🔴 أكثر خطرًا على مريض التليف الكبدي : مسكنات NSAIDs ( مثل ibuprofen )
🟢 أقل خطرًا على مريض التليف الكبدي : paracetamol( بجرعه يومية 2جرام)
صلاح الدين منصور الضبارة

🛑short acting CCB VS long acting CCB drugs

🛑ACEI /ARB drug and hyperkalemia
✅ACE inhibitors and ARBs generally raise the serum potassium concentration by less than 0.5 mEq/L in patients with relatively normal kidney function.

✅More prominent hyperkalemia may be seen in patients with chronic kidney disease, diabetes, concurrent use of a drug promoting potassium retention such as a potassium-sparing diuretic or a nonsteroidal antiinflammatory drug, or among older adult

#UPTODATE2026
#Clinical_Notes

🛑fever in surgical patients
✅Most patients with fever after the third postoperative day have an infection.
#UPTODATE2026
#Clinical_Notes

✅Antibiotics are not routinely indicated for most patients with fever in the early postoperative periods( within the first three days after surgery)
✅ but hemodynamically unstable patients should be treated empirically with broad-spectrum antibiotics, which should be discontinued after 48 hours if no source of infection has been identified.
#Clinical_Notes

🛑Hypocalcemia and nephrotic syndrome
✅Hypocalcemia is common, however, due to hypoalbuminemia; this does not affect the physiologically important free (or ionized) calcium concentration.
✅Measurement of the ionized calcium concentration is generally required to confirm hypocalcemia in nephrotic patients with a low total serum calcium.

#UPTODATE2026

🛑 beta blockers and esophageal varices. 

🅰We do not initiate beta blockers to prevent recurrent bleeding in patients with any of the following conditions because of the risk of adverse events (eg, decreased cardiac output, increased mortality):

✅Hyponatremia (serum sodium concentration <130 mEq/L)

✅Acute kidney injury

✅Spontaneous bacterial peritonitis: Beta blocker therapy in patients with spontaneous bacterial peritonitis is associated with higher mortality risk

✅Diuretic-resistant ascites: Beta blocker therapy in patients with diuretic-resistant ascites is associated with higher mortality risk

●History of adverse effects with beta blockers: Patients with a prior history of adverse effects related to beta blockers are not candidates for therapy (eg, bronchoconstriction, heart failure, acute kidney injury)

✅Systolic blood pressure <90 mmHg

#UPTODATE2026

✅كل معلومة انشرها هنا هي صدقه جارية لروح والدي بإذن الله
اللهُم أجعل قبر أبي مُنيراً بارداً ، وأفتح له باباً تهبّ منه
نسائم الجنة لا يُسد أبداً ..❤

دواء Colchicine قد تجده في وصفة مريض
✅Gout
✅Pseudogout
✅familial Mediterranean fever
✅Pericarditis
✅Behcet's disease
✅Acut cornory syndrome
#Salah

🛑Isoniazid (INH) toxicity

✅Seizure treatment with pyridoxine and benzodiazepine

✅The dose of pyridoxine is 1 g IV for every gram of INH ingested.
✅ When the quantity of INH ingested is unknown, 5 g IV may be administered to an adult and 70 mg/kg (maximum 5 g) to a child.

#UPTODATE2026

🛑بخصوص دواء Buspirone المستخدم في Generalized anxiety disorder
✅في معلومه مهمه كذا
هو انه بيكون أكثر فائدة عند المرضى الذين لم يستخدموا BZD سابقًا
وانه استخدام البنزوديازيبينات خلال شهر قبل بدء البوسبيرون قد يقلل فعاليته (هذا الكلام حسب البورد الأمريكي في Psychiatric)

🛑 Drug That Should Not Be Taken with Food
✅Ampicillin
✅Astemizole
✅Cefaclor
✅Didanosine
✅Digoxin
✅Diltiazem
✅Etidronate
✅Furosemide
✅Indinavir
✅Isoniazid
✅Labetalol
✅Lansoprazole
✅Levodopa
✅Lithium
✅Metoprolol
✅Nimodipine
✅Penicillamine
✅Propranolol
✅Rifampin
✅Zafirlukast

🛑Common medication and their antidotes