Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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But, you know, one of the things I learned during the COVID pandemic when, you know, we essentially for the first month or so went totally remote.
We were managing, you know, hundreds of patients with heart failure sitting at home and all these
And people were very worried about coming to the hospital.
So we were asking people to take metolzone at home.
Metolzone, for readers, is a thiazide diuretic.
It is a very effective diuretic pill.
The issue with it is that it can cause your potassium to totally tank.
The other quick tip about metolzone is that it's often a really long-acting drug.
So oftentimes, it's a 48-hour type of drug or sometimes even longer.
But we've always been traditionally very nervous about giving it in the outpatient setting.
But when we didn't have a choice, we would just tell people, well, take metolzone and then double your potassium supplementation for the next, say, three days.
And we, you know, thankfully didn't have any adverse effect.
So I think that is one thing that, you know, if you are worried about hypokalemia, I mean, I think you could essentially empirically treat patients with just doubling their potassium.
In the hospice setting,
Or in someone with, say, renal failure, this comes up often, you know, someone's potassium is four, and in the hospital, we check the potassium, sorry, the creatinine is four, and we check it every day, and now you're going to hospice, and patients feel nervous that how am I going to titrate my diuretic based on my creatinine?
And I think the only thing that matters is volume status.
So if you're volume overloaded, your kidneys are going to be congested and your creatinine is going to be up regardless.
So when I see a patient in the hospital, the creatinine is important, but the most important thing is their volume status.
And you've seen this yourself where folks come in, they're volume overloaded, their creatinine is four, you start diuresing them and the creatinine comes down.
And I think part of what we can do on the inpatient side, and we can do especially in cardiology, is getting people to move past the numbers.
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