Archive for the ‘Medical’ Category

Cardiac effects of loperamide overdose

April 29, 2016, 5:59 pm

Loperamide★★★☆☆

Not your regular high: cardiac dysrhythmias caused by loperamide. Wightman RS et al. Clin Toxicol 2016 Jun;54:454-458

Abstract

Loperamide is an over-the-counter anti-diarrhea medication that is available without prescription under a variety of brand names including Imodium. In therapeutic doses, loperamide acts as a peripheral mu-opioid receptor agonist but doesn’t cross the blood-brain barrier (BBB). However, in massive …

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Bedside echocardiography findings in carbon monoxide-poisoned patients

April 28, 2016, 9:34 pm

★★★★☆

Incidence and patterns of cardiomyopathy in carbon monoxide-poisoned patients with myocardial injury. Cha YS et al. Clin Toxicol 2016 Apr 11 [Epub ahead of print]

Abstract

At last year’s Social Media and Critical Care (SMACC) conference in Chicago, I gave a talk remarking on how bedside ultrasound imaging in critically ill toxicology patients is underused and little studied. I suggested …

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Metronidazole-induced cerebellar syndrome

April 15, 2016, 3:45 pm

Metronidazole_encephalopathy★★★½☆

Metronidazole-Associated Encephalopathy. Farmakiotis D, Zeluff B. N Engl J Med 2016 Apr 14;374:1465

Full Text           

Exposure to metronidazole (Flagyl) can precipitate a subacute cerebellar syndrome, typically manifested with dysarthria and ataxia, with or without cognitive impairment. This adverse effect is uncommon and little-appreciated. Although usually associated with prolonged exposure to the antibiotic for treatment of conditions such as abscesses of …

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Vasculitis after snorting cocaine contaminated with levamisole

April 7, 2016, 2:28 pm

Lawrence et al. Allergy Rhinol (Providence) 2014 Copyright policy — open-access

Lawrence et al. Allergy Rhinol (Providence) 2014
Copyright policy — open-access

★★★½☆

Cocaine-induced ecchymotic rash. Voore NK. Cleve Clin J Med 2016 Apr;3:252-253.

Full Text

Since at least 2010, a large percentage of cocaine samples seized in the United States has contained levamisole, a veterinary anti-worm medication.

Levamisole had previously used in humans as an anti-helminthic and also in some …

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Cocaine-associated cardiotoxicity: a systematic review yields no answers

April 6, 2016, 3:26 pm

Christopher Siesarchik/shutterstock.com

Christopher Siesarchik/shutterstock.com

★★★☆☆

Treatment of cocaine cardiovascular toxicity: a systematic review. Richards JR et al. Clin Toxicol 2016 Feb 26 [Epub ahead of print]

Abstract

This paper is the most frustrating thing I’ve read since I force marched my way through the “Oxen of the Sun” chapter of James Joyce’s Ulysses. I must say that, despite its difficulties, …

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Is ketamine safe and effective in excited delirium?

March 29, 2016, 12:43 pm

Zerbor/shutterstock.com

Zerbor/shutterstock.com

★★★☆☆

Ketamine as Rescue Treatment for Difficult-to-Sedate Severe Acute Behavioral Disturbance in the Emergency Department. Isbister GK et al. Ann Emerg Med 2016 Feb 10 [Epub ahead of print]

Abstract

Rapidly sedating a toxicology patient who presents with excited delirium is a critical — yet often difficult — action. These patients are typically difficult to control and resistant to sedation …

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Is possible chest wall rigidity after illicit intravenous fentanyl administration clinically significant?

March 25, 2016, 6:05 pm

fentanyl★★★☆☆

Could chest wall rigidity be a factor in rapid deaths from illicit fentanyl abuse? Burns G et al. Clin Toxicol 2016 Mar 21 [Epub ahead of print]

Abstract

Wooden chest syndrome” describes marked muscle rigidity — especially involving the thoracic and abdominal muscles — that is an occasional adverse effect associated with the intravenous administration of lipophilic synthetic …

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Sunday with SMACC: Amal Mattu on Lessons Learned from The Princess Bride

February 28, 2016, 7:52 pm

As the 2016 Social Media and Critical Care (SMACC) conference fast approaches — it will take place June 13-16 in Dublin — let’s look back on one my favorite talks from last years smaccCHICAGO get together. It’s Amal Mattu reflecting on lessons important to both life and emergency medicine contained in the 1987 film The Princess Bride. As with …

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Shiitake happens: dermatitis from uncooked mushrooms

February 20, 2016, 12:18 pm

puttography/shutterstock.com

puttography/shutterstock.com

★★★½☆

Shiitake dermatitis: the tale of an under-recognised, undercooked fungus. McNally A et al. Med J Aust 2016 Feb 15;204:124-6

Reference

 

Just when you thought it was safe to go back to the farmers’ market . . .

This interesting paper presents a series of 3 cases of flagellate dermatitis following consumption of raw or undercooked shiitake mushrooms. …

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