Archive for January 2015

Tox Tunes #93: Lithium (Evanescence)

January 26, 2015, 12:54 am

As with the Nirvana song of the same title, the lyrics are not completely clear as to whether the singer is describing the experience of the drug, or using it as a metaphor for emotional ambivalence. (We should note that in fact Nirvana’s “Lithium” never mentions the drug in its lyrics.)

I thought of this song after reviewing the new …

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Saturdays with SMACC: Hinds & May debate cricoid pressure

January 24, 2015, 3:02 pm

At the 2014 smaccGOLD conference in Australia, two motorsport enthusiasts, Drs. Brent May (@DocBrent) and John Hinds (@DocJohnHinds) engaged in a very amusing debate about the efficacy of cricoid pressure in managing airways. Taking the pro side, Dr. May argued that applying cricoid pressure is superior (or at least non-inferior) to not doing so in preventing aspiration. Dr. Hinds’ position …

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Hemodialysis in lithium poisoning: what is the evidence?

January 23, 2015, 11:59 pm

0Lithium Carbonate, 300mg, 1,000 Capsules per Bottle★★★½☆

Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup. Decker BS et al. Clin J Am Soc Nephrol 2015 Jan 12 [Epub ahead of print]


The purpose of this review, from the Extracorporeal Treatments in Poisoning (EXTRIP) workgroup, was to give evidence-based recommendations related to use of hemodialysis and other extracorporeal modalities in the …

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Evidence does not support use of long-term opioid therapy for chronic pain

January 21, 2015, 11:14 pm


The Effectivenss and Risks of Long-Term Opioid Therapy for Chronic Pain: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Chou R et al.  Ann Intern Med 2015 Jan 13 [Epub ahead of print]


Although prescription opioids have been advocated and used for long-term treatment of chronic non-cancer pain, there is scant literature supporting such …

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Tox Tunes #92: Born in Chicago (Paul Butterfield)

January 18, 2015, 11:23 pm

This is my favorite live version of Paul Butterfield’s blues classic “Born in Chicago” (written by Nick Gravenites.) It also features Rick Danko on bass and Blondie Chaplin on guitar. Although this visceral and gritty song does not specifically mention drugs, they are certainly alluded to in the lyrics:

Well, my first friend went down
When I was 17 …

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Tox in the news: 72 die in Mozambique from poisoned beer

January 16, 2015, 1:03 am



In a very strange story that’s been developing all week, the Washington Post reported that at least 72 people died in Mozambique after consuming poisoned beer offered at a funeral gathering. Details are scarce and the poison (or poisons) has not yet been identified, but a limited clinical scenario can be gleaned from reading news coverage.

Apparently, the funeral …

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TPR Podcast Episode #7: Interview with Guy Weinberg about lipid rescue therapy

January 14, 2015, 5:12 pm

NOTE: The audio quality of this recording is understandable but definitely choppy and sub-optimal. However, the concepts discussed are so important that we are uploading the file for those who want to listen. We will also post a transcript of the discussion in the next few days. In this episode the TPR team interviews Dr. Guy Weinberg from the Department of Anesthesia at the University of Illinois Medical Center in Chicago. Dr. Weinberg, among his many other accomplishments, was instrumental in developing the modality of lipid rescue therapy in treating cardiotoxicity caused by parenteral injection of local anesthetics such as bupivacaine. He also runs the website LipidRescue™ Resuscitation. The discussion is worth listening to

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Whole bowel irrigation? Don’t just do something, stand there!

January 13, 2015, 1:03 am


Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Thanacoody R et al. Clin Toxicol 2015 Jan;53:5-12.


In 1997 the American Academy of Clinical Toxicology (AACT) and the Euroopean Association of Poisons Centre and Clinical Toxicologists (EAPCCT) published a position paper regarding the use of whole bowel irrigation (WBI) for gastrointestinal decontamination in the poisoned patient. …

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Hallucinogenic stimulant PMMA found in “Superman” pills that killed 4 in Britain

January 8, 2015, 5:22 pm

The Guardian (U.K.) reported yesterday that the deaths of 4 men in Britain over the holidays were associated with a drug — purported to be MDMA (ecstasy) — that actually contained the hallucinogenic stimulant PMMA, a far more dangerous drug. The deaths all seemed to be related to a 5-sided pill that reproduced the famous Superman logo.


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