Sriracha, Zohydro, and more: tox on the web

March 5, 2014, 3:57 pm


The science of Sriracha: The American Chemical Society has a must-see video on Sriracha hot sauce — it goes well with everything — including disquisitions about the origin of the Scoville scale and the physiology of capsaicinoids. (HT @ToxTalk)

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Early ads for sedatives: The Milwaukee Journal-Sentinel — which is doing some of the best reporting in the country on drugs and the pharmaceutical industry — has a great collection of medical journal ads for tranquilizers from the 1950s and 60s.  This post accompanies their story on the deadly interaction between sedatives and opioids.
Where did the potassium go?: At Life in the Fast Lane, Kylie McNamara has posted a great case of puzzling hypokalemia in Q&A form. A conundrum worthy of Dr. House.

Must-read post about getting around scientific paywalls: The Incubator blog from Rockefeller University has a must-read post about scientific paywalls and how they can be circumvented using resources such as Google Scholar, Reddit Scholar, and Twitter (#ICanHazPDF). Don’t miss this one.

Just say no: Forbes posts about the movement to stop the impending release of the opioid Zohydro-ER onto the pharmaceutical market. This formulation contains up to 50 mg of hydrocodone per pill, 5-10 times more than either Vicodin or Lortab. It does not contain acetaminophen. In addition, it does not contain any abuse-deterrent technology, which will make it easy to crush and then snort or inject. A very important issue, given the ongoing epidemic of prescription opiate overdoses and dramatic increases in deaths from heroin. Zohydro-ER may be approved as early as this month.

The Maryland Poison Center’s update ToxTidbits also covered Zohydro recently.

In a related story, a joint report from the Milwaukee Journal Sentinel (again!!) and Medpage reveals that last year 30 million prescriptions for opioids were written by non-physicians — nurse practitioners, physicians’ assistants, even optometrists. The article makes the point that the real issue probably is probably prescribing by persons not well-trained in using the powerful analgesics. This group would include many physicians.

This is not good: The Wall Street Journal reports on a study in the Journal of Adolescent Medicine showing that almost half of teenagers who complain of headaches are prescribed opioids. And this trend is much worse in emergency departments:

Teenagers with visits for headache to the emergency department had twice the rate of opioid prescriptions as those who had not visited the emergency department. And, those who had three or more emergency department visits were four times more likely to have opioid prescriptions.

I agree with @DavidJuurlink: this is madness. Very distressing.

Gravel, a (relatively) new designer drug: The Kingsport (TN) Times-News reports that the area has seen a marked increase in the number of incidents associated with an addictive news street drug called “gravel”. Although samples purported to be any illicit drug can contain virtually anything, this drug seems to be predominantly alpha-Pyrrolidinopentiophenone (α-PVP) and to produce impressive degrees of paranoia.

Was he killed by his wife or his doctors?: The Guardian (U.K.) reviews Kate Coloquhoun’s book Did She Kill Him? about Florence Maybrick, the American woman who was put on trial in Victorian England for allegedly killing her husband. Although there was no doubt that the victim had been exposed to multiple poisons — including strychnine, arsenic, belladonna, phosphoric acid and cyanide — he was a health nut who willingly took tonics containing these ingredients. But why did his wife extract arsenic from the wallpaper? (HT @ToxTalk)

False positive immunoassay screen for amphetamines: On his blog The Dose Makes the Poison, @ForensicToxGuy posts about agents that can show up as amphetamine on a urine drug screen test. I hadn’t realized that ranitidine falls in this category.


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