Metronidazole-induced cerebellar syndrome

April 15, 2016, 3:45 pm

Metronidazole_encephalopathy★★★½☆

Metronidazole-Associated Encephalopathy. Farmakiotis D, Zeluff B. N Engl J Med 2016 Apr 14;374:1465

Full Text           

Exposure to metronidazole (Flagyl) can precipitate a subacute cerebellar syndrome, typically manifested with dysarthria and ataxia, with or without cognitive impairment. This adverse effect is uncommon and little-appreciated. Although usually associated with prolonged exposure to the antibiotic for treatment of conditions such as abscesses of …

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Vasculitis after snorting cocaine contaminated with levamisole

April 7, 2016, 2:28 pm

Lawrence et al. Allergy Rhinol (Providence) 2014 Copyright policy — open-access

Lawrence et al. Allergy Rhinol (Providence) 2014
Copyright policy — open-access

★★★½☆

Cocaine-induced ecchymotic rash. Voore NK. Cleve Clin J Med 2016 Apr;3:252-253.

Full Text

Since at least 2010, a large percentage of cocaine samples seized in the United States has contained levamisole, a veterinary anti-worm medication.

Levamisole had previously used in humans as an anti-helminthic and also in some …

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Cocaine-associated cardiotoxicity: a systematic review yields no answers

April 6, 2016, 3:26 pm

Christopher Siesarchik/shutterstock.com

Christopher Siesarchik/shutterstock.com

★★★☆☆

Treatment of cocaine cardiovascular toxicity: a systematic review. Richards JR et al. Clin Toxicol 2016 Feb 26 [Epub ahead of print]

Abstract

This paper is the most frustrating thing I’ve read since I force marched my way through the “Oxen of the Sun” chapter of James Joyce’s Ulysses. I must say that, despite its difficulties, …

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Is ketamine safe and effective in excited delirium?

March 29, 2016, 12:43 pm

Zerbor/shutterstock.com

Zerbor/shutterstock.com

★★★☆☆

Ketamine as Rescue Treatment for Difficult-to-Sedate Severe Acute Behavioral Disturbance in the Emergency Department. Isbister GK et al. Ann Emerg Med 2016 Feb 10 [Epub ahead of print]

Abstract

Rapidly sedating a toxicology patient who presents with excited delirium is a critical — yet often difficult — action. These patients are typically difficult to control and resistant to sedation …

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Is possible chest wall rigidity after illicit intravenous fentanyl administration clinically significant?

March 25, 2016, 6:05 pm

fentanyl★★★☆☆

Could chest wall rigidity be a factor in rapid deaths from illicit fentanyl abuse? Burns G et al. Clin Toxicol 2016 Mar 21 [Epub ahead of print]

Abstract

Wooden chest syndrome” describes marked muscle rigidity — especially involving the thoracic and abdominal muscles — that is an occasional adverse effect associated with the intravenous administration of lipophilic synthetic …

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TPR Podcast Episode #11: Google Glass and the Toxicologist

March 19, 2016, 5:31 pm

TPR Podcast Episode #11: Google Glass and the Toxicologist, with Dr. Peter Chai

 

Written by Leon Gussow MD FACMT

 

In this episode, Steve Aks and I talk to Dr. Peter Chai, a senior medical toxicology fellow at the University of Massachusetts in Worcester, about his research on Google Glass and its potential use as an aid to consultation on …

Podcast Episode
Play

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Sunday with SMACC: Amal Mattu on Lessons Learned from The Princess Bride

February 28, 2016, 7:52 pm

As the 2016 Social Media and Critical Care (SMACC) conference fast approaches — it will take place June 13-16 in Dublin — let’s look back on one my favorite talks from last years smaccCHICAGO get together. It’s Amal Mattu reflecting on lessons important to both life and emergency medicine contained in the 1987 film The Princess Bride. As with …

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Shiitake happens: dermatitis from uncooked mushrooms

February 20, 2016, 12:18 pm

puttography/shutterstock.com

puttography/shutterstock.com

★★★½☆

Shiitake dermatitis: the tale of an under-recognised, undercooked fungus. McNally A et al. Med J Aust 2016 Feb 15;204:124-6

Reference

 

Just when you thought it was safe to go back to the farmers’ market . . .

This interesting paper presents a series of 3 cases of flagellate dermatitis following consumption of raw or undercooked shiitake mushrooms. …

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Tox Tunes #106: Mountain Dew (The Stanley Brothers)

February 15, 2016, 12:43 am

Long before there was the soft drink, the term “mountain dew” referred to bootleg whiskey. Actually, the use of the term may have been brought over from Ireland. According to the Merriam-Webster dictionary, the use of the term to denote illegal alcohol goes back to the 1800s.

When I went to camp as a teenager, this was one of …

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