Smoking turns breathing into effort, reminding us how precious healthy lungs are
This bill passed the House of Representatives by a vote of 210-201
Octreotide is first-line because: Causes splanchnic vasoconstriction Portal venous pressure & blood flow to varices Rapid onset effective hemostasis Safer than vasopressin (fewer systemic side effects) Recommended by Baveno & AASLD guidelines Other options: Omeprazole useful in peptic ulcer bleeding, not varices Sucralfate mucosal protectant, no role in acute bleeding Metoclopramide prokinetic, no hemostatic effect Uses of Octreotide Acute esophageal & gastric variceal bleeding Acromegaly Carcinoid syndrome VIPoma Severe secretory diarrhea Mechanism of Action (MOA) Somatostatin analog Inhibits release of vasodilatory hormones (glucagon) Causes splanchnic vasoconstriction Portal venous inflow variceal pressure bleeding control Minimum & Maximum Dose (Acute Variceal Bleed) #Minimum dose: IV bolus 50 micrograms, followed by 50 micrograms/hour infusion #Maximum dose: Continuous infusion up to 100 micrograms/hour (based on response) (Duration: usually 25 days) Mnemonic OCTREO = OCTREO-tide tightens the PORTAL pipe Tightens splanchnic vessels stops variceal bleed Clinical Pearl Start octreotide immediately in suspected variceal bleeding do not wait for endoscopy
As a compassionate society, we have a responsibility to ensure our fellow Americans suffering with mental illness have the resources they need to seek help and recover
Eye and Ear study, If patients tell me that they are smoking, I now have direct evidence to say that the same symptoms that are making them miserable are exacerbated further by smoking.On that front, theres both good and bad news
This bill had 154 cosponsors in the House and 84 cosponsors in the Senate, and President Trump has even truthed favorable things about this bill
