Adverse Drug Events: Case Challenge Series

This case-based series will illustrate potential adverse events and drug interactions that are sometimes seen with medications commonly used in the primary care setting.

Douglas S. Paauw, MD, MACP, is a primary care internist, a professor of medicine, the Rathmann Family Foundation Endowed Chair for Patient-centered Clinical Education, and director of student teaching at the University of Washington (UW) School of Medicine. He has received numerous awards for distinguished teaching from UW as well as from the Association of American Medical Colleges. In 2008 he was elected Master of the American College of Physicians (ACP), and in 2015 he received the ACP Centennial Legacy award for the State of Washington chapter.

Dr Paauw graduated from the University of Michigan Medical School, completed a primary care internal medicine residency at UW, and served as chief resident at Harborview Medical Center. He has been on the faculty of the UW School of Medicine since 1989.

Why Is Serotonin Syndrome on the Rise? Increased use of a growing number of available serotonergic drugs is probably fueling the rise in incidence of serotonin syndrome. Which combinations are particularly risky?
Medscape Internal Medicine, December 02, 2020
Any 'Natural' Products Effective for Migraine? As all clinicians know, natural does not always mean safe. Are there risks to use of alternative therapies to treat migraine?
Medscape Internal Medicine, October 30, 2020
Flu Vaccine Important, but Will GBS Patients Believe You? Influenza vaccination will be critically important this season. Dr Paauw reviews the literature that should help you convince your post-GBS patients to get it.
Medscape Internal Medicine, September 28, 2020
Drugs to Avoid in Patients on DOACs DOACs overall have substantially fewer drug-drug interactions than warfarin, but there are still a few to watch out for.
Medscape Internal Medicine, July 23, 2020
Post-ACS Therapy: Why My Own Approach Has Changed What therapy do you suggest for patients after an acute coronary event? A recent study has changed Dr Paauw's approach.
Medscape Internal Medicine, June 17, 2020
Vitamin B12 Deficiency: What Form Is Best? Conventional wisdom says that oral B12 is too poorly absorbed to be able to correct a deficiency. Is that really true?
Medscape Internal Medicine, March 09, 2020
Are Drug Expiration Dates a Myth? All drugs are required by law to have an expiration date. Replacing them is expensive . Is it unnecessary?
Medscape Internal Medicine, February 05, 2020
How to Have a Better Hangover? Does order of drinking beer and wine affect hangover severity? Or does it just not matter?
Medscape Internal Medicine, December 17, 2019
The Headache Most Often Misdiagnosed Does this woman have sinusitis, migraine, medication overuse, or something else?
Medscape Internal Medicine, December 11, 2019
Iron Supplementation: How Much Is Enough? Iron supplements can be pretty miserable to take. What is the minimum amount that is both effective and tolerable?
Medscape Internal Medicine, November 15, 2019
Suturing Fingers: OK to Use Epinephrine? Conventional wisdom says not to use epinephrine in digital blocks. But is it time for that to change?
Medscape Internal Medicine, September 17, 2019
Alcohol and Metronidazole Interaction: Real or Fake? Your patient is taking metronidazole, but he's also going to be in a wedding in 3 days. How would you advise him?
Medscape Internal Medicine, August 21, 2019
Treating Hypertension: Is Anything Safe? Some antihypertensives have been found to be associated with cancers. Others are subject to recalls owing to contamination. What is the best way to treat a newly diagnosed patient with hypertension?
Medscape Internal Medicine, July 23, 2019
Guillain-Barré Syndrome and Vaccines: Time to Say Yes? A woman with a history of Guillain-Barre syndrome presents for care. What vaccines would you give her?
Medscape Internal Medicine, July 02, 2019
The Antibiotic You Should (Almost) Always Avoid What is the safest choice to treat CAP in an older patient? And what is the one drug you should always avoid if possible? How does your choice compare with the expert's?
Medscape Internal Medicine, May 23, 2019
Triptans and SSRIs: Is Serotonin Syndrome Really a Risk? While the FDA--and EHRs--warn against the combination of triptans and SSRIs, is serotonin syndrome really a risk with use of this combination?
Medscape Internal Medicine, June 07, 2018
NOACs for Atrial Fibrillation: Important Drug/Drug Interactions What drugs have important interactions with direct Xa and direct thrombin inhibitors?
Medscape Internal Medicine, January 03, 2018
Clearing the Patient on Bisphosphonates for Dental Procedures Your patient on a bisphosphonate needs a dental procedure and the dentist won't do it until you clear her. What should you do?
Medscape Internal Medicine, July 28, 2017
NSAIDs and CV Risk: The Bottom Line A man with a previous heart attack requires pain management for osteoarthritis. Which agent is safest?
Medscape Internal Medicine, June 23, 2017
Which Drug Is Causing This Woman's Syncope? An elderly woman's fainting spells are likely to be related to one of the many medications she's taking, but which one?
Medscape Internal Medicine, May 16, 2017