Archive for April 2010

Pediatric Nicotine Ingestions

April 30, 2010, 9:24 pm


Unintentional Child Poisonings Through Ingestion of Conventional and Novel Tobacco Products.  Connolly GN et al.   Pediatrics 2010;125:896-899.

Full Text

This study looked retrospectively at all cases of children < 6 years of age ingesting only tobacco products that were reported to 61 regional poison control centers in the years 2006-2008.  A total of 13,705 cases were identified, 70% of which …

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Amiodarone neurotoxicity

April 27, 2010, 10:38 pm


Hepatic Dysfunction and Neurotoxicity in a Patient Receiving Long-Term Low-Dose Amiodarone Therapy.   Arkun A et al. J Emerg Med 2010;38:337-339.


This instructive case report describes a 90-year-old male who developed neurotoxicity 18 months after starting amiodarone 200 mg daily for paroxysmal atrial fibrillation.  Neurologic manifestations included confusion, dizziness, proximal lower extremity weakness, and ataxia.  Work-up revealed mild hepatic dysfunction …

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Cognitive Bias and Premature Closure

April 26, 2010, 2:42 pm

Life in the Fast Lane discusses an interesting case that demonstrates the danger of premature closure (that is, jumping to conclusions) when evaluating complex acutely ill patients.  We had an example of this pitfall — fortunately avoided by the sharp emergency doc — presented at tox rounds this morning.  A sixty-year-old man was brought into the emergency department responding only …

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Tox Tunes #17: When I Get Low I Get High (Ella Fitzgerald)

April 25, 2010, 3:31 pm

The “First Lady of Song” — Ella Fitzgerald (1917-1996) — would have been 93 years old today. Her collection Ella Fitzgerald Sings the Gershwin Songbook has TPR’s vote as one of the two greatest albums in the history of American music (the other vote goes to The Complete Recordings of Robert Johnson). Happy Birthday, Ella!…

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Mephedrone after the ban

April 25, 2010, 2:46 pm

The Telegraph (U.K.) published a long piece this week surveying the use of mephedrone in Britain now that the Home Secretary has classified the drug as a class-B substance.  In the article, Dr. Paul Dargan, a toxicologist at Guy’s and St. Thomas’ hospitals, talks about the effects of mephedrone:

“‘The pattern of toxicity is very similar to other stimulant …

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Salvia divinorum and YouTube

April 24, 2010, 11:56 am


Salvia divinorum: Effects and use among YouTube users. Lange JE et al  Drug and Alcohol Dependence 2010;108:138-140.


Salvinorin A — the active ingredient in the plant Salvia divinorum –is a unique hallucinogen: it is not an alkaloid, contains no nitrogen, and does not interact with serotonin receptors.  Rather, it is a high-affinity, selective agonist that acts at the kappa …

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Propofol as a drug of abuse

April 23, 2010, 9:24 am


The abuse potential of propofol. Wilson C et al. Clin Toxicol 2010;48:165-170.


Ever since the death of Michael Jackson last year, interest in propofol abuse — especially among medical professionals — has peaked.  This excellent systematic literature review surveys the characteristics of the drug that make it so dangerous and tempting. Propofol has a rapid onset and short (~15-minute) …

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Toro! Toro! Toro!

April 22, 2010, 9:19 am

The Wall Street Journal Health Blog reports on a study showing that different kinds of sushi have varying levels of mercury, sometimes approaching or exceeding limits set by federal and international agencies.  Although the clinical effect on adults exposed to mercury at these levels is uncertain, there is some concern that the developing fetal brain could sustain damage from the …

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Tox Tunes #16: Eight Miles High (Leo Kottke)

April 21, 2010, 1:15 am

Leo Kottke — who once described his own voice as sounding like “geese farts on a muggy day” — is a phenomenal guitarist. His amazing debut album — 6 and 12 String Guitar was constantly on TPR‘s turntable when it came out in the early 1970s, and it was one of the highlights of this correspondent’s aborted radio …

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