295. 5 Medications You Should NEVER Give or Prescribe in the ED

Blake Briggs (0:11)

Welcome back, EM Board Bombs, Blake Briggs here, co-founder, co-host, and of course, the other co-founder, co-host, Lil Tifat Hussein is here, and we have a special guest.

Iltifat Husain (0:18)

Special guest.

Blake Briggs (0:19)

So he's back.

You know how much we hate Big Pharma. Well, we don't have Big Pharma, we have Lil Pharma on. Lil Pharma. At Lil Pharma, on Instagram, TikTok, real awesome content she produces. I love scrolling through Instagram and finding her stuff. It's so informative.

Iltifat Husain (0:37)

Yeah, I feel like I learn stuff, right?

Abbi Briscoe (0:39)

Yes, I do too. That's the great thing.

Iltifat Husain (0:40)

In this day and age with Insta, all this stuff, it's just like, you're like, did I, like 10 minutes of my life were wasted, but reading through her content, I'm like, okay, great. Like, I actually learned something that I can even teach my residents. Yeah, it's great.

So it's good. So check her out, as Briggs mentioned, and we'll drop a link in the show notes to her different social feeds.

Blake Briggs (1:05)

Thanks for joining us again, Abbi. We appreciate having you.

Abbi Briscoe (1:07)

Yeah, thanks for having me. I'm excited to be here.

Blake Briggs (1:10)

So normally what we do is we do a question answer, leave you hanging, tell you what's going on with CME, which we'll tell you about in a second. This episode, we have an awesome countdown, what we're doing, worst meds ever in the ED.

And we hope that your list is the same as ours. And if it's not, hopefully you walk away from this and you know, okay, I probably shouldn't do that anymore. But before we get into that, as Iltifat is so eager to tell you about, I'm so excited. We need to tell you about our new podcast branching that we have and we just are so excited that we have launched it. If you liked EM Rapid Bombs, maybe you still like EM Rapid Bombs, which is wonderful for board prep. That's great. But what if you're like, hey, I've taken my boards, I never want to look back, I never want to think about them again. Same with Abbi, she's just having PTSD, thinking about all these board exam questions.

What if you wanted to keep learning EM Board Bombs style, but in a non-Ivory Tower, non-rambling, two-hour long podcast episode? What do we have for you?

Iltifat Husain (2:06)

Yeah. It's like 15-minute episodes or less. That's our thing. It's on the way to shift. That's the biggest feedback we got. When we polled Friends, this was two years in the making, everyone was like, can I just listen and learn something on the way to work? Like why do I have to sit for hours and put a podcast on 2X to get through it? So again, not knocking those other Emergency Medicine CME Podcasts. They're fantastic. If you want to do hours and hours of content, that's wonderful. But if you want to do that, we're not for you, like we say.

But if you want to do short 15-minute episodes that hit super high-yield EM topics, practice updates, especially in things like IFIB management, SVT management, spoiler alert, Briggs and I don't use the Densine for SVT. But anyways, if you want to learn about things like that, you can listen to the podcast. But hey, let's get into it. I feel like these topics that we're going to talk about, like meds that we hate to use, it's going to get a lot of blowback. I know, we're going to be hearing about it. A lot of comments, a lot of blowback. But I think it's just something that has to be done.

It has to be done.

Blake Briggs (3:11)

Abbi, why don't you lead us in. What is the first thing on your mind where you're like, if this podcast ended in 30 seconds, I have to make sure this med is talked about?

Iltifat Husain (3:20)

Yeah.

Abbi Briscoe (3:21)

Oh, it's got to be tramadol. Tramadol, one of the worst meds out there. I don't think we should be prescribing it at all.

Iltifat Husain (3:30)

Boom, full stop. So you're saying out of everything, that's the one.

Abbi Briscoe (3:34)

That's the one, yeah. There's a lot of reasons for this. It comes down to pharmacokinetics and seizure risk, and serotonin syndrome risk. There's all sorts of issues that come along with this. But the biggest thing really for me is that it was marketed as a safe opioid, which just grinds my gears because I don't know what that means, safe opioid. What is that? I don't know, an oxymoron in my opinion.