Question of the Day – Monday, February 28, 2022
Which chelator is FDA-approved for clinically-significant internal contamination with radioactive americium-241? DTPA, or diethylenetriamine pentaacetate. DTPA is indicated for treatment of internal contamination with radioactive plutonium, americium, or curium. Treatment should be started as soon as possible after contamination, and ideally within the first 24…
Question of the Day – Friday, February 25, 2022
What type of hepatotoxicity is associated with iron poisoning? Zone 1 (periportal) necrosis. Toxicity is related to oxidative damage due to high concentrations of iron and oxygen in the periportal region. Contributor: Rachel Schult, PharmD, DABAT, University of Rochester Medical Center Tenenbein M. Hepatotoxicity in…
Question of the Day – Thursday, February 24, 2022
What gases may be produced during welding in the presence of trichloroethyene? Phosgene and dichloroacetyl chloride. A case report describes use of trichloroethylene as a degreaser prior to welding resulting in respiratory symptoms followed by delayed pulmonary edema. Formation of phosgene and dichloroacetyl chloride from…
Question of the Day – Wednesday, February 23, 2022
What solvents are associated with dying back peripheral neuropathy? N-hexane and methyl n-butyl ketone. Axonal destruction results from the metabolite, 2,5-hexanedione, and starts in a stocking-glove distribution. Contributor: Rachel Schult, PharmD, DABAT, University of Rochester Medical Center Chang YC. Neurotoxic effects of n-hexane on the…
Question of the Day – Tuesday, February 22, 2022
Polycyclic aromatic hydrocarbons found in tobacco smoke are associated with clinically significant drug interactions related to what hepatic enzyme effect? CYP1A2 enzyme induction. This increases theophylline clearance up to 100% leading to potential toxicity after smoking cessation. Some authors recommend decreasing the dose of CYP1A2…
Question of the Day – Monday, February 21, 2022
What food additive resulted in increased clearance of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)? Olestra. Initially investigated as a dietary fat substitute, olestra administration resulted in clearance rates 8-10 times higher in 2 patients with TCDD exposure. Contributor: Rachel Schult, PharmD, DABAT, University of Rochester Medical Center Geusau A,…
Question of the Day – Friday, February 18, 2022
Why are free serum concentrations recommended for monitoring of phenytoin and valproic acid in patients with renal failure? Uremia. Both phenytoin and valproic acid are highly bound to serum albumin and are displaced from protein binding sites in the presence of uremia. Contributor: Rachel Schult,…
Question of the Day – Thursday, February 17, 2022
What is the mechanism of clarithromycin interaction with digoxin? Clarithromycin inhibits p-glycoprotein and is associated with a 70% increase in digoxin serum concentrations after 7 days of combination therapy. Contributor: Rachel Schult, PharmD, DABAT, University of Rochester Medical Center Tanaka H, et al. Effect of…
Question of the Day – Wednesday, February 16, 2022
What are the metabolism/transport effects of St. John’s Wort? Cytochrome P450 enzyme induction (including CYP3A4) and p-glycoprotein induction due to pregnane-X-receptor activation. Contributor: Rachel Schult, PharmD, DABAT, University of Rochester Medical Center Nicolussi S, et al. Clinical relevance of St. John’s Wort drug interactions revisited….
Question of the Day – Tuesday, February 15, 2022
Lead intoxication can mimic what rare inherited disease? Lead intoxication can mimic the presentation of acute intermittent porphyria with diffuse abdominal pain, vomiting, irritability and mood disturbances. Contributor: Michael J. Hodgman, MD, Upstate New York Poison Center, Dept. of Emergency Medicine, SUNY Upstate Willett LL,…