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Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology

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https://read.qxmd.com/read/30903576/ten-years-of-robotripping-evidence-of-tolerance-to-dextromethorphan-hydrobromide-in-a-long-term-user
#1
Travis D Olives, Sean P Boley, Jenna M LeRoy, Samuel J Stellpflug
INTRODUCTION: Dextromethorphan hydrobromide is widely available as an over-the-counter cough suppressant. A semi-synthetic opioid displaying N-methyl-D-aspartate receptor antagonism, it is commonly abused for recreational purposes. Spuriously elevated serum chloride concentrations are a well-described phenomenon in the setting of dextromethorphan hydrobromide toxicity, but evidence to suggest the development of tolerance is limited to case reports. CASE: A 32-year-old male known to chronically ingest dextromethorphan hydrobromide for recreational purposes presented to regional hospitals on 179 occasions over 110 months and was treated for dextromethorphan toxicity on 163/174 (93...
March 22, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30895518/a-swine-model-of-severe-propranolol-toxicity-permitting-direct-measurement-of-brain-tissue-oxygenation
#2
Benjamin S Orozco, Kristin M Engebretsen, Joel S Holger, Samuel J Stellpflug
INTRODUCTION: High-dose insulin (HDI) therapy has been used successfully for beta-blocker toxicity, but needs further study when hypotension persists despite HDI. The objective was to develop a model of propranolol toxicity with persistent hypotension despite HDI and to develop means to measure cerebral oxygen tension (PbrO2 ). METHODS: Eight anesthetized Yorkshire pigs were instrumented with a tracheostomy, Swan-Ganz catheter, arterial catheter, and intra-cerebral pressure and oxygen monitor...
March 20, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30895517/the-recommendation-and-use-of-extracorporeal-membrane-oxygenation-ecmo-in-cases-reported-to-the-california-poison-control-system
#3
Justin Lewis, M Zarate, S Tran, T Albertson
INTRODUCTION: Antidotes are available to treat some specific poisonings; however, the mainstay of treatment for the poisoned patient remains supportive care. Extracorporeal membrane oxygenation (ECMO) is one of the most aggressive supportive measures available to manage poisoned patients. OBJECTIVE: To characterize the recommendation and use of ECMO in cases reported to the California Poison Control System (CPCS). METHODS: This retrospective chart review queried the CPCS database from 1997 to 2016 for cases containing the American Association of Poison Control Centers (AAPCC) code for ECMO, and "ECMO" and "ECLS" free-text searches...
March 20, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30850943/in-response-to-impact-of-targeted-temperature-management-on-ed-patients-with-drug-overdose-related-cardiac-arrest
#4
LETTER
John H Fountain, William Eggleston
No abstract text is available yet for this article.
March 8, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30838508/in-reply-impact-of-targeted-temperature-management-on-ed-patients-with-drug-overdose-related-cardiac-arrest
#5
LETTER
Sharaf Khan, Chad M Meyers, Suzanne Bentley, Alex F Manini
No abstract text is available yet for this article.
March 5, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30825071/acmt-2019-annual-scientific-meeting-abstracts-san-francisco-ca
#6
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30805884/naloxone-deserts-in-nj-cities-sociodemographic-factors-which-may-impact-retail-pharmacy-naloxone-availability
#7
Kevin W Lozo, Lewis S Nelson, Christine Ramdin, Diane P Calello
INTRODUCTION: Retail pharmacies in NJ are permitted to dispense naloxone without a prescription. However, not all pharmacies have participated in this effort, and it is not clear what factors may impact its availability. We sought to determine the naloxone availability of select NJ cities and what sociodemographic factors are associated with its availability. We compared naloxone availability in retail pharmacies to median household income, population, and the prevalence of opioid-related hospital visits (ORHV)...
February 25, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30747326/adverse-effects-of-physostigmine
#8
REVIEW
Ann M Arens, Tom Kearney
INTRODUCTION: Physostigmine is a tertiary amine carbamate acetylcholinesterase inhibitor. Its ability to cross the blood-brain barrier makes it an effective antidote to reverse anticholinergic delirium. Physostigmine is underutilized following the publication of patients with sudden cardiac arrest after physostigmine administration in patients with tricyclic antidepressant (TCA) overdoses. We completed a narrative literature review to identify reported adverse effects associated with physostigmine administration...
