Question Of The Day

According to a recent article, what blood level of caffeine should providers consider hemodialysis? Greater than 140 mg/dL. Yoshizawa T, Kamijo Y, Hanazawa T, Usui K. Criterion for initiating hemodialysis based on serum caffeine concentration in treating severe caffeine poisoning. Am J Emerg Med. 2021…

What is Blue Lotus? Blue Lotus (Nymphea nouchali) is an aquatic plant naturally found in parts of eastern Africa and the Middle East. It has been used as a sleep aid and anxiolytic. With larger doses a variety of effects were described in this case…

What is the estimated lethal dose of sodium chloride? The estimated lethal dose of sodium chloride is 0.75-3 g/kg. Soy sauce contains 17-18% sodium chloride and ingestion of large quantities of soy sauce can result in rapid hypernatremia and death if not rapidly identified and…

Herbal dietary supplements were responsible for what percentage of cases of acute liver failure that led to listing with the United Network for Organ Sharing between 2013 and 2020? Between 1995 and 2020 investigators using the United Network for Organ Sharing database report that from…

A recent double-blinded, randomized clinical trial comparing physostigmine (bolus and infusion) and benzodiazepines for the treatment of antimuscarinic delirium and agitation, found superior control of agitation and delirium after bolus dosing in which group? According to the cited reference, physostigmine provided superior control of delirium…

What patient and clinical characteristics are most strongly associated with severe outcomes in patients presenting with acute diphenhydramine poisoning? According to the cited reference, acidemia, QRS prolongation (>120ms), and elevated anion gap are most strongly associated with severe outcomes in diphenhydramine toxicity. Acidemia was the…

A recent case report presented a case of severe gabapentin withdrawal after a brief accidental pause of the medication. What treatment do the authors recommend for gabapentin dependence and withdrawal? The authors of the cited reference recommend a patient-centered, slow taper in patients with severe…

What role does black pepper play in the abuse of loperamide? Black pepper, which contains piperine, an inhibitor of both P-gp and CYP3A4, is used to enhance the systemic absorption and central nervous system penetration of loperamide. Wu PE, Juurlink DN. Clinical Review: Loperamide Toxicity….

Although gabapentin appears safe, even at high doses, a withdrawal syndrome is rarely reported after abrupt cessation. What symptoms are associated with gabapentin withdrawal? According to the cited reference, patients with gabapentin withdrawal can experience anxiety, diaphoresis, palpitations, agitation, altered mental status, headaches. Seizures and…

What treatment is recommended for patients with quinine-induced hemolytic-uremic syndrome? According to the cited reference, although there is no set guideline for the treatment of quinine-induced HUS, most authorities consider plasmapheresis as the standard of care, especially in severe cases. In the cited case report,…