58

medications involved and your drug. Interactions

10:00

himself sometimes is this times are

10:02

you really need to provide the

10:04

right therapeutics momentum from the get

10:06

go. Otherwise just the way things

10:08

go in the hospital of changing

10:11

medication, someone's on the antibiotics, other

10:13

on or whatever. it just takes

10:15

a long time and so just

10:17

getting it right from the gecko

10:19

is important and thus others you

10:21

are are from says come in

10:23

handy. Nursing effect

10:26

size as an athlete firstly

10:28

into our next segment. The

10:30

segment I'm calling Pharmacy Riddles and

10:32

the Swans. You guys are going

10:34

to have to collaborate. Five got

10:36

a couple riddles force you to

10:38

so you're not competing here. This

10:40

is totally collaborating to come up

10:42

with the best answer. Sale or

10:45

not competing, but I see a score.

10:47

Card friends Mcafee Others for salmon.

10:49

Sorry I'm set up a teaser

10:51

for years due to their here

10:53

is the first rentals he put

10:55

up a tree their I'm gonna

10:57

read it for our listeners here

10:59

are it's born in nineteenth century

11:01

for doubt. That. Later served

11:03

a different bout. Times. In

11:06

Structure: Party in Action. Hypothyroidism

11:08

and tremor. My adverse reactions. Wow,

11:10

that's really good. Yeah, I did

11:12

not Isis. One sound of this

11:14

thing coming up next is one

11:17

I did right. But I did

11:19

was look at the credits in

11:21

the show notes for the Swanson.

11:24

So what's a doubt? Treatments

11:26

allopurinol. As with say that

11:28

scannable culture seems okay i'm

11:30

in tears culture scene cause.

11:33

Of cause thyroid dysfunction

11:35

a tremor. That I think that

11:37

like lithium can cause really bad tremor until

11:39

but that seems like. Weird that

11:41

a be I know. Lithium was

11:43

actually initially created as a diuretic

11:46

the Reagan and Alzheimer's Society has

11:48

left out. yet us out. Type

11:51

with I mean that with i am he owed

11:53

around or something since I was in cause like

11:56

know it's and destroy your thyroid. As a

11:58

probably thirty, as as as a. But.

12:01

Ah but I feel like maybe in the answer is

12:03

like I feel like it probably is cool to see

12:05

and I don't know that causes tremor though. the culture

12:08

seems like a crazy. Drugs. Have we said

12:10

this? You have said ugh, Access or

12:12

I ah. Man

12:15

I guess. The ones

12:17

reached out of jail for agree I served

12:19

a different bow that means is it was

12:21

unusual. And novel anymore? Like really weird. It

12:23

works on your telomeres right And sell it

12:26

were to get another. Microtubule. Okay,

12:28

let's have. A

12:32

feeling has the i'm going to think what's his name but.

12:35

At her out on that unknown as

12:37

or it. Matters encouraged to

12:40

his alley around not a Muralitharan

12:42

all that much healthier vice. City's

12:46

lithium was. I.

12:49

Was I to the seller was

12:51

emphasized I rather thought the that

12:53

than they found out that these

12:55

vices heard it's having different I

12:57

go out they are saying I'm

12:59

really. Proud of myself as being like

13:01

an atheist. Lithium. Wow, that's a big

13:03

thing is that to the local like

13:05

bipolar disorder is that they often out

13:07

like tremors. Doesn't make them stop Thousand

13:09

Yeah, so that's why I thought of

13:11

Lithium. Mississauga. I told his

13:13

services few years and I did

13:15

google Rupert because he said that

13:17

arm and what I am finding

13:20

here is that does lower your

13:22

acid levels in the blood but

13:24

is not an effective treatment for

13:26

doubt. And in notes. And then

13:28

there's also. A

13:30

Jewish Us totally glossed over. kind of

13:32

dead giveaway hear these tiny and structure.

13:35

To. Ah same.

13:38

As any sense and Elena. If

13:41

I often for a particularly tiny

13:43

elements as well. Or you're right,

13:45

it is. Mike Microtubules. For

13:47

classes I told you set up that. I

13:49

also told you that with animals who not

13:51

the answer as the sole owner. Or

13:55

it a chance to redeem ourselves. Can flip

13:57

over a piece of paper and. Take

14:00

a look at our next read:

14:02

Oldest one I did right? Okay,

14:05

after his brother met an untimely

14:07

demise, this substance found itself at

14:09

the heart of an admirable prize

14:12

inside every mitochondrial from the head

14:14

to the tell it looks at

14:16

tate vessels and simply says no.

