Archive for October 2011

Delayed rhabdomyolysis after doxylamine overdose

October 30, 2011, 11:58 pm


The associative factors of delayed-onset rhabdomyolysis in patients with doxylamine overdose. Kim HJ et al. Am J Emerg Med 2011;29:903-907.


I should have known from the bizarre way the title of this paper is phrased — why not the more straightforward “Factors associated with delayed onset rhabdomyolysis  . . . etc? — that neither the authors nor the editors …

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Defense expert blows smoke at Michael Jackson death trial

October 28, 2011, 12:48 pm

“The important point is you would not expect to see any free lorazepam in the stomach because, um, it is completely absorbed if, unless, um, I mean, you would not expect to see any free lorazepam in the stomach if it was only given intravenously, that’s my point, because there’s no what they call post-mortem redistribution, which means a drug …

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Just when you thought it was safe to go back trick or treating . . .

October 27, 2011, 9:59 pm

With Halloween just around the corner, the U.S. Food and Drug Administration reminds us all that too much black licorice in your holiday candy stash may cause hypokalemia, hypertension, congestive heart failure, hypertension, and edema.

Real black licorice contains gllycyrrhizin, a compound that gives licorice root its sweet taste. This glycoside inhibits 11-β-hydroxysteroid dehydrogenase, causing increased cortisol levels and …

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Tox Tunes #51: Gypsy Love Songs (Richard Thompson)

October 27, 2011, 9:01 pm

After my post several days ago about the “Mickey Finn“, a reader commented reminding me that the knockout drink is also mentioned in Richard Thompson’s “Gypsy Love Songs”. This clip is from a Toronto concert in the early 1990s, with a band including Shawn Colvin. Despite the hum on this clip, it shows Thompson at his live best.  …

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Review of methemoglobinemia neither clear nor current

October 26, 2011, 8:08 pm



Methemoglobinemia: Pathogenesis, Diagnosis, and Management. South Med J November 2011;104:757-761.


It’s hard to figure out what the editors of Southern Medical Journal thought the point of publishing this review article was.  It is not up-to-date — no mention that methylene blue can be associated with serotonin syndrome — and it is not particularly clear in it’s discussion of …

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The “Mickey Finn”

October 25, 2011, 8:07 pm


Short answer question case series: the perils of urine toxicology testing. Graubard M et al. Emerg Med J November 28:998-999.

No abstract available

This short case vignette describes a 32-year-old man who presents to the emergency department with meiosis and apnea. After responding to naloxone, he states that someone slipped him a “Mickey Finn” at a bar.  One hour later, …

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Interview with J.W. Huffman (creator of JWH-018 and other synthetic cannabinoids)

October 24, 2011, 7:36 pm

J.W. Huffman

I missed this interview with J.W. Huffman — the creator of JWH-018 and other synthetic cannabinoid molecules — when it appeared Los Angeles Times last month. Dr. Huffman says that the entire kerfuffle that has come about because his laboratory research into the interaction between chemicals and cannabinoid receptors in the central nervous system a “royal pain in …

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No pressure immobilization in U.S. pit viper bites

October 23, 2011, 9:51 pm

In a convincing short opinion piece published at Emergency Physicians Monthly, Dr. Michael Levine from the Maricopa Medical Center in Phoenix takes issue with a treatment recommendation for management of Crotilinae  snakebite put forth in the American Heart Association/American Red Cross first aid guidelines. Crotilinae pit vipers include rattlesnakes, copperheads, and cottonmouths.

This document, published in October 2010, …

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Tox Tunes #50: Lost in the Ozone Again (Commander Cody and His Lost Planet Airmen)

October 23, 2011, 11:50 am

Commander Cody and His Lost Planet Airmen started as a bar band in Ann Arbor, Michigan in the late 1960s. Their music incorporated many styles — Texas swing, country rock, rockabilly, and R&B. They sounded like a cross between The Eagles and Asleep at the Wheel, but after a six-pack and a couple of hits of meth. Their biggest single …

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