Archive for February 2014

Hyperbaric oxygen for gas emboli following hydrogen peroxide ingestion

February 26, 2014, 10:08 pm

Early ad for hydrogen peroxide

Early ad for hydrogen peroxide

★★★☆☆

Hyperbaric Oxygen Therapy For Systemic Gas Embolism After Hydrogen Peroxide Ingestion. Byrne B et al. J Emerg Med 2014 Feb;46:171-175.

Abstract

Concentrated hydrogen peroxide (> 10%) is caustic and directly injures gastrointestinal mucosa after ingestion. In addition, when it contacts tissue catalase it releases large amounts of oxygen (1 ml of 35% hydrogen peroxide will …

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The Dark Side of Acetaminophen, and more: Tox on the Web

February 23, 2014, 1:48 am

 

The Dark Side of Acetaminophen: The Toronto Star has a long article this weekend about the hepatotoxicity of acetaminophen, both when taken in deliberate overdose as a suicidal gesture or attempt, or ingested in supra-therapeutic (or even therapeutic) doses.   It was put together with the help of the investigative unit ProPublica and goes over much of the material covered …

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TPR Podcast Episode #2: Chinese Restaurant Toxicology

February 21, 2014, 8:17 pm

Just when you thought it was safe to go back to the Chinese restaurant. Episode #2 of the TPR podcast features the toxicology of Chinese food, including Hunan hand, durian-induced hyperkalemia, the soy sauce challenge, and more! To read the show notes, click on "Read More" below.

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Why is cocaine adulterated with an animal dewormer? Mystery solved?

February 20, 2014, 7:41 pm

levamisole★★★½☆

Aminorex, a metabolic of the cocaine adulterant levamisole, exerts amphetamine like actions at monoamine transporters. Hofmaier T et al. Neurochem Int 2013 Dec 1 [Epub ahead of print]

Abstract

During the last decade, many shipments of cocaine seized by U.S. drug authorities have been found to be adulterated with levamisole, a veterinary anti-worming medicine. The drug in the past …

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Driving under the influence (of marijuana)

February 19, 2014, 12:06 am

How safe is driving under the influence of marijuana? For forensic purposes, are there tests that can establish impairment from THC? If so, how can they be used fairly and accurately. These are important questions now — especially in the states of Washington and Colorado — and they are explored in a very interesting article by Maggie Koerth-Baker in this …

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Asystole shortly after intravenous fat emulsion for overdose: causation or coincidence?

February 17, 2014, 11:52 pm

intralipid★★★☆☆

Asystole Immediately Following Intravenous Fat Emulsion for Overdose. Cole JB et al. J Med Toxicol 2014 Feb 12. [Epub ahead of print]

Abstract

This case paper describes 2 patients who developed asystole within 60 seconds of being given intravenous fat emulsion (IFE) bolus for treatment of severe cardiotoxicity. Both patients had return of spontaneous circulation (ROSC) after several minutes of …

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Tox Tunes #78: Needle of Death (Neil Young)

February 16, 2014, 4:33 pm

This beautiful cover version of Bert Jansch’s “Needle of Death” by Neil Young is from a concert at Carnegie Hall’s Isaac Stern auditorium this past January. The visuals and the sound aren’t much — the clip was recorded from the balcony seats — but I find the performance moving anyway, especially at this time when the number of heroin overdose …

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6 Pearls About Metformin and Lactic Acidosis

February 13, 2014, 4:00 pm

1376258597_Metformin★★★½☆

Metformin accumulation: Lactic acidosis and high plasmatic metformin levels in a retrospective case series of 66 patients on chronic therapy. Vecchio S et al. Clin Toxicol 2014 Feb;52:129-135.

Abstract

Metformin is frequently used alone or in combination to treat type 2 diabetes. It lowers blood glucose by decreasing hepatic gluconeogenesis, predominantly by inhibiting mitochondrial respiratory chain complex I. …

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You don’t need Dr. House to suspect cobalt toxicity in a patient with an artificial hip

February 11, 2014, 10:48 pm

Dr. Gregory House

Dr. Gregory House

★★★☆☆

Cobalt intoxication diagnosed with the help of Dr. House. Dahms K et al.  Lancet 2014 Feb 8;383:574.

Full text

This is a neat short case report that can fix in the mind the features of cobalt toxicity. A 55-year-old man came to clinic with a history of:

  • severe heart failure (ejection fraction = 25%)
  • decreased hearing acuity

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