Pik Mukherji, MD, EM/IM attending at Long Island Jewish Medical Center in New Hyde Park, NY (@ercowboy), seems to bask in his role as self-appointed FOAM skeptic and is known for his rhyming Twitter profile, “Devil’s Advocate (by choice and intent), Offense (if given) Never Meant.” Dr. Mukherji also enjoys a reputation as a master educator. His points on Twitter are always succinct and relevant, like this excellent reminder for resuscitating hypoglycemic patients of all ages: “Rule of 50s to correct sugar: % dextrose x cc/kg=50. Adult gets D50 at 1cc/kg. Kid gets D25 at 2cc/kg. Infant gets D10 at 5cc/kg. #EMConf.”

The final entry for this month’s installment of “The Feed” doesn’t exactly fit the “traditional medical education” category, but it’s so good that I have to include it. From University of Maryland ED pharmacist and toxicologist and frequent Academic Life in Emergency Medicine contributor—and arguably its MVP—Bryan Hayes, PharmD (@PharmERToxGuy), comes, “The 2014 list of Oral Dosage Forms That Should Not Be Crushed. From @ismp1. http://www.ismp.org/tools/donotcrush.pdf  #FOAMed.” This online PDF from the Institute of Safe Medication Practices, a nonprofit patient safety organization, contains a list of all medications that should not be crushed. For each entry, the list includes the active ingredient, the relevant formulation (tablet versus capsule, etc.), and a brief and precise reason the medication shouldn’t be crushed. Some of these are obvious and trivial (such as the advice to avoid crushing any extended-release formulation), while others are obscure yet important and downright fascinating. For example, did you know that you should never crush Cellcept (mycophenolate mofetil, an immunosuppressive agent for transplant patients) because direct exposure to the active ingredient can enhance tumor production? I sure didn’t. Insights like these are what cause so many of us to keep drinking from the endless fountain of FOAM.

Dr. Faust is an emergency-medicine resident at Mount Sinai Hospital in New York and Elmhurst Hospital Center in Queens. He tweets about #FOAMed and classical music @jeremyfaust.