Tox Tunes #89: Strange Brew (Cream)

October 26, 2014, 4:28 pm


“Strange brew — killin’ what’s inside of you”


It always seemed to me that the subtext of this song was about drugs, although the lyrics don’t explicitly reference psychedelics or any other recreational pharmaceuticals.

The song, found on Cream’s second album Disraeli Gears, is a reworking of Buddy Guy’s and Junior Wells’ version of an early blues …

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Saturday with SMACC: Evidence-Based Education — What Works

October 11, 2014, 12:18 pm

Victoria Brazil Evidence-Based Education — What Works– from Social Media and Critical Care on Vimeo.

From SMACC Gold: Victoria Brazil asks what educational modalities and interventions are effective in medical education, what does “effectiveness” really mean and how do we measure it. Here are links to some of the studies and resources she mentions:

The Great Dr. Fox Lecture:

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More than you ever wanted to know about synthetic cannabinoids

October 9, 2014, 1:08 pm


Synthetic cannabinoids: Epidemiology, pharmacodynamics, and clinical implications. Castaneto MS et al.  Drug Alcohol Depend 2014 Aug 18 [Epub ahead of print]


This article is not really readable, but I’m not sure it was meant to be read. Rather, it’s a reference paper with (by my count) 228 citations through the year 2014. It will be invaluable for anyone surveying …

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TPR Podcast Episode #6: I’m tripping and I can’t get down

October 6, 2014, 11:52 pm

Although summer is over and the polar vortex is knocking at the door, in this episode of the TPR podcast we look back at massive summer music festivals and the drugs which can be encountered among attendees. Theresa Kim, Leon Gussow, and guest discussant Dr.Tim Erickson cover agents such as synthetic cathinones ("bath salts"), piperazine compounds, GHB, methoxetamine, and "N-bomb."

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Rosary pea ingestion: no testing needed

October 3, 2014, 8:42 pm

A. precatorius seeds

A. precatorius seeds


A Case of Abrin Toxin Poisoning, Confirmed via Quantitation of L-Abrine (N-Methyl-L-Tryptophan) Biomarker. Wooten JV et al. J Med Toxicol 2014 Feb 13 [Epub ahead of print]


The decorative rosary pea or jequirity pea (Abrus precatorius) contains the toxin abrin, a protein that inhibits the function of mRNA, leading to impaired …

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Must-listen podcast: anti-NMDA receptor encephalitis

September 29, 2014, 11:34 am


As part of its “Best Case Ever” series, the Emergency Medicine Cases podcast has a superb discussion by Dr. David Carr of anti-NMDA receptor encephalitis, a relatively new but important diagnosis that is generally under-recognized and often missed. To listen to it, click here.

The reason this diagnosis is of interest to toxicologists is that during the early …

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Tox on the web: narcotic noodles, intranasal narcan, and much more!

September 29, 2014, 12:11 am

The Antidote: A long piece in the  The New Yorker by Ian Frazier describes the epidemic of overdoses from both prescription opiate analgesics and heroin, how that epidemic affects the New York City borough of Staten Island, and the potential role of intranasal naloxone in reducing the number of deaths. A little superficial regarding the origins of the epidemic and …

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Review: cobalt toxicity and artificial metal hips

September 25, 2014, 1:28 pm



Systemic toxicity related to metal hip prostheses. Bradberry SM et al. Clin Toxicol 2014;52:837-847.


As TPR has reported before, cobalt poisoning can cause hypothyroidism, cardiomyopathy, and neurotoxicity. Neurological manifestations include:

  • optic nerve damage and retinopathy with reduced visual acuity
  • bilateral nerve deafness and tinnitus
  • polyneuropathy (sensory and motor)
  • cognitive impairment and memory loss

A number of papers and …

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Avoid couchlock! Four things to know about cannabis pharmacology

September 18, 2014, 11:23 am


With medical marijuana now legal in 23 states and the District of Columbia — and recreational weed available in Colorado and Washington State — knowing the pharmacokinetics of THC has never been more important, both for consumers and the physicians who must counsel and treat them. Recently, the New York Times’ Pulitzer Prize-winning columnist Maureen Dowd got into trouble …

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