Question Of The Day

In a retrospective review of gabapentinoid related deaths in Australia from 2000-2020, what was the frequency of detection of opioids and sedative hypnotics? Drugs other than gabapentioids were detected in 99.8% of cases. Opioids were detected in 90.1%, and sedative hypnotics in 76.9%. Of note,…

Bloom of which species of dinoflagellate has recently been attributed to death from paralytic shelfish poisoning in Alaska? Alexandrium Catenella bloom resulted accumulation of saxitoxin in blue mussels and dogwinkle snails. Ingestion of these self harvested mollusks resulted in death of a patient in a…

What were the main findings of a 12 year retrospective study on pediatric ED visits for cannabis intoxication in Toronto from 2008-2019? “Children with cannabis-related ED visits in the peri-post legalization period experienced significantly higher rates of ICU admission compared to those who presented in…

In 21 patients treated with repeated titrated doses of digoxin-Fab, what was the median total dose of digoxin-Fab? Chan BS et al. reported experience with titrating doses of digoxin antibodies in acute digoxin poisoned patients and in 21 patients, the median dose of digoxin-Fab was…

What are the most commonly reported clinical effects after perampanel overdose? In a recent retrospective review of the National Poison Data System, drowsiness, agitation, ataxia and confusion were the most frequently reported clinical effects after perampanel overdose. Minhaj FS et al. Clinical effects and outcomes…

This antidote has recently been shown to generate thiocyanate by directly interacting with cyanide. Sodium tetrathionate. Chan A et al. Development of sodium tetrathionate as a cyanide and methanethiol antidote. Clin Tox Published online July 2021. https://doi.org/10.1080/15563650.2021.1953517  

In 20 out of 266 patients who presented to the emergency department after an opioid overdose 19/20 (95%) tested positive for fentanyl. Most required no venipuncture and were ineligible for the study. Was there a correlation between naloxone dose equivalents and blood fentanyl concentrations? No….

In a retrospective study of pediatric patients ages (0-18 years) who presented to the ED of a single urban hospital in Arizona, the authors compared patients treated with serial single vial doses of scorpion F(ab’)2 antivenom vs the FDA approved dosing of a single dose…

What kind of reproductive toxicity was seen in Swiss male mice after chronic exposure to cannabidiol (CBD)? There was a decrease in total circulating testosterone by 76% (still within normal physiological range), an increase sperm head abnormalities, and a 38% reduction in the amount of…

How is CBD metabolized? CBD is metabolized in the liver and intestine by cytochrome P450 enzymes including CYP2C19 and CYP3A4 and 5′-diphosphoglucuronosyltransferase (UGT) isoforms including UGT1A7, UGT1A9, and UGT2B7. Interetsingly, CBD has also been documented as an inducer and inhibitor of CYP3A and CYP2C, as…