Archive for January 2016

Tox Tunes #105: How Can a Poor Man Stand Such Times and Live (Ry Cooder)

January 31, 2016, 9:52 pm

Well the doctor comes around with a face all bright,
And he says in a little while you’ll be all right.
All he gives is a humbug pill,
A dose of dope and a great big bill —
Tell me how can a poor man stand such times and live?

“How Can a Poor Man Stand Such Times and Live” …

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Saturday with SMACC: Strayer on how to use opioids (and how not to use opioids)

January 30, 2016, 11:12 pm


The 3rd (and final) release of registrations for the 2016 Social Media and Critical Care (SMACC) conference in Dublin (June 13-16) will take place on February 3 at 09:00 Sydney time — or 4 pm Tuesday February 2 Chicago time. The 2nd release early December sold out in just one hour (!) after being posted,  so if you’re interested in …

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Cannabis psychopharmacology: it’s more complex than you might imagine

January 29, 2016, 6:06 pm




The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD. Cannabis and Cannabinoid Research 2016 Jan;1:44-46

Full Text

This short interview with Ethan Russo MD should be of interested to toxicologists and other clinicians who might counsel patients on issues regarding medical marijuana. It contains some interesting information about the different biologically active chemicals contained in …

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Extracorporeal treatment for digoxin toxicity: just say no

January 28, 2016, 3:42 pm


Extracorporeal treatment for digoxin poisoning: systematic review and recommendations from the EXTRIP Workgroup. Mowry JB et al. Clin Toxicol 2016 Feb;54:103-14.


“Forced diuresis, and hemodialysis are ineffective in enhancing the elimination of digoxin because of its large volume of distribution (4-10 L/kg), which makes it relatively inaccessible to these techniques.” Goldfrank’s Toxicologic Emergencies (Tenth Edition, 2015)

That one sentence …

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Tox on the Web: deadly French drug trial, fatal food, and more!

January 23, 2016, 6:42 pm



Must-read post about the catastrophic phase 1 French drug trial: In a superb must-read post at the Forbes magazine website,  David Kroll discusses what we know about the disastrous drug safety trial in France that left 1 subject dead and 4 others with varying degrees of neurological damage.The drug in question — named BIA 10-2474 — is an …

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Happy Birthday, Wilbur Scoville! (1865-1942)

January 22, 2016, 12:46 am

Pass the Carolina Reaper!…

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Definitive paper on phenytoin/phosphenytoin-associated purple glove syndrome

January 21, 2016, 8:55 pm

Purple glove syndrome (

Purple glove syndrome (


Purple Glove Syndrome after Phenytoin or Fosphenytoin Administration: Review of Reported Cases and Recommendations for Prevention. Garbovsky LA et al. J Med Toxicol 2015 Dec;11:445-459.


Purple glove syndrome (PGS) is an uncommon adverse drug reaction to parenteral administration of phenytoin or fosphenytoin marked by severe progressive soft tissue discoloration, swelling and pain in the distal …

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Review of synthetic cannabinoids out-of-date as soon as it’s published

January 19, 2016, 11:38 pm

Kronic Purple Haze★★★☆☆

A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment. Tait RJ et al. Clin Toxicol 2016 Jan;54:1-13.


This paper review clinical literature related to use of synthetic cannabinoids (SCs) through the end of 2015. Although it seems comprehensive, and cites 108 references, it is of course already at least 18 months …

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Must-read: combination acetaminophen-opioid formulations should be abandoned

January 12, 2016, 7:16 pm


The prescription paradox of acetaminophen safety. Dart RC, Green JL. Pharmacoepidemiol Drug Saf 2015 Dec 29 [Epub ahead of print]


Last week, we pointed out that the American College of Medical Toxicology (ACMT) had issued a position statement on prescribing opioids that had missed a good opportunity to call for abandoning use of pharmaceutical products that combined strong opioids …

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