TPR Podcast Episode #14: VX and the Assassination of Kim Jong-Nam

March 30, 2017, 2:43 pm

When Kim Jong Nam — the half-brother of Korean leader Kim Jong Un — was assassinated in February while waiting for a flight at the Kuala Lumpur International Airport in Malaysia, attention was focused on one of the deadliest chemicals in the world: the nerge agent VX. What is VX, why is it such an effective poison, and how are victims of exposure managed medically. These are some of the questions we'll be examining in this edition of the TPR podcast.
Podcast Episode

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Tox Tunes #109: I Killed Robert Johnson (The Stone Foxes)

March 5, 2017, 10:20 pm

More myths and legends are attached to the life of Robert Johnson (1911 – 1938) than surround any other American blues artist. It’s said that he sold his soul to the devil down at a Mississippi crossroads in return for the ability to play guitar with a technique that musicians like Eric Clapton are still trying to replicate. It’s said …

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Labetalol in acute cocaine toxicity: is it safe?

March 1, 2017, 2:10 pm


Acute Toxicity from Topical Cocaine for Epistaxis: Treatment with Labetalol. Richards JR et al. J Emerg Med 2017 Mar;52:311-313.


There has long been a debate among toxicologists — still unresolved — as to whether it is safe to use a beta-blocker to treat cocaine-related hypertension and tachycardia. The (theoretical) concern is that since cocaine is both an α- and …

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Tox Tunes #108: Commit a Crime (Howlin’ Wolf)

February 26, 2017, 1:09 pm

You put poison in my coffee, instead of milk or cream
You put poison in my coffee, instead of milk or cream
You bout the evilest woman, that I ever seen

You mixed my drinks with a can of Red Devil lye
You mixed my drinks with a can of Red Devil lye
Then you sit down, watch me, hopin’

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Did the nerve agent VX kill Kim Jong Nam?

February 24, 2017, 2:44 pm

Last night Malaysian authorities announced that they identified the nerve agent VX taken off the face of Kim Jong Nam, who was murdered on February 13 at Kuala Lumpur International Airport.

As the History Channel video above indicates, nerve agents are potent acetylcholinesterase inhibitors that utilize the same mechanism as organophosphate insecticides such as parathion. Conceptually, the effect of VX …

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Must-watch: video showing murder of Kim Jong Nam

February 22, 2017, 1:25 pm

Screen Shot 2017-02-22 at 10.24.10 AM

Extraordinary security footage from Kuala Lumpur International Airport in Malaysia showing details surrounding the February 13 killing by poison of Kim Jong Nam, the half-brother of North Korea leader Kim Jong Un. The video was posted by Fuji Television and the Wall Street Journal, and can be seen by clicking here.

The video makes it possible to establish …

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Do not get a serum acetaminophen level less than 4 hours after an acute ingestion

February 9, 2017, 2:50 pm


Can a serum acetaminophen concentration obtained less than 4 hours post-ingestion determine which patients do not require treatment with acetylcysteine? Yarema MC et al. Clin Toxicol 2017 Feb;55:102-108.


For decades the decision whether or not to treat acute acetaminophen [APAP] toxicity with N-acetylcysteine (NAC) has been guided by a serum APAP level drawn 4 or more hours after …

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Amnesia and hippocampal ischemia in 4 opiate abusers: a case series

February 1, 2017, 12:26 am

Hippocampus (

Hippocampus (


Complete, bilateral hippocampal ischemia: a case series. Small JE et al. Neruocase 2016 Oct;22:411-415.


Last week, we reviewed an MMWR investigation into a cluster of 14 cases of acute anterograde amnesia with MRI evidence of bilateral hippocampal ischemia identified in Massachusetts during the years 2012-2016. This constellation of features is distinctly unusual — especially when symmetric and …

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Anterograde amnesia and bilateral hippocampus ischemia: is it caused by substance abuse?

January 26, 2017, 11:51 pm

Bilateral hippocampal ischemia on MRI [Source: MMWR]

Diffusion weighted MRI findings in patient with unusual amnestic syndrome — Massachusetts, 2012
[Source: MMWR]


Cluster of an Unusual Amnestic Syndrome — Massachusetts, 2012-2016. Barash JA et al. MMWR Morb Mortal Wkly Rep 2017;66:76-79

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Late in 2015 a Boston neurologist reported a cluster of 4 cases of anterograde amnesia associated with MRI evidence of bilateral hippocampal ischemia. After …

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