Question of the Day – Monday, October 10, 2022
What is the proposed mechanism of action for N-acetylcysteine in cyclopeptide mushroom poisoning? Non-specific hepatoprotective effects due to free radical scavenging and glutathione repletion and is typically recommended to be administered using the standard IV NAC regimen. Ye Y. Management of Amanita phalloides poisoning: A…
Question of the Day – Friday, October 7, 2022
Nitrous oxide causes a functional vitamin B12 deficiency by what mechanism? Irreversible oxidation of the central cobalt ion from its monovalent to divalent state, rendering B12 inactive. Methylcobalamin and adenosylcobalamin, the activated forms of Vitamin B12, are necessary cofactors for two essential enzymes involved in…
Question of the Day – Thursday, October 6, 2022
According to a recent retrospective analysis of prospectively collected data from patients with snakebite reported to the ToxIC North American Snakebite Registry, crotalidae immune F(ab’)2 (equine) was superior to crotalidae immune polyvalent Fab (ovine) in preventing what sequelae of North American rattlesnake envenomation? Late hemotoxicity….
Question of the Day – Wednesday, October 5, 2022
According to a recent systematic review of ethylene glycol poisoning, what was the glycol concentration that best predicted acute kidney injury? AKI was expected if the glycolate concentration was >12.9 mmol/L, (sensitivity 78.5%, specificity 88.1%, positive predictive value 86.4%, negative predictive value 80.9%). This correlated…
Question of the Day – Tuesday, October 4, 2022
What is the proposed mechanism of action for silibinin in cyclopeptide mushroom poisoning? Reduced enterohepatic recirculation and uptake into hepatocytes through organic anion-transporter (OAT) inhibition. Ye Y. Management of Amanita phalloides poisoning: A literature review and update. J Crit Care. 2018;46:17-22. doi: 10.1016/j.jcrc.2018.03.028.
Question of the Day – Monday, October 3, 2022
What is the proposed mechanism of action for penicillin G in cyclopeptide mushroom poisoning? Prevention of a-Amanitin uptake into hepatocytes via organic anion-transporter polypeptide 1B3 (OATP1B3) inhibition. The suggested dose of 1 MU/kg/day is at least 2-3 times higher than doses typically used for antibiosis….
Question of the Day – Friday, September 30, 2022
According to a recent systematic review, at what ethylene glycol concentration threshold is ethanol monotherapy expected to fail? Contrary to fomepizole, the ethylene glycol concentration appeared to predictive of ethanol failure in the cited systematic review. The authors postulate that the higher affinity and/or better…
Question of the Day – Thursday, September 29, 2022
According to a recent systematic review, at what ethylene glycol concentration threshold is fomepizole monotherapy expected to fail? As suggested by prior reports, the cited reference did not identify an ethylene glycol concentration over which fomepizole treatment is expected to fail. Adverse outcomes and treatment…
Question of the Day – Wednesday, September 28, 2022
What is Samidorphan? Samidorphan is a µ-opioid receptor antagonist that also has partial agonist activity at κ- and δ-opioid receptors in vitro. It has µ-opioid antagonist effects that last up to 24 hours and hasgreater affinity for the µ-opioid receptor than both naltrexone and buprenorphine. In…
Mark Thoman, MD, FAAP, FAACT, FACMT 1936-2022
Mark Thoman, MD, passed away in Tucson, Arizona, on September 15th, just as NACCT was getting underway in San Francisco. This is a memorable description of Mark’s dedicated lifetime as a pediatrician and his role in the remarkable founding efforts of AACT, AAPCC and ACMT….