14:19

It is available as a

14:21

tablet and ointments an ivy

14:23

transdermal To Side effects include

14:25

an explosive headache, Overdose.

14:28

And you'll turn blue. Okay, I'm.

14:31

thinking. Like. Nature

14:33

And that's honestly I'm

14:36

proceeds. Ards, Nitroglycerine Knowledge

14:38

of I said sen press I

14:40

feel like. You're. right? it's probably.

14:42

And nitrogen. containing.

14:45

Drugs yeah I mean the headaches

14:47

are so turning blue with it

14:49

and and or so tight muscles

14:52

simply says know some as simply

14:54

says know is that the surfer

14:56

and I like I was such

14:58

as up our out there are

15:01

a major metro pray I think

15:03

that the same person. As

15:06

it is nitroglycerine, Niger answers or

15:08

something like air. Ah, and any

15:10

thoughts on that the first part

15:12

after his brother met an untimely

15:14

demise. Story of the. Invention.

15:17

Nitroglycerine. Mean. Like murder. His.

15:20

Brother. With nitroglycerine earning him to

15:22

my his brother died. From.

15:24

And accidents involving nitroglycerine.

15:27

Found. Itself at the heart of not

15:29

like old eyes and. I. Did they light

15:31

on fire? like an explosion? So nitroglycerine

15:33

is a key component for

15:35

Dynamite, who this famous person

15:38

invented and then potentially maybe

15:40

sought to look at bad

15:42

about it's use and war.

15:44

And then he invented a

15:46

prize. And I know. You're

15:49

an Ivy Ciresi now. Malpractice of

15:51

Asia like office Alfred Nobel really

15:54

brought his brother died of our

15:56

nitroglycerine act I believe was a

15:58

boy on explosion. They did invent

16:01

dynamite and then some people say

16:03

that some guilt over it's use

16:05

in wars made him create the

16:07

Nobel prize to confront him. His

16:09

name? no way file does not.

16:11

So tough it ncr in research

16:13

into right as far as ruins

16:15

since I've been nitroglycerine like how

16:17

people that work in factories where

16:19

there's a lot of nitroglycerine they

16:21

will on Sundays feel like they're

16:23

having a heart attack. His aunt

16:25

like the Sunday heart attack. Because.

16:27

They leave the factory for a couple

16:30

days. They're nice. Was there nitroglycerine. And

16:33

and vessels offers. Up until I

16:35

feel like they have a hard man right? Yeah

16:37

and then versus how that works for

16:39

a set up and apparently they don't

16:41

feel that much better on Monday to

16:44

they come back and then they get

16:46

what's called like the Monday sickness as

16:48

other vessels open back up again. Very

16:50

fascinating drugs, that nitroglycerine and then the

16:52

overdose you'll turn blue do we get

16:54

with that is referencing names of any

16:57

means it has met him of of

16:59

anemia is a possible effect of it

17:01

said margin of overdose. So yeah. I

17:03

think as Angelic Cyanide Texas' Thatcher

17:05

from side. right? Yeah, could very well

17:08

be your title, just as your medical

17:10

center. Attack

17:13

Just oh yes as I've got one more

17:15

this more of a logic puzzle. Okay, so

17:17

I don't have a renown free as he

17:19

do have to listen very closely here. See

17:22

Been feeling very sick lately and

17:24

decided to visit. Your doctor gives

17:26

you two medications to take medicine.

17:28

Why in medicine acts your instructed

17:30

to you must take. One

17:32

pill every day of each and

17:34

they must be taken together. So.

17:37

One of x one of why and he take less

17:40

than that amount You'll die from the illness. If you

17:42

take more you'll die from an overdose. So.

17:45

You're. Putting away the pills in your medicine

17:47

cabinet and you drop the bottles. Three.

17:49

Pills Bolland. You. Count the

17:51

remaining pills and realize that you

17:53

must have. One. From

17:55

bottle acts and to from bought

17:57

a while but unfortunately the pills.

