These articles contain toxicology information, ED scenarios, timely topics, updates, and research.
Second-generation antipsychotics (SGA) include aripiprazole (Abilify®), quetiapine (Seroquel®), risperidone (Risperdal®), olanzapine (Zyprexa®) and ziprasidone (Geodon®). They were originally called “atypical neuroleptics” when introduced in the 1990s because they had an “atypical” side effect profile compared to the long-used, first-generation antipsychotics (FGA) such as haloperidol and the phenothiazines.
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How to Properly Manage Snake Bites Snake bite calls have been increasing at the Missouri Poison Center signaling the start of snake season as the warmer weather brings snakes (and people!) out of their nests. Most snakes found in Missouri are harmless and beneficial in the ecosystem, but we have five venomous species. We have already seen unnecessary and potentially harmful interventions used in the management of snake bites in hospitals across Missouri. Before you manage your next snake bite, review our recommendations for optimum treatment of a snake bite.
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Chloroquine & Hydroxychloroquine Chloroquine (formerly Aralen®) and its close relative Hydroxychloroquine (Plaquenil®) are in the news as potential treatments for COVID-19. Individuals are obtaining supplies of these drugs from both pharmaceutical and non-pharmaceutical sources, intending to use them either as prophylaxis and/or as treatment for COVID-19.
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Although they end in “lol,” beta blocker overdoses are no laughing matter. They require careful management since they can cause life-threatening effects. Recently, the Missouri Poison Center updated and clarified its guidelines to ensure the best evidence-based treatment of beta blocker overdoses
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The marijuana plant produces numerous related compounds; the two most abundant are ∆9 THC (tetrahydrocannabinol) and CBD (cannabidiol). THC is responsible for the psychoactive effects, while CBD is non-psychoactive but purported to have beneficial health effects.
Read MoreChemical burns are common injuries seen in the ED, but some potentially caustic agents are not obvious. The ash residue which remains after wood is burned contains variable amounts of potassium hydroxide and potassium carbonate. The solution of lye that results from wood ash soaked or boiled in water is …
Read MoreTwo million Americans have Opioid Use Disorder (DSM-V), showing a pattern of opioid use leading to problems or distress. One distinguishing characteristic is experiencing withdrawal and taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms. Another is craving – the intense desire for repeated opioid use. …
Read MoreDoes anything surprise us anymore?– Yes, even the over-the-counter antidiarrheal drug, loperamide (Imodium), can be abused. It is a legal, inexpensive, and accessible alternative for someone with opioid use disorder, or merely curious about the pleasurable effects of opioids. It is also used for self-treatment of opioid withdrawal symptoms, giving …
Read MoreQUICK FACTS Sodium bicarbonate has been touted as a home-remedy detox to pass a drug test. A quick internet search of “baking soda to pass drug test” yields >1 million search results. Sodium bicarbonate plus gastric acid releases carbon dioxide. Doses suggested on the internet for detox are not safe. …
Read MoreQUICK FACTS Baclofen reduces muscle tone and spasticity. It has a delayed peak and prolonged half-life in overdose. Deep coma with absent brain stem reflexes may mimic brain death in overdose. Treatment is symptomatic and supportive, there is no antidote. Baclofen controls muscle spasticity in conditions such as multiple sclerosis …
Read MoreQUICK FACTS Venlafaxine and desvenlafaxine can cause delayed onset seizures. There is also a risk of serotonin toxicity in overdose. There are active metabolites, so symptoms can be prolonged. Benzodiazepines are the first line treatment to manage seizures. Venlafaxine (Effexor®) is a popular medication used to treat numerous conditions such …
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While not particularly in vogue as abused substances, use of inhalants for euphoriant effects caused several dozen toxic cases in Missouri in the last 2 years, including 2 fatalities.
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