by Sarah Shafer *Not the video game I’ve gotten some version of this call many times in my budding career as a medical toxicologist: “Hello, we have a something-year-old patient in the ER who overdosed on ______ (fill in the blank) medication. How long do we need to watch them before we can medically clear […]
Tox and Hound – One Therapy To Rule Them All? Sugar vs Squeeze in Cardiotoxic Poisoning
by Jon Cole and Meghan Spyres Jon: Meghan, thank you for joining me on this post. I’ve wanted to write about the logistics of high dose insulin (HDI) for some time now, but I have a lot of my own biases about where insulin belongs in the ordering of our therapies for sick cardiotoxic overdoses […]
Tox & Hound – A Toxicological Brain Teaser. The Complexities of Valproic Acid Metabolism.
by Christine Murphy What do you think about when you hear the words “drug toxicity”? Do you think about a patient who overdosed or someone who is experiencing a toxic side effect from a medication? A lot of times, the answer might depend on what we remember about a drug when we hear the name. […]
“B-Sides” in Analgesia
by Meghan Spyres Ketamine was gifted to the world as a result of investigations into its evil older brother: phencyclidine (PCP). PCP, commonly known as ‘angel dust’ (quite the misnomer, Urban Dictionary suggests the use of the more fitting ‘devil dust’. . .) was initially used as a pharmaceutical in the 1950s under trade name […]
Tox & Hound – MALA-ficence
Predicting Outcome in Metformin Lactic Acidosis by Diane Calello A 56-year-old male with diabetes and hepatitis comes in after an intentional overdose of his own metformin. On evaluation, he is awake and alert but mildly tachycardic. Lab evaluation demonstrates elevated lactate at 4 mmol/L and a pH of 7.3. Will he die? Metformin is one […]
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