Archive for April 2014

Discussion of salicylate toxicity misses several key points

April 29, 2014, 3:41 pm


Salicylate-induced pulmonary edema — a near-miss diagnosis. Yuklyaeva N et al. Am J Emerg Med 2014 May;32(5):490.e5-6. doi: 10.1016

Reference – no abstract available

This is a potentially interesting case, but the discussion misses so many important points and is so clueless about some key issues that I find it impossible to recommend reading the paper.

A 43-year-old woman in …

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Make the diagnosis, Sherlock!

April 28, 2014, 10:30 pm




Case 12-2014: A 59-Year-Old Man with Fatigue, Abdominal Pain, Anemia, and Abnormal Liver Function. Friedman LS et al. N Engl J Med 2014 Apr 17;370:1542-1550.

Reference – no abstract available

This is from the long-running series “Case Records of the Massachusetts General Hospital.”

A 59-year-old man presents to an outpatient clinic with abdominal pain, dysgeusia, constipation, nausea, a …

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Tox Tunes #82: One Toke Over the Line (Lawrence Welk)

April 27, 2014, 11:51 am

In a September 1970 speech at the Sahara Hotel in Las Vegas, vice President Spiro Agnew attacked the “creeping permissiveness” pervading American society and the influence of drugs that “threatens to sap our national strength.” He singled out some then popular songs that he identified as “latent drug culture propaganda.”

One of the songs he had in mind was Brewer

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The Greatest Tox Scene in Opera

April 24, 2014, 1:36 am

Mozart’s Cosi fan tutte has what is, beyond any argument, the greatest and funniest medical toxicology scene in all of opera. On this Saturday (April 26), the Metropolitan Opera Live in HD series will broadcast Cosi to theaters around the world,with James Levine conducting. As one who thinks that the 3 operas — The Marriage of Figaro, Don Giovanni

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More about phenibut

April 22, 2014, 6:15 pm


Phenibut (β-Phenyl-GABA): A Tranquilizer and Nootropic Drug. Lapin I. CNS Drug Rev 2001;7:471-481.


Since posting about phenibut yesterday, I wondered how much medical literature existed describing its pharmacology and toxicology. This paper — not included in the  the initial accepted manuscript of O’Connell et al but referenced in the Wikipedia entry on phenibut — is the most complete …

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Toxicity from phenibut, a legal over-the-counter baclofen analogue

April 21, 2014, 7:30 pm


Phenibut, the appearance of another potentially dangerous product in the Univted States. O’Connell CW et al. Am J Med 2014 Apr 5 [Epub ahead of print]


This short case report describes a 25-year-old man who was brought to the emergency department after being found with decreased mental status and responsiveness.

On arrival at the hospital, his vital signs were …

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Tox Tunes #81: Junko Partner (Dr. John)

April 20, 2014, 11:39 am

This is a great version of the blues standard from Dr. John‘s 1972 album Gumbo. The song has been covered by everyone from Professor Longhair to The Clash.

The liner notes call this song “the anthem of the dopers, the whores, the pimps, the cons”:

Lee Allenwails on this one, how many tenor choruses does he have,

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Rocky Mountain Poison Center Staff Discuss Legalized Pot in Colorado

April 19, 2014, 5:44 pm

Dr. Eric Lavonas,  associate director of the Rocky Mountain Poison and Drug Center, discussed the situation with legalized cannabis in Colorado on 710KNUS in Denver. He noted that the 3 main problems emergency departments have been dealing since legalization have been psychotic reactions from persons not accustomed to the potency of the marijuana that’s on the market, the severe vomiting …

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Supercut: death by poison

April 14, 2014, 3:24 pm

Inspired by the Game of Thrones episode last night and (SPOILER ALERT) King Joffrey’s richly deserved dispatch by poison, this supercut of poisonings in movies and on TV comes from Abraham Riesman and…

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