Archive for August 2012

Ibogaine — an hallucinogen that was NOT a factor in the 1972 presidential campaign

August 29, 2012, 7:02 pm

★★½☆☆

Fatalities Temporally Associated with the Ingestion of Ibogaine. Alper KR et al. J Forensic Sci 2012 Mar;57:398-412.

Abstract

Ibogaine is a psychoactive alkaloid found in the bark of the root of the iboga plant (Tabernanthe iboga), a shrub that grows in the rain forests of western Central Africa. The plant  is an important adjunct to Bwiti religious ceremonies …

Read More »

Guidelines for reversing overdose of dabigatran (Pradaxa) and other new anticoagulants

August 29, 2012, 12:33 am

★★★☆☆

Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. Kaatz S et al. Am J Hematol 2012;87:S141-S145.

Full Text

This article is the result of a huge effort:

Representatives from ten organizations that focus on thrombosis and anticoagulation convened a meeting in December 2011 and collaborated to develop pragmatic guidance to help clinicians manage the reversal of

Read More »

Fetal Lead Exposure from Ayurvedic Medications

August 27, 2012, 9:10 pm

★★★½☆

Lead Poisoning in Pregnant Women Who Used Ayurvedic Medications from India — New York City, 2011-2012. MMWR 2012 Aug 24;61:641-646.

Full Text

Fetal lead exposures carries increased risk of low birth weight, developmental delay, cognitive impairment, behavioral abnormalities, and miscarriage. Some traditional Ayurvedic medications from India — especially those of the “rasa shastra” type prepared with metals or …

Read More »

Tox Tunes #61: Reefer Head Woman (Jazz Gillum and His Jazz Boys)

August 26, 2012, 9:34 pm

Although Jazz Gillum is given credit for the similarly titled track on Aerosmith’s Night in the Ruts album, this 1938 song is very different lyrically and musically.

William “Jazz” Gillum (1904-1966) was a Mississippi-born blues harmonica player who recorded for the RCA Bluebird label in Chicago. In The Blackwell Guide to Blues Records, John Cowley writes:

A singer with

Read More »

Is hemodialysis effective in thallium poisoning

August 25, 2012, 10:35 pm

★★★☆☆
A Fatal Case of Thallium Toxicity: Challenges in Management. Riyaz R et al. J Med Toxicol 2012 Aug 4 [Epub ahead of print]

Abstract

This case report emphasizes an important clinical point. The case describes a 36-year-old man who presented to hospital with vomiting and abdominal pain 45 minutes after ingesting an unknown amount of thallium rodenticide.

Treatment included supportive …

Read More »

Famous neurologist/author, massive drug use, and talking philosophical spiders

August 24, 2012, 7:21 pm

The current issue of The New Yorker magazine carries an amazing piece (subscription required) by author and neurologist Oliver Sacks detailing his extensive drug use while a neurology resident at UCLA and a young attending physician in New York.

Sacks — who meticulously describes the drug effects he observed in himself —started with marijuana, but soon escalated to taking …

Read More »

Empiric hydroxocobalamin for smoke inhalation: what’s the cost? where’s the evidence?

August 22, 2012, 5:30 pm

★½☆☆☆

Empiric Management of Cyanide Toxicity Associated with Smoke Inhalation. O’Brien DJ et al. Prehosp Disaster Med 2011;26:374-382.

Abstract

Whether or not to use empiric hydroxocobalamin to treat victims of smoke inhalation is a hotly debated topic for which all sides agree there is no (and will probably never be any) definitive evidence. A recent editorial in Annals of Emergency Medicine

Read More »

Case Report: fatal GI bleed 6 days after one dose of dabigatran (Pradaxa)

August 21, 2012, 7:55 pm

★★★☆☆

Fatal gastrointestinal hemorrhage after a single dose of dabigatran. Kernan L et al. Clin Toxicol 2012;50:571-573.

Abstract

The RE-LY trial, the major study evaluating use of dabigatran etexilate (Pradaxa) as an anticoagulant to prevent stroke in patients with atrial fibrillation, excluded subjects with creatinine clearance less than 30 ml per minute. Since elderly patients frequently have undetected renal insufficiency

Read More »

Superb review of hemodialysis and other enhanced elimination techniques

August 16, 2012, 5:30 pm

★★★★½

Extracorporeal Removal Techniques for the Poisoned Patient: A Review for the Intensivist. Fertel BS et al. J Intensive Care Med 2010 May-June;25:139-148.

Abstract

I missed this must-read paper when it was published over 2 years ago, but am delighted I finally caught up with it. I reviewed articles on extracorporeal removal (ECR) techniques in toxicology cases while preparing a 2010 …

Read More »