Question Of The Day

What are the most common side effects of buprenorphine/naloxone treatment? According to the package insert for the Suboxone film, the most common side effects are headache (36%), nausea (15%), and vomiting (8%). Other potential side effects include constipation, pain, increased sweating, and insomnia. https://www.suboxone.com/content/pdfs/prescribing-information.pdf  

It has been noted that the residual calculated osmolal gap increases with increasing ethanol levels. Purssell et al. found that there is a linear relationship between the serum ethanol level and the osmolal gap. What do they suggest the multiplicative factor for ethanol in formulas…

Patients with this genetic polymorphism are potentially at higher risk of the decreased therapeutic effect of diazepam? Skryabin VY et al. recently evaluated the effects of CYP2C19 genetic polymorphisms on the steady state concentration of diazepam in patients with alcohol withdrawal syndrome. They postulate that…

This has been an effective and well-tolerated treatment strategy for patients with major depressive disorder who are partial or non-responders to antidepressant therapy? L-methylfolate 15 mg/day added to SSRIs or as monotherapy can be an effective and well tolerated treatment strategy. It is particularly effective…

What is the case fatality rate for dinitrophenol? Gziut T et al. retrospectively evaluated dinitrophenol exposures from 38 countries between January 2010 and September 2020. 456 separate cases of DNP exposures were evaluated. Case fatality overall was 11.9% (95% CI 9, 15.4). Gziut T &…

What is the most common home remedy used in Nigeria for pediatric poisonings? A retrospective study of 127 children that presented to the emergency department in a teaching hospital in Nigeria from 1989 through 1998 revealed that oral administration of palm oil is the most…

What was the effect of IV calcium chloride used for hyperkalemia due to acute digoxin toxicity in a porcine model? While no definitive conclusion, the administration of IV calcium chloride for hyperkalemia in digoxin toxicity does not appear to be as detrimental as older literature…

What is the benefit of IV single bag high dose NAC when compared with standard triple bag IV NAC in high-risk acetaminophen ingestions? In a recent retrospective study the outcome of severe hepatotoxicity in high risk acetaminophen ingestion was compared between the standard triple bag…

In a recent study evaluating the use of high dose NAC for massive acetaminophen overdose, was there a statistically significant difference in outcome compared to standard dose? This study was unable to identify a statistically significant difference between high dose and standard dose NAC used…

In the case series examining the use of fomepizole as an adjunct in the treatment of acetaminophen overdose, what is the proposed mechanism for how fomepizole would reduce hepatotoxicity in patients with acetaminophen toxicity? Fomepizole is a CYP2E1 inhibitor, which can prevent acetaminophen conversion to…