Archive for November 2012

Excellent review of octreotide as an antidote for sulfonylurea overdose

November 29, 2012, 3:24 pm


Octreotide for the treatment of sulfonylurea poisoning. Glatstein M et al. Clin Toxicol 2012;50:795-804.


Sulfonylurea hypoglyemic medications such as glipizide and glyburide increase release of insulting from the pancreas, thereby lowering serum glucose levels. Octreotide, a synthetic somatostatin analog, has the opposite effect, inhibiting pancreatic insulin release through a different mechanism.

Episodes of hypoglycemia following sulfonylurea overdose can …

Read More »

Review of carbon monoxide toxicity misses some key references

November 20, 2012, 8:32 pm


Carbon Monoxide Poisoning. Guzman JA. Crit Care Clin 2012;28:537-548.


This is a fairly well done review of carbon monoxide (CO) toxicity, with a rational discussion about what is known and unknown about treatment, including hyperbaric oxygen (HBO). However, there are some significant omissions in the reference list. For example, a key — though flawed — study into the role …

Read More »

Was the “Pain as a 5th Vital Sign” campaign in part a marketing ploy?

November 19, 2012, 7:44 pm


Rethinking Opioid Prescribing to Protect Patient Safety and Public Health. Alexander GC et al. JAMA 2012 Nov 13;308:1865-1866.

First page

The authors of this “Viewpoint” piece begin by noting that the rates of death and complication from prescription drug abuse have been increasing astronomically:

The annual number of fatal drug overdoses in the United States now surpasses the annual number

Read More »

Danish astronomer with missing nose did not die from mercury poisoning

November 19, 2012, 12:13 am

Tycho Brahe

Two years ago, TPR reported that the body of  Tycho Brahe (1546-1601) had been exhumed for tests to determine if the Danish astronomer had been poisoned by mercury. AFter all, in the early 1900s some mercury had been found in hair from his beard.

Earlier this week,  an article in Time magazine revealed that the evidence is in …

Read More »

NY Times: FDA investigating 13 deaths possibly associated with 5-Hour Energy shots

November 17, 2012, 12:31 am

The New York Times reported this week that the Food and Drug Administration is investigating 13 reports of deaths occurring over the last 4 years in which 5-Hour Energy caffeinated energy shot was cited. (Although the Times calls 5-Hour Energy a “highly caffeinated energy shot”, according to study by Forbes Magazine a 2-oz shot contains 150-210 mg caffeine, considerably less

Read More »

25I-NBOMe: a dangerous new hallucinogen

November 15, 2012, 4:33 pm



25C-NBOMe — New potent hallucinogenic substance identified on the drug market. Zuba D et al. Forensic Sci Int. 2012 Sep 15. pii: S0379-0738(12)00390-8. doi: 10.1016/j.forsciint.2012.08.027. [Epub ahead of print]


The New Orleans Times-Picayune online reported earlier this month that an Arkansas man died at in October after taking a small amount of the hallucinogenic phenethylamine 25I-NBOMe (also called …

Read More »

Suboxone (buprenorphine): one pill can kill

November 15, 2012, 1:10 am


Buprenorphine May Not Be as Safe as You Think: A Pediatric Fatality From Unintentional Exposure. Kim HK et al. Pediatrics 2012 Nov 5 [Epub ahead of print]


Buprenorphine — a partial agonist at the opioid μ receptors as well as a κ receptor antagonist — is used to treat pain and opiate addiction as an alternative to methadone. Although …

Read More »

Tachycardia and altered mental status after smoking “K2”; but what is “K2”?

November 14, 2012, 12:25 am


Acute Intoxication Caused by a Synthetic Cannabinoid in Two Adolescents. Heath TS et al.  J Pediatr Pharmacol Ther 2012;17:177-181.

Full Text

This paper, from the Medical University of South Carolina in Charleston,  describes two teenagers (ages 17 and 15 years) who presented to the emergency department after reportedly smoking a product labelled as “K2″. Both patients presented with …

Read More »

Carisoprodol: risk for addiction and withdrawal

November 12, 2012, 9:26 pm


Carisoprodol: Update on Abuse Potential and Legal Status. Reeves RR et al. Southern Med J 2012 Nov;105:619-623.


Carisoprodol (Soma) is a centrally actingskeletal muscle relaxant that is metabolized to meprobamate, a drug that was a popular sedative before it was supplanted by the benzodiazepines. Both drugs activate GABAA receptors.

The primary manifestation of carisoprodol overdose is …

Read More »