Archive for March 2013

Tox Tunes #71: Cocaine Blues (Roy Hogsed)

March 31, 2013, 12:44 pm

This song, written by T.J. Arnall and covered by many artists including, famously, Johnny Cash, is surely one of the nastiest in all of country western music. Roy Hogsed’s 1947 Capitol recording topped off at #15 on the country music charts the following year.

There are many different songs with the title “Cocaine Blues“. This one is a …

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Weekly Review: toxicology on the blogosphere

March 30, 2013, 9:37 pm

Cocaine Toxicity and Placental AbruptionAt Academic Life in Emergency Medicine, Nikita Joshi has posted the script for a case simulation exercise featuring cocaine, third-trimester emergencies, and domestic violence.

All Juiced UpIn the regular toxicology column in Emergency Physicians Monthly, Mike Nelson and Tim Erickson point out that performance-enhancing drugs are not just for elite professional …

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Does phenobarbital add benefit in treating alcohol withdrawal syndrome?

March 29, 2013, 7:43 pm


Phenobarbital for Acute Alcohol Withdrawal: A Prospective Randomized Double-Blind Placebo-Controlled Study. Rosenson J et al. J Emerg Med 2013;44:592-598.


This well done study looked primarily at the effect of adding phenobarbital to standardized symptom-triggered therapy (using lorazepam). The primary outcome was the rate of ICU admission.

One hundred and two patients were randomized to receive either the standard treatment …

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Chronic tea ingestion causing bone pain and “rugger-jersey spine”

March 28, 2013, 1:58 pm

Rugger-jersey spine


Skeletal Fluorosis Due to Excessive Tea Drinking. Kakumanu N, Rao SD. N Engl J Med 2013 Mar 21;368:1140.

Full Text

“Sick of tea? That’s like being sick of breathing!”
Uncle Iroh

This very interesting, very short case report describes a 47-year-old woman who presented with a 5-year history of pain in the lower back and extremities.  Work-up …

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More criticism of New England Journal CPC on Alcohol Withdrawal

March 28, 2013, 12:46 am

Three months ago, TPR reviewed a discussion of alcohol withdrawal in the New England Journal of Medicine and was unimpressed. Giving the article only 2 skulls, we noted that “the discussion here is so confused, unfocused, and incomplete that it’s surprising that the combined forces of Mass General and the Journal could not produce a more enlightening review.”

In …

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A “big Christmas cardigan”: recreational use of ketamine and methoxetamine

March 26, 2013, 3:09 pm


From “Special K” to “Special M”: The Evolution of the Recreational Use of Ketamine and Methoxetamine. Corazza O et al. CNS Neurosci Ther 2013 Feb 20 {Epub ahead of print]


Methoxetamine (MXE) is a derivative of ketamine that for the last several years has been sold over the internet as a designer drug. Like ketamine, it produces acute cerebellar

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Long ago and far away: the best toxicology literature of 2011

March 23, 2013, 12:42 am


The toxicology literature of 2011: issues impacting the emergency physician. Charlton NP et al. Am J Emerg Med 2013 Mar;31:597-601.


This just-published article is a very good summary of some important medical articles relating to medical toxicology published in 2011. (Well, one article actually saw print in 2010.) The title is somewhat embarrassing — suggesting that the paper is …

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Did “sizzurp” put Lil’ Wayne into intensive care?

March 21, 2013, 4:55 pm

When rapper Lil’ Wayne was admitted to Cedars-sinai Medical Center last week after suffering multiple seizures, there were rumors (so far unconfirmed) that he had gone back to using concoction called sizzurp.

Sizzurp is usually compounded using a mixture of prescription cough syrup containing promethazine and codeine, a soft drink, and pieces of Jolly Rancher candy. Because of the dark …

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Toxidrome flash quiz – 5 quick cases

March 19, 2013, 9:23 pm

The Broome Docs blog has posted a challenge in toxidrome recognition posed by 5 patients presenting to a remote emergency department in rural Australia. So put away all books and note material and take on the challenge here.…

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