Administrator Clintox - One

What risk factors were identified as leading to increased risk of lead toxicity due to retained bullets/fragments in a recent systematic review? Location of the retained fragment, presence of fracture or trauma, number of fragments, hypermetabolic states, and bullet retention duration Emily K. Kershner, Natasha…

Historical QOD 10/28/08: Name the King’s College Criteria for acetaminophen-induced fulminant hepatic failure necessitating liver transplantation, The criteria include a pH < 7.2, PT > 100 seconds, creatinine >3.3 mg/dL, and grade III or IV encephalopathy. Since its inception, the additional criteria of a lactate…

In a study evaluating serotonin syndrome in older adults, what were the most commonly reported symptoms? Tremor and hyperreflexia Erken N, Kaya D, Dost FS, Ates Bulut E, Isik AT. Antidepressant-induced serotonin syndrome in older patients: a cross-sectional study. Psychogeriatrics. 2022 Jul;22(4):502-508. doi: 10.1111/psyg.12849. Epub…

What medication has been applied topically to the site of an esophageal stricture in order to improve the outcome of those requiring endoscopic dilation caused by the ingestion of a caustic agent? Mitomycin C applied topically at the time of dilation has been shown to…

What pathway leads to insulin resistance in calcium channel blocker overdose? Calcium channel blockers cause dysregulation of the phosphoinositide 3-kinase pathway for glucose entry by inhibiting protein kinase B, resulting in insulin resistance and need for high doses of insulin (1-10 units/kg/hr) to treat myocardial…

Holiday Tox: In the beloved Dr. Seuss story “How the Grinch Stole Christmas”, the song unforgettably sung by Thurl Ravenscroft compares him to sandwich with two toxic substances. 1. If one were to eat the Grinch sandwich, what effects might follow? 2. What antidotes may…

Historical QOD 10/24/08: Name medications implicated in drug-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. This list is quite extensive, but can include ticlopidine, clopidogrel, ciprofloxacin, cephalexin, piperacillin, metronidazole, penicillin, famotidine, cimetidine, certain statins, antineoplastic agents, cyclosporine, tacrolimus, interferon, and quinidine. Dlott JS et al. Drug-induced thrombotic…

In which industrial/occupational settings has Dinitrophenol has been used? DNP has been used in munitions manufacturing, it has also been used as a dye, wood preservation, herbicide and photographic developer Grundlingh J, Dargan PI, El-Zanfaly M, Wood DM. 2,4-dinitrophenol (DNP): a weight loss agent with…

In a study evaluating the performance of urine drug screening (UDS) in trauma patients using LC-MS confirmatory testing, what were the most common false negative results? The most common substances identified with LC-MS that screening negative on UDS were gabapentin, opioids (fentanyl, buprenorphine, hydrocodone, oxycodone,…

In a recent retrospective study, what did amlodipine poisoned patients treated with high dose insulin require more of? Cole J et al. performed a retrospective review of calcium channel blocker poisonings from a single poison center over a two year time frame. The authors found…