Complements Are Not Always a Good Thing: Novel Therapies for Angioedema.

Hereditary angioedema attacks are rare, but emergency care providers must be aware of the clinical presentation and treatment of these patients because the emergency department remains the most common setting where these patients seek treatment. If providers are not aware of the past medical history of these patients, they are likely to receive standard therapies for respiratory distress and anaphylaxis including antihistamines, corticosteroids, and epinephrine. However, these medications may not work in these patients, given the pathophysiology of their underlying disease. Since 2009, several new therapies have been approved for the treatment of acute hereditary angioedema attacks. This article discusses pathophysiology, clinical presentation, and use of novel therapies for the management of angioedema.

That's a Phat Antidote: Intravenous Fat Emulsions and Toxicological Emergencies.

Health care providers in the emergency department (ED) frequently find themselves caring for patients who may have overdosed on a medication(s) or other toxic substance. These patients can prove to be a challenge, as providers must try to determine the substance(s) involved so that the appropriate treatment can be initiated. For those patients who are hemodynamically unstable upon presentation, it is important to note that supportive care is of the utmost importance, as there are few substances that have antidotes available. In these situations, lipid emulsion can be considered. This is especially true in the setting of the following toxicities: local anesthetics, ß-blockers, calcium channel blockers, and the tricyclic antidepressants. Even though lipid emulsion may not be used that frequently in the ED, it is important to be aware of its role in the setting of toxicological emergencies, how it should be dosed and administered, and the necessary safety precautions.