Early metabolic acidosis and coma in massive acetaminophen overdose

August 7, 2015, 1:33 pm

mind-the-gap★★★½☆

Coma and Severe Acidosis: Remember to Consider Acetaminophen. Villano JH et al. J Med Toxicol 2015 July 8 [Epub ahead of print]

Reference

This paper, from UC-San Diego, contains an excellent case discussion that makes numerous important points about a patient who presents with decreased mental status and high-anion-gap metabolic acidosis.

The patient was a 28-year-old male who was …

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Review: liquid nicotine toxicity

July 30, 2015, 3:45 pm

e-cig-liquid-hookah-town-300x224★★½☆☆

Liquid Nicotine Toxicity. Kim JW, Baum CR. Pediatr Emer Care 2015;31:517-524.

Abstract

This review of liquid nicotine toxicity is part of the continuing medical education series in Pediatric Emergency Care.

While there are a few good clinical nuggets buried in this review, they are surrounded by so many distracting and unnecessary epidemiological facts that the whole paper — though …

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Venlafaxine abuse

July 29, 2015, 10:56 pm

Venlafaxine★★½☆☆

Venlafaxine as the ‘baby ecstasy’? Literature overview and analysis of web-based misusers’ experiences. Francesconi G et al. Hum Psychopharmacol Clin Exp 2015 Jul;30:255-261. 

Abstract

In 2003, Sattar et al published a case report of venlafaxine abuse in a 38-year-old man. The patient had been prescribed 225-mg extended-release venlafaxine daily. He found that increasing his dose by 50% — to 337.5-mg …

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Case series: anxiety and agitation following exposure to the synthetic cannabinoid ADB-PINACA

July 28, 2015, 11:12 pm

crazy.clown_.synthetic.marijuana-298x300★★★☆☆

A Common Source Outbreak of Severe Delirium Associated with Exposure to the Novel Synthetic Cannabinoid ADB-PINACA. Schwartz MD et al. J Emerg Med 2015 May;48:573-80.

Abstract

As noted in a recent survey of synthetic cannabinoid exposures in the New England Journal of Medicine, the synthetic cannabinoid (SC) ADB-PINACA was associated with outbreaks in August and September 2013, both in …

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Death after consuming a marijuana edible

July 23, 2015, 6:08 pm

Screen Shot 2015-07-23 at 2.01.10 PM★★★★☆

Death Following Ingestion of an Edible Marijuana Product — Colorado, March 2014. MMWR 2015 July 24;64:771-772.

Full Text

This report describes the investigation by the Colorado Department of Public Health and Environment (CDPHE) into a well-publicized fatality that occurred shortly after recreational marijuana became available in that state.

In March 2014, a 19-year-old man ingested one piece of a marijuana …

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5F-ADB-PINACA and other extremely potent new synthetic cannabindoids

July 22, 2015, 5:18 pm

IndoleVSIndazole

★★★½☆

Pharmacology of Indole and Indazole Synthetic Cannabinoid Designer Drugs AB-FUBINACA, ADB-FUBINACA, AB-PINACA, ADB-PINACA, 5F-AB-PINACA, 5F-ADB-PINACA, ADBICA, and 5F-ADBICA. Banister SD et al. ACS Chem Neurosci 2015 July 17 [Epub ahead of print]

Abstract

As TPR noted in a recent post, many recently reported cases of severe toxicity or death associated with exposure to synthetic cannabinoids (SCs) involved relatively new …

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Serious toxicity and fatalities from synthetic cannabinoids

July 20, 2015, 1:44 pm

crazy.monkey-246x300★★★½☆

Synthetic Cannabinoid—Related Illnesses and Deaths. Trecki J et al. N Engl J Med 2015 Jul 9;373:103-107.

Reference

As the authors point out in this interesting article, there has been a recent surge in reports of fatalities and severe toxicity from synthetic cannabinoids (SCs). This is likely from a combination of increased incidence and more diligent surveillance.

The most interesting part …

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Tox Tunes #99: Casey Jones (Grateful Dead)

July 5, 2015, 2:49 pm

The critical response to the final 3 performances of the Grateful Dead’s “Fare Thee Well” tour has been decidedly mixed. In the New York Times, Jon Pareles reported that “Even with a handful of the Dead’s inevitable stumbles, the music was strong.”

On the other hand, Greg Kot’s review in the Chicago Tribune was headlined “Grateful Dead pay

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Tox Tunes #98: Truckin’ (The Grateful Dead)

July 3, 2015, 6:53 pm

Surprisingly, “Tox Tunes” has featured only one Grateful Dead song so far. This weekend seemed a good time to catch up, as the remnants of The Dead play their farewell concerts at Soldier Field in Chicago in the biggest festival the Windy City has seen since smaccUS.

There are, of course, a number of drug references in the song, which …

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