18:00

Completely identical. you have no way of

18:02

telling them apart. How can you still

18:04

save these pills? On. The floor

18:06

maintain your proper daily dosage and

18:08

take all of the pills. That's

18:12

interesting. So. You

18:15

could. Is in

18:18

his have to take take exactly. Like

18:21

one. One. And one doesn't'

18:24

Like cats and. I guess I

18:26

guess I did bring a clue. Fatalities

18:28

or eight hours a day ten hours

18:30

ahead on them. Sally and I said

18:32

salaries that are to access this is

18:34

upheld. Sad as that. So okay, so

18:36

that's the first partner does explain how

18:39

that would work. We really have said.

18:41

Cut them into all of them

18:43

and had snow. Yeah. He. Just as

18:45

the first step become all other

18:47

cities and then. You.

18:50

To. That. You take. Each

18:53

has its that. One or one yeah, husband

18:55

eats and then you take a fast and then oh

18:57

wait, and then you take a half from the bottles

18:59

that you know and you cut down the house. And

19:01

then you take. A sauce. And.

19:04

Seems of those has the us are you

19:06

a seizure reducing breathlessness? we know we have

19:09

one of slacks and to fill wise if

19:11

you take one more pill accent of the

19:13

bottle and I got to into and then

19:15

just cut them all and how they have

19:18

and then put his happens to suffer piles

19:20

although you wouldn't know which hath borne switch

19:22

pose you would guarantee that each piles contains

19:24

a full. Till. Acts and fulfill

19:27

why? Moving on to a segment

19:29

three, this is really fun game.

19:31

Similar to the game balderdash I'm

19:34

gonna give you a a proper

19:36

nouns and you ought to come

19:38

up. With. The definition I

19:40

think of picked some words that you has

19:43

probably not seen before. There's a chance you

19:45

have seen them, so you might be kind

19:47

of. Making. Up your definition but

19:49

I will still be as fair as possible

19:52

in deciding who actually came close to. That

19:54

says if he really doesn't matter at all

19:56

these saying I don't know what, he's innocent.

19:58

I have a lot of noise. That editing

20:00

medical words are the only. They

20:02

only gotten a lot of medical

20:05

words. They all are medical now

20:07

and. Say tell me medical terms and like I

20:09

don't know what you just said to me please that

20:11

night and lame since. The end

20:13

I did try to pick some that

20:16

are kind of at the intersection of

20:18

medicine and pharmacy same as should be

20:20

there sir but was it or get

20:22

service number one thousand scallions of first

20:24

for digitally questionnaire travels once your first

20:26

for this first one of and your

20:28

word is. Sippy. Diet.

20:32

Sits die and up. That is

20:34

as I pp y diet. What

20:36

is a sippy diet? Ah,

20:39

Mississippi, it has to be an

20:41

acronym. Ah, That's my,

20:43

that's my desk. And so

20:46

yeah this is amazing I

20:48

confidently telling you what it

20:51

is mystically oh yeah forgot

20:53

extra points for being as

20:55

for found that the Up

20:58

Us okay yeah a Sippy

21:00

Dyads is a is actually

21:02

a diet that is completely

21:05

a liquid and one that

21:07

you are able to consume

21:10

when you have issues like

21:12

with are we were never

21:14

uttered. Your jaw wired shards or something

21:16

like that and so it's one that you actually

21:18

have to after in a sip to to consume.

21:21

That Does this Have you? done? And

21:24

tell you what is a city

21:26

diet. So I feel like I

21:28

had a similar idea to Travis Set

21:30

that l. The liquid has to be

21:33

in a sippy cup and be blended

21:35

so they can drink get through. The.

21:37

City. Of that and

21:40

I'm gonna make your answer will the difference

21:42

of what I what is yours to treat

21:44

if I read the wise see our people.

21:46

Well off masses abscesses that are

21:48

on treated as and maybe potentially like

21:51

blood flags and and I mean on

21:53

just for those people that are on

21:55

air when box and my seas or

21:58

something. Who has to now? I

22:00

wish of these is closer out of

22:02

reach of Christ definition. Maybe you can

22:04

help me think of which is closer.

