Question of the Day – Thursday March 25, 2021
Which prescription medication is metabolized to diethyldithiocarbamate (DDC) and is used off-label as a nickel chelator? Disulfiram. Disulfiram is a prescription drug that is metabolized by cleaving the disulfide bond to yield two molecules of DDC (a nickel chelator used outside of the USA). Disulfiram…
Question of the Day – Wednesday March 24, 2021
What weight loss supplement, labelled as extremely dangerous and not fit for human consumption in 1938, continues to be used today and has similar toxicological mechanism to salicylate toxicity? Dinitrophenol (DNP) Dinitrophenol, like aspirin, decouples oxidative phosphorylation. The energy that no longer can be made…
Question of the Day – Tuesday March 23, 2021
A 38 yo female with large B cell lymphoma who received a CAR-T cell infusion 7 days ago presenting with a temperature of 39°C, RR 26 rpm, BP 70/40, SaO2 84% on room air, that did not respond to 6 L of supplemental oxygen by…
Question of the Day – Monday March 22, 2021
What structural property of alprazolam has been cited in discussion of its differntial pharmacological effects when compared with other benzodiazepines? Alprazolam is a triazolobenzodiazepine with a benzodiazepine receptor affinity roughly 4 times that of diazepam. It is an intermediate acting benzodiazepine with an elimination half life of 12…
Important Announcement Regarding NACCT 2021
Dear Friends and Colleagues, The American Academy of Clinical Toxicology (AACT) Board of Trustees and the American Association of Poison Control Centers (AAPCC) Executive Committee have agreed to develop a “hybrid” meeting of the North American Congress of Clinical Toxicology (NACCT). This means there will be…
Question of the Day – Friday March 19, 2021
What is the dosing and frequency of clonazepam that has been reported to be efficacious in cessation of alprazolam without significant withdrawal symptoms? Substitution of clonazepam for alprazolam at a mg per mg dose divided twice daily, with a 1 to 1.5 mg daily reduction every…
Question of the Day – Thursday March 18, 2021
What findings have been associated with neonatal venlafaxine discontinuation syndrome? poor feeding, jitteriness, respiratory distress, and myoclonic seizure-like activity have been reported. Holland J, Brown R. Neonatal venlafaxine discontinuation syndrome: A mini-review. Eur J Paediatr Neurol. 2017 Mar;21(2):264-268. doi: 10.1016/j.ejpn.2016.11.003. Epub 2016 Nov 25. PMID:…
Question of the Day – Wednesday March 17, 2021
What is the proposed mechanism for false positive enzymatic ethanol assay results? Enyzmatic ethanol assays measure the production of NADH from NAD+ which is formed at the same molar per molar ratio of ethanol to acetylaldehyde. Lactate is metabolized to pyruvate with the same molar…
Question of the Day – Tuesday March 16, 2021
What are the most common immune related adverse events from Immune Checkpoint Inhibitors (ICIs)? Dermatologic skin findings are the most common presentatio of immune related adverse events from ICIs. Most immune related adverse events occur within 3 – 6 weeks of starting therapy with the…