Poison Alerts

You give naloxone – a lot of naloxone – and the patient still has some CNS and respiratory depression and hypotension. What gives? Fentanyl has almost replaced heroin in recreational drugs, but the creators of such experiences are always trying…

Gabapentin (Neurontin®, others) is FDA-approved for partial-onset seizures, post-herpetic neuralgia, and restless leg syndrome; pregabalin (Lyrica®) for fibromyalgia, various painful neuralgias, and partial-onset seizures. Both have myriad off-label uses including chronic cough, migraine prophylaxis, pruritus, bipolar and anxiety disorders, hot…

Since its introduction in 1995, tramadol has become the second most-widely-prescribed opioid analgesic in the US, topped only by combination hydrocodone-acetaminophen. It is most effectively used for chronic, moderate-to-severe pain conditions such as neuropathic pain and osteoarthritis, but it also…

According to marketing slogans from the 1920s, lithium “takes the ouch out of the grouch.” Back then, it was an ingredient in 7UP® soda and sold as a hangover remedy. Long absent from soda, lithium today is a commonly prescribed mood…

Often included in “One Pill Can Kill” lists, sulfonylureas (SU) have the potential for significant toxicity in overdose. These medications were the first orally-active agents to treat Type 2 Diabetes, approved in the late 1950s, but now represent only one class among many newer antidiabetic agents and combination products.

Acetaminophen overdose is very common and if the antidote, n-acetylcysteine, is given within 8 hours it prevents hepatotoxicity in most cases. The revolutionary change in NAC dosing was introduced about 5 years ago, but the complexity of the different concentrations of NAC in each IV bag leads to frequent dosing and administration errors.

It is only natural to assume that an overdose with an agent used to treat diabetes will result in very low blood sugar. This is certainly true with insulin and sulfonylurea agents such as glipizide or glyburide, but it is not the case with metformin overdose. Metformin is one of the most commonly prescribed drugs in the world, used as a first-line treatment for Type 2 diabetes and many off-label indications such as polycystic ovary syndrome, obesity, and antipsychotic-induced weight gain.