22:07

So it's named after Bernard Sippy. So

22:09

much be able to give. Now it's

22:11

first in an acronym. ah and it's

22:13

a bland diet for the treatment of

22:15

peptic ulcer disease consisting of measured amounts

22:17

of milk, cream, farina and any what

22:20

is that for in as a form

22:22

of milled wheat to kind of looks

22:24

like oatmeal. With. Knows here first

22:26

and ago when you're have point each

22:28

one else has. since I say not

22:31

I'd probably say one of us closer

22:33

there. so if you to come down

22:35

to the next one and tell you

22:37

have to answer person this one out

22:39

what is a use p regimen. That

22:43

is why use Z P.

22:45

A use be regimen

22:48

is a way to.

22:50

Wrap open wounds and keep

22:53

them moist and. Air

22:55

raid at so that they do not.

22:58

Ancestor. And become

23:00

infected. Of Esa

23:03

is de. Use Be A

23:05

Use Steam Met him in person. Or

23:08

a Travis yeah obviously used

23:10

to regimen is a discharge

23:12

or ah at home regimen

23:14

that you i instruct euro

23:16

cardiac patience to do. It's

23:18

a workout regimen that's easy

23:20

to you know and issues

23:22

and follow Anna and a

23:24

heart healthy manner. Of

23:27

has. Doesn't like like a

23:29

Russian like cardiology. Fresh Internet again.

23:31

this one has to be so hard

23:34

to get quite that I'll tell you

23:36

the correct answer. So this it's an

23:38

An outdated. Form. Of

23:40

emergency contraception. so it's

23:43

the most most. Said

23:47

it involves using regular birth control

23:49

pills as a form of merchants

23:51

contraception. Only birth control pills that

23:53

contain both estrogen and progesterone can

23:56

be used for the use the

23:58

method as isn't as effective. Those

24:00

are more updated forms of emergency

24:02

contraception like plan B or Allah

24:04

or the Copper are you D

24:06

but was shown to have some

24:08

advocacy item or you'll have to

24:10

go a half point on each.

24:13

Has Kelly said a method of

24:15

rapid wounds Trump says workout regimen

24:17

I don't know a similar be

24:19

wanted to see this point. Out

24:23

to visit for someone has to get a point

24:25

soda I can give a handful you don't censor

24:27

of harsh as I just as I guess. Exactly

24:30

wrong What I do, the rumors

24:32

are incorrect Css. I was just

24:34

a process. I think I remember

24:36

learning about that in pharmacy, but I don't

24:39

think that it is tied to a name

24:41

is now set and then again, Who

24:43

knows. Yeah, yeah, we're not in

24:45

endorsing this method, but it is

24:47

interesting that that can work Is

24:49

emergency contraception? Essentially just take double

24:51

the dose of normal birth control.

24:53

Like every eight hours of things.

24:55

What I read next: One guy

24:57

as for going back to Travis

24:59

answering first? What is a. Beat.

25:02

Sword Jars reflex

25:04

is spelled. Be.

25:06

Z O L D. Dash.

25:09

J A R I S

25:11

C H. Yeah.

25:15

That decide Jairus

25:18

reflects his. It's

25:20

when your cells

25:23

actually have. A

25:25

really aggressive immune response

25:28

and so you end

25:30

up basically spiking a

25:32

fever when you get

25:35

any. Cell

25:37

lysis. Okay, Chalua

25:40

come up with said an

25:42

alternate to doesn't Matter. Yeah.

25:46

Cel. I would say that this

25:48

reflects his when you're. in

25:51

just a substance that far

25:53

forms a ah fall because

25:55

it sounds like a beast

25:58

some older and that

26:00

reflexes when your peristalsis stops

26:02

because of the substance that you've

26:04

ingested. I don't know

26:06

if that really counts as a reflex, but... That's

26:10

interesting. I'm

26:12

tempted to give it to Travis on

26:14

this one because it is more cell-mediated.

26:19

The trigger is more a sudden

26:21

reduction in left ventricular volume or

26:23

pressure, such as a

26:25

massive hemorrhage. But it can also

26:27

be triggered by administration of certain

26:29

drugs that act on cardiac receptors.

26:32

Yeah, so nothing that I said there. I

26:36

think I'm going to give the point here.

26:38

Yeah, I could think it was the Gyrish-Hirksheimer

26:40

reaction, and I was wondering if Gyrish is

26:42

the same guy. Very

26:47

well, it could be. We'll leave it

26:49

to our listeners. We'll look that one

26:52

up. But you didn't quite nail what

26:54

the response is. It's actually a triad

26:56

of responses, bradycardia, apnea, and hypotension. So they're

26:59

all somewhat cardioprotective reflexes in

27:01

the setting of massive hemorrhage.

