Toxicology Archives - Page 3 of 9 - The Emergency Medical Minute

Toxicology

Podcast # 496: Hallucinogens

Author: David Holland, MD Educational Pearls: Hallucinogenics have been used for a variety of cultural and religious reasons for thousands of years In the 1960’s a Harvard professor began experimenting with psilocybin mushrooms. There was resulting public outcry, eventually leading to all hallucinogens being listed as schedule I drugs Common hallucinogens include: LSD (acid), Mescaline…

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Podcast #494: A Standard Toxicology Approach

Contributor: JP Brewer, MD Educational Pearls: Obtaining collateral is often vital to determine the potential drugs accessible to the patient – this may include medications found in their medicine cabinet prescribed to them or a family member After this, use ancillary sources such as EMS, family/friends, and police to determine the patient’s last normal, PMH…

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Podcast # 493: One Pill for the Kill

Contributor: JP Brewer, MD Educational Pearls: Because of their smaller size, there are a variety of adult-dose pills that are potentially toxic to children. The most common categories of medications that may be toxic include cardiac, diabetic, pain, psychiatric, anti-malarial, and herbals/caustics Oral hypoglycemics such as sulfonylureas can be particularly dangerous in children. Opiates and…

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Podcast # 486: Morel Mushrooms

Contributor: Nick Hatch, MD Educational Pearls: True morel mushrooms are commonly foraged The false morel mushroom (Gyromitra esculenta) looks similar to the true morel, but is toxic False morel mushroom toxicity can cause gastrointestinal symptoms as well as liver failure, rhabdomyolysis, and seizures Seizures can be refractory to benzodiazepine therapy and may require use of…

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Podcast # 480: Inhalant Abuse

Author: Sam Killian, MD Educational Pearls: Abuse occurs by breathing in volatile substances such as solvents, glues, paints, butane, and propane Inhalants are generally depressants Estimated that 100-125 people die every year in the US from acute inhalant abuse. Short-term effects include memory impairment, slurred speech, diplopia, seizures, and cardiac arrhythmias Long term effects include…

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Podcast # 464: Narcan’t?

Author: Aaron Lessen, MD Educational Pearls: A problem of take-home-naloxone is the administration of it by an able-bodied bystander Australian study looked at consecutive opioid overdose deaths in a single year to identify characteristics of overdose and potential for bystander administered naloxone Of the 235 fatal heroin overdoses reviewed, 83% were alone with only 17%…

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Podcast # 463: Buproprion Overdose

Author: Erik Verzemnieks, MD Educational Pearls: Buproprion is used as an antidepressant and for smoking cessation Severe buproprion overdoses can cause seizures and lead to cardiac dysrhythmias Benzodiazepines are treatment of choice for seizures Bicarbonate and Interlipid are also possible treatment options with less evidence References Stall N, Godwin J, Juurlink D. Bupropion abuse and…

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Podcast # 462: Death after OD

Author: Don Stader, MD Educational Pearls: 10% of patients seen in the emergency department for opioid overdose patients will die within a year Half of these overdoses will occur in the next month This mortality rate is higher than patients with STEMI, of which 7% will die within one year Take-home naloxone, as well as…

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Podcast # 459 Clonidine Ingestion

Author:  Julian Orenstein, MD Educational Pearls:   Severe clonidine ingestion can present as a fluctuating mental status between typically accompanied by changes in vital signs (hypotension/bradycardia) Respiratory depression requiring intubation is not uncommon   References Isbister GK, Heppell SP, Page CB, Ryan NM. Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not…

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Podcast # 455: Hunting for PeeCP

Author: Michael Hunt, MD Educational Pearls:   Like all tests, urine toxicology (utox) screens can have false positives Prescription medications such as demerol, antipsychotics, ketamine, and tramadol can all produce a false positive utox for PCP Over-the-counter medication such as dextromethorphan also mimic PCP on utox   References Doyon S. (January 2014). False Positive Urine…

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