Lipid therapy in oral poisoning: a not-so-systematic review

December 27, 2016, 4:12 pm


No support for lipid rescue in oral poisoning: A systematic review and analysis of 160 published cases. Forsberg M et al. Hum Exp Toxicol 2016 Nov 24 [Epub ahead of print]


The authors’ goal was “to present a systematic review and case analysis of practically all published reports on humans treated with lipid rescue for LAST [local anesthetic systemic …

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Synthetic cannabinoid AMB-FUBINACA responsible for July 2016 “zombie” episode

December 18, 2016, 6:37 pm


“Zombie” Outbreak Caused by the Synthetic Cannabinoid AMB-FUBINACA in New York, Adams AJ et al. N Engl J Med 2016 Dec 14 [Epub ahead of print]


On July 12, 2016, the New York Times reported that in the course of one day, in the Bushwick and Bedford-Stuyvesant areas of Brooklyn, 33 people had been transported to hospitals after apparently …

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Tox Tunes #107: Lullaby (The Cure)

December 11, 2016, 11:11 pm

There is, to be sure, disagreement as to whether the subtext of this song involves child abuse or drug addiction. The director of this video, Tim Pope, has stated that Lullaby is “an allegory of [The Cure frontman] Robert Smith’s druggy past.” Certainly, the lyrics would back back this up:

On candy stripe legs the Spiderman comes
Softly through …

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Great video: tongue fasciculations in organophosphate poisoning

December 8, 2016, 2:50 pm


Tongue Fasciculations in Organophosphate Poisoning. Chhabria BA, Bhalla A. . N Engl J Med 2016 Dec 8;375:e47

Full text with video

The New England Journal of Medicine just posted a brief case of dichlorvos poisoning with a great video demonstrating organophosphate-induced tongue fasciculations. The case and video can be seen here.

The NEJM also has video of tongue fasciculations …

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Loperamide abuse and cardiac dysrhythmia

November 25, 2016, 10:59 am


Cardiac Dysrhythmias After Loperamide Abuse — New York, 2008-2016. Eggleston W et al. MMWR 2016 Nov 18;65:1276-1277.

Full Text

Last week we reviewed a new paper showing that the number of cases of loperamide abuse reported to the National Poison Data System increased by 91% from the years 2000 to 2015. For reasons detailed in that review and in my …

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Treating “heroin” overdose: the past is no guide

November 22, 2016, 12:06 am


Do heroin overdose patients require observation after receiving naloxone? Tillman MW et al. Clin Toxicol 2016 Nov 16:1-7 [Epub ahead of print]


The stated goal of this study was to search the medical literature in an attempt to answer 3 main questions:

  1. “What are the medical risks to a heroin user who refuses ambulance transfer after naloxone?
  2. “If

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How to interpret urine drug tests for marijuana: a review

November 19, 2016, 5:45 pm

Linda Parton/

Linda Parton/


Interpretation of Workplace Tests for Cannabinoids. Kulig K. J Med Toxicol 2016 Sep 29 [Epub ahead of print]


The interpretation of workplace urine drug tests for marijuana often becomes a point of contention in workman’s compensation cases or proceedings moving towards firing an employee. In may experience, the court or arbitrator not infrequently gets the science of …

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Missing loperamide (Imodium) abuse can be a fatal mistake

November 15, 2016, 5:45 pm


Epidemiologic Trends in Loperamide Abuse and Misuse. Vakkalanka JP et al. Ann Emerg Med 2016 Nov 4 [Epub ahead of print]


This paper reviews loperamide exposures reported to the National Poison Data System  over the 6-year period from 2010 through 2015. Because of the well-recognized limitations involved in retrospective analysis of poison center data, there is not much clinically …

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Does exposure to marijuana cause myocardial infarction?

November 12, 2016, 2:38 pm


Prolonged cardiac arrest complicating a massive ST-segment elevation myocardial infarction associated with marijuana consumption. Orsini J et al. J Community Hosp Intern Med Perspect 2016 Sept 7;6(4):31695

Full Text

The medical literature contains scattered, rare case reports and series describing myocardial infarction, acute coronary syndrome, and cardiac arrest associated with exposure to cannabis. (Extreme emphasis on the word “associated.”) This …

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