Question Of The Day

The sodium dithionite test in urine confirms this toxin? In a patient with paraquat or diquat poisoning, their urine will turn blue or green, respectively when sodium dithionite in sodium hydroxide is added to their urine. Koo JR et al. Rapid analysis of plasma paraquat…

A 50 yo male has collapsed after ingesting aconite. The cardiac monitor displays ventricular tachycardia without a pulse and hypotension. Which antidysrhythmic is recommended as first-line therapy for aconite induced ventricular tachydysrhythmia? The authors recommended amiodarone followed by lidocaine and phenytoin. Wood C, Coulson J,…

This ratio has been postulated to be a predictor for delayed neuropsychiatric sequalae secondary to carbon monoxide poisoning? Serum Glucose/Potassium Ratio Demirtas E. et al. Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning. Human and Experimental Toxicology….

Dietary supplements are estimated to be responsible for thousands of emergency department visits annually. What were the top two prohibited stimulants identified in some dietary supplements? In a recent analysis of 17 brands of supplements, 9 prohibited stimulants were identified with deterenol and phenpromethamine being…

A recent review of poison center data shows an increase incidence of sodium nitrite exposures. What was the mortality rate in this study? McCann SD et al. reports a rising incidence of intentional sodium nitrite exposures to poison centers particularly since 2017. They observed a…

What poison is thought to be behind Socrates fatal ingestion? Coniine in poison hemlock (Conium maculatum). The description of Socrates death includes centripetal paralysis and loss of sensation spreading from feet to abdomen, and maintenance of alertness. Coniine, an alkaloid of great importance in common…

What is deterenol? Deterenol is a pure beta-agonist that was used briefly in Europe 40 years ago as an ophthalmic medication. It has never been marketed as a pharmaceutical in the United States. In 2004 the FDA declared deterenol an un-allowed dietary supplement. Despite this…

What is Chlormequat? Chlormequat is a plant growth regulator that has direct agonist activity at muscarinic and nicotinic acetylcholine receptors in mammals. Hartter I, Remane D, Rabe C, Wissenbach DK, Peters FT, Eyer F. Surviving chlormequat poisoning – pharmacokinetics and the role of atropine. Clin…

Veratrum toxicity is reported after inadvertent ingestion of Veratrum viride (false hellebore) mistaken for which plant? Allium tricocca (ramps or wild leeks). A case report describes accidental ingestion resulting in vomiting, paresthesias, diaphoresis, bradycardia, and hypotension. The patient recovered approximately 8 hours post-ingestion with supportive…

What is the suspected mechanism of carbapenem-induced reduction in valproic acid serum concentrations? Acylpeptide hydrolase inhibition. Valproic acid is conjugated with glucuronic acid in the liver and excreted in bile. Acylpeptide hydrolase in the gastrointestinal tract removes glucuronic acid causing reabsorption of valproic acid and…