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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Tox on the Web: sarin, lithium, strychnine, and much more!

September 18, 2014, 12:36 am


Toxicologist as Man on Couch with Laptop: This video shows a short presentation by Larissa Laskowski a first year fellow at the NYC Poison Control Center, describing the work of Eliot Higgins and the Brown Moses blog. Higgins — an unemployed finance worker several years ago with no knowledge about weapons of warfare — started blogging about the …

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Case Report: Synthetic Cannabinoid K2 and Myocardial Infarction

September 16, 2014, 7:29 pm


K2—Not the Spice of Life; Synthetic Cannabinoids and ST Elevation Myocardial Infarction: A Case Report. McKeever RG et al. J Med Toxicol 2014 Aug 26 [Epub ahead of print]


Use of synthetic cannabinoids has been associated with a broad range of adverse effects, including tachycardia, hypertension, seizures, psychosis, renal injury, and cyclic vomiting.

This article describes 16-year-old male who …

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Conservative treatment for asymptomatic body packers?

September 10, 2014, 5:32 pm

Body packer

Body packer


Asymptomatic body packers should be treated conservatively. Glovinski PV et al. Dan Med J 2013 Nov;60:A4723


Kudos to the authors for putting their general conclusion in the title. Unfortunately, there’ s less here than meets the eye.

This is a retrospective review of 57 patients suspected of body packing, seen at Hvidovre Hospital in Denmark. However, …

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Do pediatric patients require endoscopy after ingesting a laundry pod?

September 8, 2014, 5:16 pm


Laundry Detergent Pod Ingestions: Is There a Need for Endoscopy? Smith E et al. J Med Toxicol 2014 Sep;10(3):286-91


The authors never answer their title question definitively, but you wouldn’t expect that they’d be able to on the basis of this small case series and the limited data published to date.

Ingestion of laundry detergent pod (LDP) ingredients can …

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Tox Tunes #88: Junco Partner (Professor Longhair)

September 7, 2014, 10:54 pm


Professor Longhair (Henry “Roy” Byrd, 1918-1980) combined classic New Orleans rhythm and blues piano with Afro-Cuban funk to produce music that was exciting and utterly original. Many years ago, I was working in a research lab in New York City, living in a West Village studio that rented for $78 a month. (Yes, it was that long ago.) I …

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Saturday with SMACC: The Art and Science of Fluid Responsiveness

September 7, 2014, 12:17 am

Haney Mallemat – The Art and Science of Fluid Responsiveness from Social Media and Critical Care on Vimeo.

From SMACC Gold: In a great talk, Haney Mallemat from the University of Maryland discusses the limitations of static indices of fluid responsiveness such as blood pressure and respiratory-induced changes in inferior vena cava diameter. He argues persuasively that dynamic indices …

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Must-read: consider hemodialysis in cases of massive acetaminophen overdose

September 5, 2014, 10:55 pm


Extracorporeal treatment of acetaminophen poisoning: Recommendations from the EXTRIP workgroup. Gosselin S et al. Clin Toxicol 2014 Aug 18:1-12. [Epub ahead of print]


These recommendations come from the Extracorporeal Treatments in Poisoning (EXTRIP) workgroup, a project established to provide some guidance on the use of hemodialysis and other techniques in toxicology cases, an area where high-quality evidence simply …

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Synthetic cannabinoid XLR-11 and driving

September 3, 2014, 11:32 pm




Driving Under the Influence of Synthetic Cannabinoid Receptor Agonist XLR-11. Lemos NP. J Forensic Sci  2014 Aug 3. doi: 10.1111/1556-4029.12550. [Epub ahead of print]


XLR-11 is one of the many different synthetic cannabinoid compounds found in samples of smokeable herbs sometimes sold as “Spice” or “Legal Marijuana.” Exposure to XLR-11 has been associated with cases of acute kidney

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