Archive for April 2013

Guidelines for Opioid Prescription: do emergency physicians need support?

April 9, 2013, 4:00 pm

pain 5th vital sign★★★★☆

Guidelines for Opioid Prescription: Why Emergency Physicians Need Support. Kunins HV et al. Ann Int Med 2013 Apr 9 [Epub ahead of print] 


In this article, 3 internists association with the New York City Department of Public Health tell emergency physicians why they need the recently published guidelines suggesting restrictions on opioid prescribing in emergency departments.

Despite the vaguely …

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The greatest jazz performance on YouTube?

April 7, 2013, 11:58 pm

This ain’t a “Tox Tune”, but as @stevesilberman mentioned in a recent tweet, today would have been Billie Holiday‘s 98th birthday. And there is no better way to remember her greatness than to enjoy this clip of her singing “Fine and Mellow” backed by a mind-blowing all-star band, including: Roy Eldridge and Doc Cheatham on trumpet, Lester Young, Ben

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Weekly Review #2: Toxicology on the Blogosphere

April 6, 2013, 12:42 pm

This week I came across two podcasts with excellent discussions of the problems and complications associated with using opioids for treating chronic pain:

ToxTalk: In Episode 10: When Morphine Hurts, Matt Zuckerman, a fellow in the University of Massachusetts medical toxicology program, talks to Drs. Eric Brush and Steve Bird about opioid-induced hyperalgesia and some adjuncts that might be …

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9-State Analysis: 1633 cases of bath salt exposure

April 5, 2013, 9:44 pm


A 9-State Analysis of Designer Stimulant, “Bath Salt,” Hospital Visits Reported to Poison Control Centers. Warrick BJ et alAnn Emerg Med 2013 Mar 20 [Epub ahead of print]


This study retrospectively reviewed data from 9 Midwest poison control centers over a 13-month period (Nov 2010 through Nov 2011) to identify cases of “bath salt” exposure evaluated

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The top 5 things to know about tramadol

April 4, 2013, 11:54 pm


Tramadol. Young JWS, Juurlink DN. CMAJ 2013 Mar 18 [Epub ahead of print]

No abstract available

This quick one-page review covers some basic clinical and pharmacological points about tramadol. These include:

  • The major analgesic effect of tramadol comes from its metabolite — O-desmethyltramadol (M1) — whic is an opioid.
  • Tramadol’s metabolism can vary considerably, with some individuals being “poor

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Review of 2C hallucinogenic stimulants

April 3, 2013, 11:31 pm

General structure of 2C agents


2C or Not 2C: Phenylethylamine Deisnger Drug Review. Dean BV et al. J Med Toxicol 2013 Mar 15 [Epub ahead of print]


The 2C hallucinogenic stimulants  are named for the 2 carbon atoms between the amino group and the benzene ring. They are relatively new and very little scientific literature describes their characteristics.

This …

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Stimulants, market expansion, and ADHD

April 2, 2013, 9:05 pm

The important lead article in yesterday’s New York Times highlighted the incredible statistic that nearly one in five American high school males have received the diagnosis of attention deficit hyperactivity disorder (ADHD). Looking at all school-age children in the United States, one in nine have been diagnosed with ADHD.

The article notes that two out of three children with the …

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Cotton Fever: a diagnosis of exclusion

April 1, 2013, 7:31 pm


Cotton Fever: An Evanescent Process Mimicking Sepsis in an Intravenous Drug Abuser. Torka P, Gill S. J Emerg Med 2013 Mar 22 [Epub ahead of print]


Cotton fever occurs in an IV drug user after injecting strained through or harvested from a cotton filter. Onset — often within half an hour of injection — presents with chills, headache, dyspnea, …

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