27:05

An interesting one, but I feel like there's

27:08

other reflexes that kind of happen in massive

27:10

hemorrhage that kind of take over. It sounds

27:12

like they're dying. They're

27:16

bleeding out. And look at this. It's a

27:18

reflex. He found it. Yeah, their heart rate's

27:20

slowing down. They're stopped breathing. Their blood pressure's

27:22

dropping. This is a reflex. Yeah, exactly. Oh.

27:25

You're just mad you didn't mind it yourself. I

27:27

can name it that. You

27:31

should do that next time somebody is hemorrhaging in

27:33

your trauma bay. What? What's it called? Beatzoid.

27:36

And I said Yarrish, because that's what I

27:38

looked up on Google. Maybe

27:42

I've been pronounced B-Tron. In the middle of the trauma room,

27:44

if they're having a beatzoid Yarrish. Yeah, they're not

27:46

having a beatzoid Yarrish reaction. If I

27:48

was in a trauma room with you, I

27:50

would just look at you and shake my head like,

27:52

what are you talking about? So ridiculous.

27:54

I'm mad. found

28:00

a way to name it after some person. Ridiculous.

28:04

All right, Callie, I think you got a chance

28:06

at this one. What is a dram? A

28:09

dram is a little boat that

28:11

you weigh things in, and a

28:13

dram is a unit of measurement

28:15

for that weight. Okay,

28:18

Travis? Interesting. Yeah,

28:20

a dram is another name for the sheet

28:27

that separates the surgeons from the

28:30

anesthesiologists in the OR. That's a

28:32

great response. I really like that,

28:34

but Callie's much closer on that.

28:37

She's very confident in that response. So at

28:39

which point you guys are tied, but I

28:41

will read you. A fluid dram is defined

28:44

as one eighth of a fluid ounce. I

28:46

guess a lot of pharmaceuticals used to be

28:48

measured in drams, but that has

28:50

been entirely replaced with metric units. But

28:53

fluid drams are still used to

28:55

measure the capacity of pill containers,

28:57

apparently. I

28:59

know that I learned something about that in compound.

29:02

Yeah, it might still force first-year pharmacists

29:04

to learn about drams. Okay, so we're

29:07

going on to our tiebreaker word. Man

29:09

is a barris-law, a compound-tractor. You

29:13

did say measure, though. At least

29:15

I knew it was a measurement. All right,

29:17

we're going back to Travis to tell

29:19

us what is Burton's line. Burton's

29:22

line. Burton's line. Yeah,

29:25

so Burton's line

29:27

is the altitude

29:29

at which when you cross

29:31

it, your risk of pulmonary

29:33

edema or cerebral edema becomes

29:35

very high. All right, Callie.

29:38

Burton's line. It is the

29:40

line in which something becomes more

29:43

toxic, and you start developing symptoms and

29:45

side effects of a medication is Burton's

29:47

line. It's not like the lethal dose

29:50

or the therapeutic dose. It's

29:52

the dose that gives you side

29:54

effects. Okay, we're going to go no points

29:56

in the sky yet, but we're all going to learn

29:59

about Burton. The blinders it is

30:01

the blue for bush line on the

30:03

guns seen in chronic lead poisoning. Ah

30:06

wow wow you really should have

30:08

gotten on says well I think I

30:10

remember looking for that was like stats

30:12

and selling for step one I've never

30:15

heard of that. A month line

30:17

birds and find hush party wanted to

30:19

say sundance how it but then it

30:21

started burden as it does snowboards outside

30:24

our. Sidebar of of

30:26

I was i'm sorry lousy. The snowboard hits

30:28

the on the back in any of the burden.

30:30

Signed up for like a might have

30:32

given your points last I heard it

30:35

is a line on the body bag

30:37

out bloopers once. Okay so our tie

30:39

breaker is we're going back to Dram.

30:41

How many milliliters is a dram? Twenty

30:44

eight point. Eight

30:46

Seven Thousand. Wow. Okay, is

30:48

this your going down as

30:50

as decimals is really concerning.

