The relationship between the intracanular concentrations of unbound (free) furosemide and its natriuretic effect is in the form of a sigmoid curve with a minimum effective furosemide excretion rate of about 10 g / min. Therefore, prolonged infusion of furosemide is more effective than repeated bolus administration. In addition, if a certain bolus dose is exceeded, no significant increase in the effect is observed. When the tubular secretion of furosemide decreases or when the drug binds to the albumin located in the lumen of the tubules (for example, in a nephrotic syndrome), the effect of furosemide decreases.
Suicide prevention poster improves ED recognition, management, Internal Medicine News, Apr. 29, 2011 - Suicide & Faith

Suicide Prevention in Faith Organizations: An Introduction

5.43 Suicide prevention poster improves ED recognition, management, Internal Medicine News, Apr. 29, 2011

A suicide prevention poster designed specifically for the emergency department (ED) can increase the likelihood that ED staff will ask patients or their loved ones about suicidal ideation, found a recent study. The poster is titled “Is Your Patient Suicidal?” and lists signs of acute suicide risk. Four EDs in New York state, ranging from rural EDs to academic departments, received the poster and an accompanying guide titled “Suicide Risk: A Guide for ED Evaluation and Triage.” Clinicians were surveyed before the posters were distributed, and a month after the posters were handed out at staff meetings or placed in clinicians’ mailboxes. Compared to a fifth ED that did not receive the poster, clinicians in the four EDs that received the materials were more likely to report that they always ask patients they are concerned about whether they are suicidal (73% versus 59%). Clinicians in EDs that received the poster also said they were more comfortable talking to patients about suicide, and were more likely to ask a patient’s friends or family members for more information if they suspected that the patient might be suicidal. “It did better than I would have expected in a thousand years for a brief intervention,” said Dr. Glenn Currier, a psychiatrist at the University of Rochester Medical Center. The benefit seemed “to span across all types of providers – physicians, residents, midlevels, and nurses – and it was essentially a free thing to do.”

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