Archive for June 2012

Does the “party pill” BZP affect the kidney?

June 30, 2012, 7:44 pm


Nephrotoxicity of recreational party drugs. Berney-Meyer L et al. Nephrology 2012;17:99-103.


Stimulant “party drugs” such as MDMA (ecstasy), N-benzylpiperazine (BZP), and the various ingredients that can be contained in “bath salt” preparations can produce a wide variety of adverse effects, including renal toxicity. Usually these effects are secondary to hyperthermia and hyperactivity, causing rhabdomyolysis and acute …

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The case of the poisoned ice tea

June 29, 2012, 1:49 pm


Sodium Azide Poisoning at a Restaurant — Dallas County, Texas, 2010. MMWR June 29, 2012;61:457-460.

Full Text

This fascinating report describes clinical details of five cases of sodium azide exposure, as well as the multi-agency investigation into the exposure.

In April 2010, five persons in Dallas County, Texas, presented to hospitals with acute dizziness. Other initial signs and symptoms were …

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Toxicity from mandrake berries used as a sexual aid

June 27, 2012, 12:50 pm


Accidental Poisoning After Ingestion of “Aphrodisiac” Berries: Diagnosis by Analytical Toxicology. Nikolaou P et al. J Emerg Med 2012 Jun;42:662-665.


Go and catch a falling star,
Get with child a mandrake root,
Tell me where all past years are,
Or who cleft the devil’s foot

John Donne (1572 -1631)

The mystique surrounding the mandrake plant goes back to antiquity. …

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Paucis Verbis: The Toxic Alcohols

June 25, 2012, 1:41 pm

Over at Academic Life in Emergency Medicine, Michelle Lin as part of her excellent “Paucis Verbis” series has posted cards summarizing the presentation and management of toxicity from ethylene glycol, methanol, and isopropyl alcohol. These cards can be printed out for handy portable reference, or saved on a smart phone or tablet.

Some selected pearls …

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Agitation and hallucinations from bath salts containing MDPV and flephedrone

June 22, 2012, 11:43 pm

4-fluoromethcathinone (flephedrone)


Psychosis from a Bath Salt Product Containing Flephedrone and MDPV with Serum, Urine, and Product Quantification. Thornton SL et al. J Med Toxicol 2012 Apr 21 {Epub ahead of print]


To date, products sold as bath salts have contained primarily the synthetic stimulant MDPV and mephedrone. However, some samples have contained 4-fluoromethcatinone (flephedrone), a drug whose …

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Do sleeping pills kill?

June 19, 2012, 6:46 pm

Recently, a study in the BMJ Open online journal suggested that patients who took sedative/hypnotic sleeping pills — even at the extremely low dose of 1 to 18 pills a year — had a markedly increased risk of early death. And that was one of the least most conservative conclusions reached by the authors. They also that these medication may …

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Weekend must-read: NY Times Magazine on cocaine inc.

June 17, 2012, 3:31 pm

The New York Times magazine today has an absolutely stunning cover story on the business of drug trafficking and the organization of the Mexican drug cartels, and the massive structure built to supply “the insatiable North American nose”. A friend says that it reads like a case-study and the Harvard Business Review,  and she’s right. (Although I suspect it’s much …

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Bath salts (MDPV): another possible cause of serotonin syndrome

June 13, 2012, 9:56 pm


Serotonin Syndrome Associated with MDPV Use: A Case Report. Mugele J et al. Ann Emerg Med 2012 Jan 9 [Epub ahead of print)


This very well done case report describes a 41-year-old woman who presented to hospital with altered mental status, agitation, and myoclonus after using “Blue Magic Bath Salts” for several days. Shortly after admission she developed hallucinations, …

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We do NOT need more studies on whole bowel irrigation

June 12, 2012, 11:16 pm


A retrospective review of whole bowel irrigation in pediatric patients. Lo JCY et al. Clin Toxicol 2012 Jun;50:414-417.


I suspected I would not find this paper useful as soon as I read the purpose of the study stated in the abstract: ” . . .to better understand the use of whole bowel irrigation (WBI) in pediatric patients”. This goal …

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