Administrator Clintox - One

What agents may be helpful in the treatment of methotrexate mediated neurotoxicity. Dextromethorphan and methylxanthines. 1. Fernandez-Fernandex FJ et al. Dextromethorphan and methylxanthines might be useful in the treatment of methotrexate induced neurotoxicity. Pediatric Emerg Care 2017; 33(5): 380. 2. Drachtman RA et al. Dextromethorphan…

What are the proposed mechanisms for methotrexate mediated neurotoxicity? Chronic folate depletion; homocysteine excess through folate dependent methylation and alterations of biopterin and adenosine metabolism resulting in decreased neurotransmitter synthesis. 1. Subrahmanian KN et al. Evaluation and Management of Acute Onset Hemiparesis in an Adolescent…

The street term “tranq” refers to what? In a recent report, there is increasing presence of xylazine in heroin and/or fentanyl deaths in Philadelphia, Pennsylvania. In Philadelphia, xylazine is referred to as “tranq” on the street and “tranq dope” refers to heroin and fentanyl cut…

During a chemotherapy treatment, a patient inadvertently received a 10 fold dosing error of IV methotrexate. Glucarpidase was given shortly after the dosing error was identified. 48 hours later, the serum methotrexate concentration was still markedly elevated. What is the likely culprit? False elevation of…

A patient presents with nausea, vomiting, flushing and altered mental status after participating in a cleanse the day prior. You note this on her ankle. What is the exposure? Kambo. Kambo or sapo is the dried skin scrapings from the giant leaf frog (Phyllomedusa bicolor)….

What can be used as a predictor for mortality in patients poisoned by cardiotoxic drugs? ECG and Troponin while CK-MB was not predictive. Hilal, M. A., Mahmoud, S. E., Shokry, M. M., & Said, A. M. (2020). Predictive Role of Cardiac Troponin I, Creatine Kinase-Mb…

What preceding signs or symptoms are strongly associated with hemolysis in patients’ envenomated by Loxosceles reclusa? One study found that the odds ratio for hemolysis was highest for malaise (OR 40.7) and myalgia (OR 10.2). Others included exanthema (OR 9.0), fever/ chills (OR 8.5), nausea…

Retinal pigment epithelium (RPE) changes have recently been described in a small subset of patients with poisoning from what? Organophosphates. In a recent study of 16 patients with organophosphate poisoning, RPE changes were the most commonly observed changes. The RPE is known to have α7…

What is a potentially life threatening effect of fetal salicylate poisoning? Intracerebral hemorrhage. Salicylate metabolites accumulate in the fetal brain and because of this, there have been cases of fatal intracerebral hemorrhage. Farid H et al. A 19 year old at 37 weeks gestation with…