Question of the Day – Monday January 3, 2022
How did outcomes differ among lithium-toxic patients not receiving hemodialysis in whom EXTRIP would support it but it would not be recommended based on Paris criteria? Neurologic symptoms worsened in 21% of patients. A retrospective evaluation of poison center data identified 219 patients in whom…
Question of the Day – Friday December 31, 2021
What are the proposed Australian criteria for extracorporeal removal of lithium? Chronic toxicity with signs of CNS toxicity and nomogram use suggesting lithium concentration will be > 1 mEq/L in 36 hours OR acute on chronic toxicity with lithium concentration > 5 mEq/L or >…
Question of the Day – Thursday December 30, 2021
What are the EXTRIP recommendations for extracorporeal removal of lithium? Severe lithium poisoning, impaired kidney function with lithium concentration > 4 mEq/L, decreased level of consciousness, seizures, or life-threatening dysrhythmias. Additionally, it is suggested for lithium concentration > 5 mEq/L, confusion, or if the expected…
Question of the Day – Wednesday December 29, 2021
What are the proposed Paris criteria for extracorporeal removal of lithium? Serum lithium concentration > 5.2 mmol/L or creatinine > 200 mcmol/L. A retrospective review identified 128 patients with lithium concentration above 1.5 mmol/L managed between 1993-2013 in the ICU of a single institution. Of…
Question of the Day – Tuesday December 28, 2021
What racial/ethnic disparities were reported regarding antidote use in ED patients? Black patients had 48% lower odds and Hispanic patients had 25% lower odds of receiving any antidote compared to non-Hispanic White patients. An analysis of a prospective cohort of patients presenting to two urban…
Question of the Day – Monday December 27, 2021
A 65-year-old male with a past medical history of DM2 on HD, HTN, and COPD presented to his family physician 3 weeks ago complaining of neuropathy. He was prescribed gabapentin 300 mg TID. What is one potential rare side effect cited in case reports of…
Question of the Day – Friday December 24, 2021
What is meant by the term, “resistant alcohol withdrawal (RAW)?” According to the cited reference, the term describes patients with severe or complicated alcohol withdrawal signs and symptoms despite having received high doses of benzodiazepines. There is not yet agreement in the field regarding the…
AACT Offices to Close for the Holidays
Wishing you safe and healthy holidays this year. The AACT office will be closed starting Friday, December 24th and through January 2nd. A team member will return your message when the office reopens.
Question of the Day – Thursday December 23, 2021
According to the 2020 American College of Addiction Medicine clinical practice guideline on alcohol withdrawal management, what tools should be used to monitor alcohol withdrawal delirium? According to the cited reference, structured assessment scales should be used, such as the Confusion Assessment Method for ICU…
Question of the Day – Wednesday December 22, 2021
In a recent study of 136,605 urine samples, what findings norbuprenorphine:buprenorphine (N:B) ratio can help identify potential cases of tampered urine specimens? According to the cited reference, a N:B ratio of <0.02 in concert with a high naloxone concentration (>1000 ng/mL) can help identify potential…