Question Of The Day

What heavy metal can exist in vapor, liquid and elemental states that produces its toxicity through irreversible inhibition of selenoenzymes? Mercury; Mercury can exist in three states as mercury vapor, elemental mercury as liquid and inorganic salts and organic compounds. Mercury can enter the body…

What is the mechanism of quinine-induced hemolytic-uremic syndrome (HUS)? According to the cited reference, the likely mechanism by which quinine induces HUS is via quinine-dependent antibodies to blood cellular constituents. These antibodies likely cause endothelial damage and the resultant nephropathy, microangiopathic hemolytic anemia, and thrombocytopenia…

What receptor mechanisms may explain dexmedetomidine’s efficacy in serotonin syndrome? Dexmedetomidine stimulates alpha-2C receptors in the striatum, which decreases serotonin levels. Additionally, alpha-2 receptors located on serotonergic terminal axons may inhibit serotonin release. Lastly, alpha-2A receptor agonism in the prefrontal cortex and locus ceruleus causes…

What is the antidote to botulinum toxicity? BAT is the only specific treatment for botulism, and the antitoxin should be given to patients as soon as possible after clinical diagnosis. Min M, Bai L, Peng X, Guo L, Wan K, Qiu Z. An Outbreak of…

According to a landmark 1981 study that researched surrogate markers for Iron toxicity, what are 5 markers that may help predict a serum iron level >300 ug/dL? WBC >15000, BG >150, presence of vomiting, presence of diarrhea and positive radiographical evidence of iron in the…

Which antioxidant has preclinical studies occurring to evaluate its effectiveness in reducing MTX toxicity for rheumatoid arthritis? Zinc Katturajan R, S V, Rasool M, Evan Prince S. Molecular toxicity of methotrexate in rheumatoid arthritis treatment: A novel perspective and therapeutic implications. Toxicology. 2021 Sep;461:152909. Submitted…

Among high-risk acetaminophen overdoses with [APAP] x AT products >/= 10,000 mg-IU/L2 and starting IV acetylcysteine (NAC) > 8 h after OD, what were the outcomes of using a one-bag, standard concentration NAC protocol compared to the three-bag NAC protocol? A retrospective study compared one-bag,…

A busy urban emergency department prospectively compared two IM treatments for patients with agitation who presented to their intoxication unit. The choice of treatment was dependent on availability. When droperidol was available, 5 mg was administered and when olanzapine was available, 10 mg was administered….

In a recent study, what effect did NAC have on INR? Minhag FS et al. recently performed an in-vitro study using blood samples from 11 healthy volunteers to evaluate the effect of different NAC doses on INR. Blood was spiked with different concentrations of NAC…

Illicit benzodiazepines are increasingly being detected both forensically and clinically. In a recent MMWR report from the ToxIC Fentalog Study Group, what were the three most commonly identified illicit benzodiazepines identified in patients with suspected opioid overdose? During October 2020 and March 2021, the presence…