30:52

Ten. I'm

30:55

gonna have to go twenty eight Point

30:58

eight aids. As

31:00

Sorry as or victor as it

31:02

is a three point seven. Know

31:05

as long as. It's

31:08

like also I. Love You might

31:10

have heard new my definition say it's one

31:12

eighth of a fluid ounce. Answer: The thought:

31:14

closer to a fluid? Okay. That so I

31:16

thought, hey, but that's pretty. Close. Yeah and

31:19

such I was willing to less

31:21

a nice yeah. Moved

31:23

on to segment number for. This.

31:26

Is the number needed to treat

31:28

game. And. Credit goes to American

31:30

Family Physician and their podcast. They often

31:32

play this game on their podcasts and

31:34

are hotter here with us trying it

31:36

out since I heard. Very fun game.

31:39

Want. You to do for this is I'm going

31:41

to give you a treatment in the disease. And

31:44

I've used the And and

31:46

T.com. To. Look up what

31:48

is the number needed to treat

31:50

So nominees is treat for our

31:52

is the number of people with

31:54

the disease that you would need

31:57

to provide treatment to to get

31:59

one successful. Response. So

32:01

if it's the antidote to a place and

32:03

it's how many people that are poisoned would

32:06

you have to give them the antidote to

32:08

save someone's life and the lower is better

32:10

because then it's if it's the numbers three,

32:12

you only need to give it a three

32:15

people to save a life in December to

32:17

be all over the place. and they give

32:19

us a good idea of the effectiveness of

32:21

different treatments or it to carry. We go

32:24

first on this one. said the treatment is

32:26

corticosteroids for the treatment of cows, ah, keys

32:28

disease and children number needed to. Treat

32:30

to reduce the outcome

32:33

of coronary artery abnormalities.

32:35

I. Think it's wow. I think it's gonna be like.

32:40

Ours: how's your and twelve. At

32:43

wow moments as a source on

32:45

the dark ah a my go

32:47

higher I'm gonna say. Twenty.

32:50

Or it's the number is ten, so

32:52

point to carry their pretty important treatment

32:55

at the end and T gives it

32:57

a rain of green says the benefits.

32:59

And and T and for farms there

33:02

were no reported harms with corticosteroid years

33:04

for opportunities from his house or his

33:06

disease for our next one this is

33:09

with the treatment of aspirin within forty

33:11

eight hours of in the scheme of

33:13

stroke to prevent. Death. Or

33:15

dependence. Yeah, I will

33:18

guess. fifteen. Or

33:20

it travis as often as if teams.

33:23

I'm actually I. I. I think it's like. Hundred

33:25

and Fifty or something. Or

33:27

intense Travis is can be closer.

33:29

and that one the number is

33:31

seventy nine. As so yes, one and

33:34

seventy nine to prevent death or dependence

33:36

by giving aspirin one in one hundred

33:38

and forty to prevent a recurrence.

33:40

Strokes. And one in eighty

33:43

nine forget complete recovery from the

33:45

strokes With that aspirin therapy. This

33:47

one does have some associated harms.

33:49

It's one in five hundred and

33:51

seventy four to cause a symptomatic

33:53

intracranial hemorrhage. And one in

33:56

two hundred and forty five to

33:58

cause a major extra cranial. The

34:00

bridge. That's a lot. That's like way higher than I thought

34:02

it would. Be easy, but it's who

34:04

gets a rating of Green from

34:07

Damn and to.com as being

34:09

a relatively safe and recommended treatment

34:11

after in the scheme it stroke

34:14

or it's next up this is

34:16

trans examine acid for the treatment

34:18

of Apis taxes number needed treat

34:21

to prevent one episode every bleeding.

34:23

One in. Fifteen.

34:26

And kept. Thinking fifty.

34:29

And. My go right

34:31

for. Phone for that

34:33

is very close since actual number is

34:36

five a flat out at sea I

34:38

say. That's

34:40

to prevent a one of Surrey

34:42

bleeding and there was no differences

34:45

in an adverse events or it.

34:47

So that's a point to Travis.

34:49

The scores two to one going

34:52

into our last one Titan tie

34:54

with this one we have antibiotics.

34:57

For. Culture Positive asymptomatic back

34:59

to your yeah in pregnant

35:01

women number needed to treat

35:03

to prevent island of writers.

35:06

Who I would say like a low

35:08

number like sudden. I.

