
Second Generation Antipsychotic Overdose
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.

SPECIAL ALERT: How to Properly Manage Snake Bites
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.

SPECIAL ALERT: Chloroquine & Hydroxychloroquine
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.

Beta Blocker Overdose
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

Marijuana and CBD: Use, Intoxication, and Treatment
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.

Wood Ash and Water as the Cause of Superficial Alkaline Burns in a Toddler
Chemical 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…

What is Kratom? Which of Your Patients Might Be Using It?
Two 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. …

Loperamide – An Unexpected Drug of Abuse
Does 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…

Gastric Perforation After Baking Soda Ingestion to Beat a Drug Test
Sodium bicarbonate has long been touted among alternative remedy aficionados as an effective agent for general cleansing and detoxification of the body, skin and hair. This reputation propelled it into another customer base for home-remedy detox – the drug user facing a urine drug screen. Internet suggestions for sodium bicarbonate…
