Are clinical pearls dead?

[sunnyandseventytwo]

I mentioned something to a coworker who's about 10 years younger than me about oral potassium (solution) acting more rapidly than IV and that it can potentially be dangerous correcting too quickly with this method. He responded with a "That's just like, your opinion, man". I replied: Well, it's a clinical pearl. He'd never heard oa clinical pearl and challenged me to find it in a guideline. Up to Date makes a vague reference supporting my statement, but the idea behind a clinical pearl is that it's not in a textbook. Has pharmacy and the medical profession become so guideline driven that there's no room for clinical pearls anymore?

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[PharmDBro2017]

We go by evidence-based medicine. Not anecdotal evidence.

 

[Rockinacoustic]

A clinical pearl may not be textbook, but is still evidence based.

If a preceptor told me 10 years ago that hydroxychloroquine may be a potential treatment for coronaviruses, is that still a clinical pearl?

 

[JustFillIt]

Ever see, “The Big Lebowski”?

This person may have just been joking around.

 

[PharFromNormal]

Any pearls on tessalon perles?

 

[JustFillIt]

Any pearls on tessalon perles?

Swallow whole with a glass of water - do not crush or chew.

 

[sunnyandseventytwo]

Any pearls on tessalon perles?

I worked in a 24 hour pharmacy as a student that dispensed a lot of Tessalon. A lot. One of the night pharmacists told me prostitutes chew them and that's why our store fills so much of it. (In case you've never chewed a Tessalon, the liquid inside has a local anesthetic effect.)

Other super fast movers at this store included Clam Paks (that's a ZPak with the first two tabs cut off), acyclovir, and all prescription insecticides. Good times.

 

[KidPharmD]

I mentioned something to a coworker who's about 10 years younger than me about oral potassium (solution) acting more rapidly than IV and that it can potentially be dangerous correcting too quickly with this method. He responded with a "That's just like, your opinion, man". I replied: Well, it's a clinical pearl. He'd never heard oa clinical pearl and challenged me to find it in a guideline. Up to Date makes a vague reference supporting my statement, but the idea behind a clinical pearl is that it's not in a textbook. Has pharmacy and the medical profession become so guideline driven that there's no room for clinical pearls anymore?

Regarding your "pearl," it isn't as straightforward as you say. It would depend on the rate of infusion of the IV potassium and the amount given. It's also questionable if "rate of correction" of potassium is actually a factor in adverse events or not. Potassium is reasonably predictable when trying to determine how much the serum potassium will change after a given amount of potassium supplementation.

Regarding pearls in general, I think you have a strange definition of them. We certainly teach pearls, but they are all evidence based. I would consider a clinical pearl to be an individual fact or piece of wisdom that can be acted on.

 

[BidingMyTime]

Regarding pearls in general, I think you have a strange definition of them. We certainly teach pearls, but they are all evidence based. I would consider a clinical pearl to be an individual fact or piece of wisdom that can be acted on.

See that is always what I've considered a clinical pearl to be. I've never heard a clinical pearl described as basically anecdotal evidence. At least that is how I read the OP. Certainly textbooks don't cover everything, but that doesn't mean that other drug information isn't covered in studies or the package insert or something....and maybe that is what OP meant?