35:10

Mean I you. I think it's gonna

35:12

be as a very high. When

35:16

I go west's America with a

35:18

hundred. Or it's the

35:20

correct number. Tell ya to on

35:22

the says you know the sensor

35:25

were ties is asymptomatic and you

35:27

get pregnant. Lady know I know.

35:29

I guess I'm saying I am.

35:31

so I'm Sam. I'm surprised this

35:33

the up and thinking back to

35:35

my studying for the shells I

35:37

believe it's because third smooth muscle

35:40

of the order is inhibited and

35:42

so factor of can flow back

35:44

towards the kidney a little bit

35:46

more easily in pregnancy. Ossetia One

35:48

in seven miscarriages. How light?

35:50

Hi. The. Risk of pilot

35:52

was nice. I would never say good it

35:54

would have in the and thus that is

35:57

interesting or it's really a tie breaker here.

35:59

there is another. If it to treating

36:01

asymptomatic back to your in pregnant

36:03

women in that is. A

36:05

one in nine to help. That's what

36:07

he gets things in either view. guess

36:09

it's a server guess is at first

36:11

will end. Sleep

36:14

on. This is a symptom of he

36:16

writes. ah. Yes

36:18

or no, I'm as it up just

36:21

or be from. I'll tell you the

36:23

to yeah it's preterm birth of at

36:25

the one nine nine asked at odds

36:28

prevent preterm birth by treating his Cincinnati

36:30

bacteria and then one in twenty was

36:32

hoped to prevent low birth weight and

36:35

there. Was no harms report and so

36:37

very effective. Also get a green

36:39

rating. Everything that was part of the

36:41

segment are they get a green rating

36:44

from the and in T.com or it's

36:46

We're moving on to our last segments

36:48

here. last this one is called

36:50

Extreme Survival Challenge so you too must

36:53

work together to answer the phone questions

36:55

the best of your ability within five

36:57

minutes. The scenario is as follows: You.

37:00

Have been teleported back in time

37:02

to Fifty Nine bc. And. Have

37:05

been dropped in Rome just as

37:07

Julius Caesar has taken control of

37:09

the Roman Empire. Your goal is

37:11

to survive. And game as

37:13

much power as quickly as

37:15

possible. What three medications are

37:17

you bringing with you? You

37:19

get unlimited amounts of whatever

37:21

three you bring. Wow! Do you

37:24

wanna do this? and like a dark and

37:26

sinister way to do this in my day

37:28

Sir Alec rewind or medicine as went way.

37:31

Yeah interesting. I mean so he

37:33

wants to survive and also gained

37:35

control in power. Same power

37:37

of right? I mean she's until

37:40

over the system to take the

37:42

throne become hers. Sets A

37:44

Here's my thoughts: Think it is our save

37:47

the world with penicillin or we could make

37:49

everybody addicted to a dog. And for. All

37:51

the power supply and how many drugs? Just Cynthia

37:53

three of the way we can do both. Since

37:57

makes me kind of person.

38:00

on who I am as a person these days. You

38:02

know, okay, so one, I

38:05

mean, I think that, yeah, having

38:08

something that does, obviously,

38:10

I think an antimicrobial

38:13

is for sure on the table. I

38:15

feel like there wasn't a lot of resistance

38:18

back then because they probably didn't exist. So

38:20

you could get away with like a penicillin,

38:23

but if we wanna do something like meropenem, we

38:25

could. It's really

38:27

just pen. It's really good. It's really

38:30

terrible, you know, because adverse

38:32

outcomes of these today. Yeah.

38:36

The world would be gone. Okay, maybe a

38:38

penicillin. Here's the other thing. What

38:40

about- It's not like augmented. I feel

38:42

like nobody hates augmented. Yeah, augmented's good. Okay,

38:44

now what about this though? What about a

38:46

pain medicine? Yeah, the other

38:49

part was like fentanyl. Yeah, maybe. Okay,

38:52

but what if, what, instead, okay, to

38:54

gain power, what

38:56

if it was like ketamine or something that's not-

38:59

You were going there and I love it. Okay.