February 11, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30632074/reversal-of-pediatric-opioid-toxicity-with-take-home-naloxone-a-case-report
#9
Jacob A Lebin, Betty C Chen, Matthew J Valento
BACKGROUND: Take-home naloxone, an opioid antagonist, has become part of a multimodal approach to curbing opioid-related mortality. However, there is little information about the utility of take-home naloxone in pediatric patients. We report a case of opioid toxicity after exposure to methadone in a pediatric patient, which was successfully reversed with take-home naloxone. CASE: A previously healthy 22-month-old girl ingested an unknown amount of liquid methadone...
January 10, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30607835/correction-to-monitoring-dose-response-of-cyanide-antidote-dimethyl-trisulfide-in-rabbits-using-diffuse-optical-spectroscopy
#10
Jangwoen Lee, Gary Rockwood, Brian Logue, Erica Manandhar, Ilona Petrikovics, Changhoon Han, Vikhyat Bebarta, Sari B Mahon, Tanya Burney, Matthew Brenner
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January 3, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30603897/poor-identification-of-emergency-department-acute-recreational-drug-toxicity-presentations-using-routine-hospital-coding-systems-the-experience-in-denmark-switzerland-and-the-uk
#11
David M Wood, Luke De La Rue, Ali A Hosin, Gesche Jurgens, Evangelia Liakoni, Fritdjof Heyerdahl, Knut Erik Hovda, Alison Dines, Isabelle Giraudon, Matthias E Liechti, Paul I Dargan
BACKGROUND: Understanding emergency department and healthcare utilisation related to acute recreational drug toxicity (ARDT) generally relies on nationally collated data based on ICD-10 coding. Previous UK studies have shown this poorly captures the true ARDT burden. The aim of this study was to investigate whether this is also the case elsewhere in Europe. METHODS: The Euro-DEN Plus database was interrogated for all presentations 1st July to 31st December 2015 to the EDs in (i) St Thomas' Hospital, London, UK; (ii) Universitätsspital Basel, Basel, Switzerland; and (iii) Zealand University Hospital, Roskilde, Denmark...
January 2, 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30499040/evaluating-the-patient-with-reported-gadolinium-associated-illness
#12
REVIEW
Tatyana Lyapustina, Charlotte Goldfine, Sean Rhyee, Kavita M Babu, Matthew K Griswold
INTRODUCTION: Gadolinium-based contrast agents (GBCAs) have been increasingly used in clinical practice since their introduction in the 1980s. Recently, increased public attention has been given to patients who report new symptoms following GBCA exposure. This review details the current knowledge surrounding GBCAs, with a focus on the known and proposed disease states that may be associated with GBCAs. Recommendations for the appropriate clinical workup of a patient suspected of having symptoms attributable to gadolinium exposure are included...
January 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30488297/study-of-factors-contributing-to-scorpion-envenomation-in-arizona
#13
Bethany K Bennett, Keith J Boesen, Sharyn A Welch, A Min Kang
INTRODUCTION: Arizona has the highest incidence of scorpion envenomation reported to US poison control centers (PCCs). Most cases reported are from a residence, but specific details are limited. METHODS: Specialists at Arizona's two PCCs prospectively completed the Factors of Envenomation in Arizona Residences Survey (FEARS) for residential scorpion exposures reported during 4-week periods in the summer and winter. Based on these results, a second questionnaire, FEARS-2, targeting indoor residential exposures was then administered...
January 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30411236/impact-of-targeted-temperature-management-on-ed-patients-with-drug-overdose-related-cardiac-arrest
#14
Sharaf Khan, Chad M Meyers, Suzanne Bentley, Alex F Manini
INTRODUCTION: Drug overdose is the leading cause of non-traumatic out-of-hospital cardiac arrest (OHCA) among young adults. This study investigates whether targeted temperature management (TTM) improves hospital survival from presumed overdose-related cardiac arrest. METHODS: Retrospective chart review of consecutive cardiac arrests presenting to an urban tertiary care hospital ED from 2011 to 2015. ED patients with cardiac arrest were included if < 50 years old, and excluded if there was a non-overdose etiology (e...
