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…
Question of the Day – Tuesday, September 27, 2022
What is the proposed mechanism of action for activated charcoal in cyclopeptide mushroom poisoning? Prevention of absorption and interruption of a-Amanitin enterohepatic recirculation. 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, September 26, 2022
What is the reported lethal dose of a-Amanitin? 0.1 mg/kg. A single mushroom contains a potentially lethal amount of the toxin. Goldfrank LR. Mushrooms. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019….
Question of the Day – Friday, September 23, 2022
How does a-Amanitin enter hepatocytes? Sodium taurocholate cotransporter polypeptide (NTCP) and organic anion-transporter polypeptide 1B3 (OATP1B3). Both are bile acid transporters located in the sinusoidal membrane of hepatocytes. Goldfrank LR. Mushrooms. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds….
Question of the Day – Thursday, September 22, 2022
What is the mechanism of toxicity of a-Amanitin? Prevents protein synthesis in hepatocytes via RNA polymerase II inhibition. Goldfrank LR. Mushrooms. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. eds. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. Accessed August 29,…
Question of the Day – Wednesday, September 21, 2022
What is the maximum safe dosage of lidocaine for tumescent lidocaine anesthesia for liposuction? Tumescent lidocaine anesthesia consists of subcutaneous injection of relatively large volumes (up to 4 L or more) of dilute lidocaine (≤1 g/L) and epinephrine (≤1 mg/L). Although some sources allow up…
Question of the Day – Tuesday, September 20, 2022
The current tumescent liposuction technique applies a subcutaneous injection of large volumes of diluted (0.05–0.10%) lidocaine as a wetting solution. Why is this technique often believed to rarely cause local anesthetic systemic toxicity (LAST)? According to the cited reference, practitioners often believe that the procedure…
Question of the Day – Monday, September 19, 2022
A patient is receiving this immune therapy to treat multiple myeloma. They present with a neurocognitive and hypokinetic movement disorder. What is the agent and what is the proposed mechanism? Ciltacabtagene autoleucel (cilta-cel). Ciltacabtagene autoleucel and idecabtagene vicleucel are B-cell maturation antigen (BCMA) targeted CAR-T…