Clinical Effects and Toxicokinetic Evaluation Following Massive Topiramate Ingestion. Lynch MJ et al. J Med Toxicol [published online 08 April 2010]
This important case report describes a 37-year-old woman who was brought to the emergency department in coma after ingesting a massive overdose of topiramate (Topamax®). Her peak level was 356 mcg/ml (reference 5-20 mcg/ml). The patient required intubation …
Emergent Complications of the Newer Anticonvulsants. Wade JF et al. J Emerg Med 2010;38:231-7.
This instructive article reviews the adverse effects and overdose presentation of some of the newer anticonvulsant medications. Studying the toxicology of these drugs is often difficult because — among other impediments — serum drug levels are not readily available. In general, overdose on these …
Now that the United Kingdom has classified mephedrone (meow-meow) a Class B drug, other substances are rushing to take its place as a “legal high” a club drug. The Guardian (U.K.) reports today that MDAI, a selective serotonin releaser first studied at Purdue University over a decade ago, is considered the most likely contender, at least by one …
My column concerning recent reports of contamination of cocaine with the veterinary de-worming medicine levamisole, and heroin with anthrax, is now available online from Emergency Medicine News.…
Life in the Fast Lane has a great summary of issues involved in managing a toddler who ingests two unknown tablets. I’ve posted my observations about the role of GI decontamination is these cases in their comments section.…
httpv://www.youtube.com/watch?v=rpoEmlxUPeQ&feature=fvw
The Canadian-American rock band Steppenwolf was big in the late 1960s, especially after two of their best known songs — “Born to be Wild” and “The Pusher” — were featured in the 1969 film Easy Rider. The lyrics to “The Pusher” make it — along with Canned Heat’s “Amphetamine Annie” — one of the most powerful anti-drug songs of that era.
An interesting article in the New York Times today describes research at Johns Hopkins and other medical centers into the use of psychedelics to relieve depression associated with cancer as well as other medical and psychiatric conditions. In the piece, one kidney cancer patient relates his experience after taking psilocybin in the study for the first time:
“All of a …
Blue Thunder Ingestion: Methanol, Nitromethane, and Elevated Creatinine. Ngo AN et al. J Med Toxicol [published online 30 March 2010]
This fascinating case report is from the California Poison Control System. A 41-year-old male presented to the emergency department in a state of intoxication, saying he had ingested vodka and “Blue Thunder” model racing car fuel. …
In my previous comment on a paper in the current Annals of Emergency Medicine comparing hydroxocobalamin with sodium nitrite as an antidote for cyanide toxicity using an animal model, I noted that the authors did not emphasize what I took to be the most interesting finding: twice as many animals died during infusion of nitrite. Although this result seems to …
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