TPR Podcast Episode #13: Naloxone in the Age of Carfentanil

January 18, 2017, 10:33 pm

In this “Lucky 13” episode of the TPR podcast, Steven and Leon discuss naloxone, and address the following issues:

 

  • Does the concept of a “heroin overdose patient” have meaning anymore in this age of U-47700, fentanyl, and carfentanil?
  • Given the adulteration of both heroin and counterfeit prescription medications with extremely potent synthetic opioids, do we have to reconsider our entire approach to opioid overdose patients?
  • Can past medical literature guide us in our management of these patients?(Hint: the answer is no.)
  • What medical toxicology paper do Steve and Leon — in an unusual state of agreement — feel was the best to appear in 2016?

 

Here are links to some of the articles discussed in the podcast:

 

 

Fentanyl Outpaces Heroin as the Deadliest Drug on Long Island. New York Times Dec 28, 2016

 

Do heroin overdose patients require observation after receiving naloxone? Willman MW et al. Clin Toxicol 2017 Feb;55:81-87.

 

Fatal Fentanyl: One Pill Can Kill. Sutter ME et al. Acad Emerg Med 2017 Jan;24:106-113.

 

Experts weigh minimum naloxone dose as opioid crisis evolves. Traynor I. Am J Health Syst Pharm 2016 Dec 1;73:1892-1894.

 

The Rising Price of Naloxone — Risks to Efforts to Stem Overdose Deaths. Gupta R et al. N Engl J Med 2016 Dec 8;375:2213-2215.

 

Fentanyl epidemic in Chicago, Illinois and surrounding Cook County. Schumann H Erickson T, Thompson TM et al. Clin Toxicol 2008 Jul;46: 501-6.

 

 

Quizzler:

 

From TPR Podcast #12: Question – What branch of yoga features the drinking of one’s own urine?

 

Answer: Amaroli Yoga

 

The winner was Dr. Angela Regina (New York). Congratulations!

 

This episode’s Quizzler: During World War II, Sir Winston Churchill and his cabinet worked from the underground Churchill War Rooms in London. Those who tour the rooms today can see that a tox-related method of putting out fires was used. (Hint: it does not involve spray fire extinguishers.) What is that method?

 

All entries should be submitted to: toxtrivia@gmail.com. Deadline is 10 pm CST (Chicago time) February 2, 2017. The winner will be chosen randomly from all correct answers, and will receive a$10 gift certificate to Amazon.com as well as a TPR tee-shirt.

 

 

References:

 

Guide to Practical Amaroli (Yoga Magazine)

 

Drink to Your Health — Urine Therapy (Agama)

 

 

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