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 (fda.gov)

Purple glove syndrome (fda.gov)


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Review of synthetic cannabinoids out-of-date as soon as it’s published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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Tox Tunes #104: Oxycontin Blues (Steve Earle)

January 11, 2016, 12:29 am

This is from Steve Earle’s 2007 CD Washington Square Serenade. The lyrics are simple and stark:

Well my daddy worked in the coal mine
Till the company shut it down
Then he sat around and drank his self blind
Till we put him back underground

Now nothing grows on this mountain
And what’s a poor boy to do

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Saturday with SMACC: Tox Dogmalysis

January 9, 2016, 8:52 pm


The 4th annual Social Media and Critical Care (SMACC) conference will take place in Dublin (Ireland, not California) later this year from June 13 through June 16. I’m really looking forward to it, both because last year’s meeting in Chicago was so much fun, and because the last day of the Dublin conference — June 16 —coincides with Bloomsday, …

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ACMT position statement on prescribing opioids: a missed opportunity

January 6, 2016, 11:26 pm


Safety Issues Regarding Prescription Opioids. American College of Medical Toxicology J Med Toxicol 2016 Jan 5 [Epub ahead of print]

No abstract available

This “Position Statement” from the American College of Medical Toxicology (ACMT) covers 3 topics related to safety issues associated with use of prescription opioids. Unfortunately, some of the positions taken by the College are, to say the …

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The 6th Annual Alexander Awards: The Best Tox Reading of 2015

December 31, 2015, 6:55 pm

Alexander Gettler

Alexander Gettler

At the end of every year, TPR bestows the coveted Alexander Awards on the best long-form writing on toxicology topics that have appeared in the popular press during the preceding 12 months. To be eligible, an article must be open-access and freely available, not locked behind some paywall. The awards were named for Alexander Gettler (1883-1968,) the head …

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Carbon monoxide “myths”

December 24, 2015, 4:47 pm


Myth busting in carbon monoxide poisoning. Hampson NB. Am J Emerg Med 2015 Nov 3 [Epub ahead of print]


This short review, by the former medical director for the Virginia Mason Center for Hyperbaric Medicine in Seattle, sets out to debunk four “myths” associated with carbon monoxide (CO) exposure. Although nothing here will surprise most emergency physicians, the paper …

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