39:03

Because there's so many uses. You really could use

39:05

ketamine. I think it'd be probably more

39:07

useful. I mean, and to also gain

39:09

power. I mean, if you gave people

39:11

recreational doses of ketamine, and like, hey,

39:13

let me tell you, I have this

39:15

and I will tell you how the

39:17

world works. And

39:23

let me show you, right? We

39:26

could become deities. Yeah, that's true. I

39:28

do like that. So- Yeah,

39:30

they'll have some experiences. Exactly, right?

39:32

And then we could make them

39:34

scary or we could make them

39:37

very, very happy. And so that's

39:39

the power play we use. Yeah,

39:41

a little less worrisome with the

39:44

breathing. Exactly, and then what

39:46

I mean- Not zero, but little

39:48

less. We talked about nitroglycerin earlier.

39:51

What if we take, and I mean, nitro, I

39:53

mean, yeah, chest pain, but I mean, fire, okay?

39:56

It would eat like so much, though. You have

39:58

a limited amount. Do we have- An unlimited amount

40:00

you do have an unlimited amount of pictures

40:02

are like a briefcase or is it okay?

40:04

Take out as much as you want you

40:06

close, it opened again. it's results. Oh yeah,

40:09

I mean without I'm I'm into so that's

40:11

interesting. You know using that suggests it reaches

40:13

as the ability to move mountains. Yeah,

40:17

make like tunnels and stuff on the left

40:19

side of it's we agree. I know

40:21

where it will help people augment and

40:23

but my temper. Stewards as we love

40:26

is we are and we're benevolent. Yeah,

40:28

we're making a lot better Divert your

40:30

stewards are both of us are. Yes,

40:33

I like them. And then i do like had

40:35

mean discuss we hasta include. In they would

40:38

every pine and pains and tell. You

40:40

know, recreational like to. Honestly, oh yes

40:43

said somebody out there that's also our

40:45

powerplay mean is that you know Ludhiana.

40:47

Caesar's exactly where the Controller of World's

40:50

now and I like ladder so I

40:52

like know the. Like we're missing like as

40:54

far as late. As are like

40:56

just a plan for how are you

40:58

can go from day one your dropped

41:01

in Rome is threatened by was in

41:03

nitroglycerin just because that resists for the

41:05

yells exorcist there are those that have

41:07

is also saw him or yeah. So

41:12

successful as poetry degree he was Virginia's

41:14

this completely eyes with a lawyer and

41:16

I you will be problematic about how

41:18

are we actually doing this a cellphone

41:20

successes. That we go into the slums

41:22

of around and we signed a sick

41:25

child and we give them of medicine.

41:27

And their shields out there. and then

41:29

everybody is gonna say like. These.

41:32

Two cities. It's okay.

41:34

Healers and I sell my does come to

41:36

us with all of your pain and then

41:39

people start something with a painfully my greatest

41:41

ketamine. and then. The. Sucked

41:43

right? I consider that than than like

41:45

wow these people are true healers says

41:48

and that some research like veer off

41:50

and are not like we're not as

41:52

yours. As well

41:54

as a fireworks We are we

41:56

ours day these. new

41:59

yard Look

42:01

at this explosion. Yeah, and then also you

42:04

can try to close your eyes, but it

42:06

won't change. And

42:09

that's where the Academy comes in again. Yeah,

42:11

exactly. And then, wow, the sober

42:14

people will see the actual explosion, and

42:16

then it's like, whoa, this is

42:18

what is happening. These people are the real deal. Yeah.

42:21

And then we get the

42:23

eye of the rulers, and

42:25

they say, wow, these two know a lot.

42:28

We become the official healers and the official

42:30

road builders, if you will.

42:32

And potentially priests. Yeah,

42:34

priests. And then we blow up mountains.

42:37

And then power gets more power. Yeah, I don't

42:39

know where this is going. All right, but I

42:41

think that is the combination. Augmentin,

42:44

ketamine, nitroglycerin. Natural

42:48

play. That might be the right

42:50

answer. I think there's not. That is the only answer.

42:53

All right, your five minutes are up. That

42:55

was very entertaining. I think it's time we wrap

42:57

this up. So thank you for

42:59

that very enjoyable discussion. Thank

43:01

you for coming on the pod, Callie. You're

43:03

welcome. Travis, Dr. Barlach, always good

43:05

to have you. Yeah, thanks, man. This

43:07

is super fun. All right, yeah. Hopefully we can

43:09

do this again sometime, and we will wrap it

43:11

up there. Thank

43:26

you.