Archive for January 2013

Does tramadol cause paradoxical hyperalgesia?

January 30, 2013, 1:01 am


Tramadol Induced Paradoxical Hyperalgesia. Lee SH et al. Pain Physician 2013;16:41-44.

Full Text

This paper presents 2 cases of patients who developed increased sensitivity to pain (hyperalgesia) as a paradoxical reaction to being chronically on tramadol. We’ve talked before about opioid-induced hyperalgesia, a still under-recognized phenomenon in which chronic opioid use increased pain perception. This is the first …

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“America’s Doctor”: What makes Dr. Oz run?

January 28, 2013, 12:26 pm

Dr. Mehmet Oz

Michael Specter’s long, nuanced and mesmerizing portrait of Dr. Mehmet Oz in the current issue of The New Yorker is an absolute must-read. Specter highlights all the facets of Oz’s personality: fierce competitor, TV personality, masterful communicator, skilled cardiac surgeon, compassionate physician, snake-oil promoter, and — at home — Mr. Oz, apparently mightily influenced by his wife, …

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Tox Tunes #69: Cocaine (Tom Rush)

January 27, 2013, 6:58 pm

Tom Rush was one of my favorite folk singers in college, when I wore out the grooves on the LP listening to his cover versions of Joni Mitchell’s “The Circle Game” and “Urge for Going” .

This somewhat jaunty version of Rev. Gary Davis’s “Cocaine Blues” is, frankly, a little too cheerful for my taste. I …

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Does smoking marijuana cause stroke?

January 26, 2013, 10:05 pm


Cannabis-related Stroke: Myth or Reality? Wolff V et al. Stroke 2013 Feb;44(2):558-63. doi: 10.1161/STROKEAHA.112.671347. Epub 2012 Dec 27.


There have been scattered reports in the literature claiming an association between the use of cannabis and ischemia and/or hemorrhagic stroke. Although no convincing mechanism has been postulated, some suggest that use of marijuana or hashish and the occurrence of stroke …

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Treating Amanita phalloides poisoning: is silibinin superior to chicken dung?

January 24, 2013, 11:17 pm

Milk thistle


Amanita phalloides poisoning and treatment with silibinin in the Australian Capital Territory and New South Wales. Roberts DM et al. Med J Aust 3013 Jan 21;198:43-47


In one of his published works, the second-century Roman physician Galen related an anecdotal method of treating mushroom poisoning:

I have heard of a physician of Mysia who administered Fowl’s dung

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The many potential problems with using dabigatran

January 23, 2013, 12:51 am


Dabigatran: Uncharted Waters and Potential Harms. Radecki RP. Ann Intern Med 2012;157:66-68.

No abstract available

The Institute for Safe Medication Practices has reported that soon after its approval in October 2010,  the oral direct thrombin inhibitor dabigatran etexilate (Pradaxa) was associated with a higher incidence of adverse events than almost any other drug.

In this opinion piece, Ryan Radecki …

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Bath-salt constituent MDPV more like methamphetamine than ecstasy

January 19, 2013, 2:15 pm


Powerful Cocaine-Like Actions of MDPV, a Principal Constituent of Psychoactive ‘Bath Salts’ Products. Baumann MH et al. Neuropsycho- pharmacology 2012 Oct 17. doi: 10.1038/npp.2012.204. [Epub ahead of print]


This article, from the National Institute on Drug Abuse, is complementary to another similar article we recently reviewed, and by some of the same authors.

Even though the paper …

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MDPV can give a false positive test for phencyclidine (PCP)

January 16, 2013, 10:33 pm


Psychoactive “bath salts”: Not so soothing. Baumann MH et al. Eur J Pharmacol 2013;698:1-5.


This article, from the Medicinal Chemistry Section of the National Institute on Drug Abuse, is an up-to-date review of certain aspects of “bath salts”, specifically the synthetic cathinones: MDPV, mephredrone, and methylone. Although much of the material the authors cover is …

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Abuse of Opana ER (oxymorphone) associated with thrombotic thrombocytopenic purpura

January 15, 2013, 2:14 am


Thrombotic Thrombocytopenic Purpura (TTP)-Like Illness Associated with Intravenous Opana ER Abuse — Tennessee, 2012. MMWR 2013 Jan 11;62:1-4.

Full Text

This paper describes a 2012  CDC investigation into a cluster of 15 cases of thrombotic thrombocytopenic purpura (TTP)-like illness in the state of Tennessee. TTP-like illness was defined as microangiopathic hemolytic anemia (hemolytic anemia anemia based on haptoglobin and lactate …

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