Originally Posted by nitemagi
This is hilarious. Wrath?
"Relative equivalent" in a patient with major liver impairment, and you want to manage without even seeing if the patient is in withdrawal? The pt. needs an ED eval or at minimum a clinic eval first. Prescribing a long-acting benzo to an alcoholic benzo with possible liver failure is quite risky.
The point of the mnemonic is that lorazepam (which is glucoronidated by the liver) is considered safer in liver impaired pt's than klonopin. Oxaz and Temaz are used, but not usually in a detox setting. If you review the literature, there are no studies that, even amongst experts, that give actual benzo "equivalencies." The most you can hope for is to ballpark it, which is why the pt needs close monitoring and not prescribing 3rd-hand via recommendations to a covering physician for their pcp.
BTW, every "resident," which is hilarious that you use the term in an inferior fashion, has at more than twice the medical education you do, and residents within my year have at least twice the psychopharm training with good supervision. But clearly You must be superior.
I don't really care if you "justify every little decision," or any decisions at all. But you're the one posting anecdotes showing your great medical knowledge and ability to handle psychopharm better than physicians. So you're opening yourself up to scrutiny. It's just that at the moment I'm the only one pointing it out. Probably because it's wiser to let you just diddle on, rather than expect you to admit there's any problems with RxP. Diminishing returns at this point.
humm, let me see... you know more about the pt. than I do because you are a 2nd year resident? I'm assuming you finish your internship, now that's hilarious and yes, I am more superior than you little resident. I'm directing it at you. I know that's eating you up right now. BTW that pt that you know more than I do just got sent off to an inpatient substance abuse treatment. If I wasn't there, he would still be somewhere doing real damage to his liver, possibly seizing, etc. So that's a huge plus for our increasing presence and the pcps want us there. You really think anybody gives two cents about your self indulgence rants? You just couldn't help try to show to us all that you know a little about drug metabolism couldn't ya?...and assume that we lowly medical psychologist would be at awe at your grand knowledge...so use your superior resident training and tell us all about the need of a psychiatric resident who feels compelled to post provocative statements toward medical psychologists? keep up the good need for validation, that will do wonders for your ability to work with others.