January 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30353414/the-effect-of-a-medical-toxicology-inpatient-service-in-an-academic-tertiary-care-referral-center
#15
Andrew M King, Shooshan Danagoulian, Michael Lynch, Nathan Menke, Yijia Mu, Melissa Saul, Michael Abesamis, Anthony F Pizon
INTRODUCTION: Morbidity and mortality from poison- and drug-related illness continue to rise in the USA. Medical toxicologists are specifically trained to diagnose and manage these patients. Inpatient medical toxicology services exist but their value-based economic benefits are not well established. METHODS: This was a retrospective study where length of stay (LOS) and payments received between a hospital with an inpatient medical toxicology service (TOX) and a similar hospital in close geographic proximity that does not have an inpatient toxicology service (NONTOX) were compared...
January 2019: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30543028/urinary-gadolinium-levels-after-contrast-enhanced-mri-in-individuals-with-normal-renal-function-a-pilot-study
#16
Dalia Alwasiyah, Christine Murphy, Paul Jannetto, Melanie Hogg, Michael C Beuhler
INTRODUCTION: Gadolinium-based contrast agents (GBCA) have been used to enhance magnetic resonance imaging (MRI) since 1985. Recently, the media and online groups have voiced concerns about gadolinium deposition in patients with normal renal function based on "elevated" urinary gadolinium levels. The determination of increased urinary gadolinium levels is based on reference ranges developed in individuals with normal renal function who were never exposed to GBCA. Studies suggest an elevated gadolinium urinary elimination greater than 72 h post GBCA scan...
December 12, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30539383/a-review-on-ingested-cyanide-risks-clinical-presentation-diagnostics-and-treatment-challenges
#17
REVIEW
Tara B Hendry-Hofer, Patrick C Ng, Alyssa E Witeof, Sari B Mahon, Matthew Brenner, Gerry R Boss, Vikhyat S Bebarta
Cyanide, a metabolic poison, is a rising chemial threat and ingestion is the most common route of exposure. Terrorist organizations have threatened to attack the USA and international food and water supplies. The toxicokinetics and toxicodynamics of oral cyanide are unique, resulting in high-dose exposures, severe symptoms, and slower onset of symptoms. There are no FDA-approved therapies tested for oral cyanide ingestions and no approved intramuscular or oral therapies, which would be valuable in mass casualty settings...
December 11, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30377951/pharmacologic-treatment-of-opioid-use-disorder-a-review-of-pharmacotherapy-adjuncts-and-toxicity
#18
REVIEW
Michael S Toce, Peter R Chai, Michele M Burns, Edward W Boyer
Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics...
December 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/30047044/barriers-and-facilitators-of-intensivists-adherence-to-hyperinsulinemia-euglycemia-therapy-in-the-treatment-of-calcium-channel-blocker-poisoning
#19
Eric Brassard, Patrick Archambault, Guillaume Lacombe, Maude St-Onge
INTRODUCTION: Adherence to poison center (PC) recommendations for the management of calcium channel blocker (CCB) poisoning is inconsistent. This study aimed to identify behaviors that determine adherence to hyperinsulinemia-euglycemia therapy (HIET) for CCB poisoning. METHODS: Semistructured interviews were conducted involving a convenience sample of 18 intensivists. Interview responses were analyzed using the theoretical domains framework (TDF) to identify relevant domains influencing physician adherence to HIET...
December 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://read.qxmd.com/read/29923027/acute-intoxications-involving-%C3%AE-pyrrolidinobutiophenone-%C3%AE-pbp-results-from-the-swedish-strida-project
#20
Lisa Franzén, Matilda Bäckberg, Olof Beck, Anders Helander
INTRODUCTION: Many new psychoactive substances (NPS) introduced as recreational drugs have been associated with severe intoxication and death. METHODS: Blood and/or urine samples were collected from intoxicated patients treated at Swedish hospitals that participated in the STRIDA project, a nationawide effort to address the growing problem of NPS. In patients undergoing evaluation for drug overdose, α-PBP was identified using liquid chromatography-mass spectrometry...
December 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
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