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 […]

Tox and Hound – Happy New Year!
We here at the hive mind of the Tox and the Hound just want to thank you, dear readers, for joining us on this incredible journey. We’ve had an exciting year, where we’ve talked about a wide range of topics and ideas. We discussed . . . Post mortem drug redistribution Buprenorphine in the ER […]
Tox and Hound – All Drugs Go to Heaven
by Andrew Stolbach “Who cares about that?” This is what my supportive wife (who also happens to be a doctor) said when I told her I wanted to write about postmortem drug testing. I can understand where she is coming from. Before writing something, it is valid to ask if this is something that my […]
The Dantastic Mr. Tox & Howard – S03E02 – All I Want for Christmas is Two New Base Pairs
Genetic terrorism and CRSPR with Dr. Jillian Theobald Join Dan (@drusyniak) &Howard (@heshiegreshie) as they explore the world of gene editing with Dr. Jillian Theobald (@JillianTheobald). Dive deep into CRISPR and how it is revolutionizing the way we view the genome and what can be done with it, both good and bad. From Bristle blocks […]
Tox and Hound – We Have A MOUD* Disorder
by Howard Greller A 37-year-old man with a history of asthma and hypothyroidism presents to your emergency department complaining that he hasn’t been feeling well for a few days. He reports having chills, nausea without vomiting, some loose stool, diffuse body aches, some rhinorrhea, and feeling ill at ease. In your detailed history, it is […]
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