Carolinas Electronic Compendium - Tox Blog
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Toxicology Blog authored by Dr. Chrissy Zauner.
Carolinas Electronic Compendium - Tox Blog
4y ago
Authored by: Dr. Chrissy Zauner
Introduction:
Laundry pod detergents were introduced to the market in the US in 2010. Following this in 2012-2013, the National Poison Data system recorded 17,230 exposures in children younger than the age of 6. The vast majority of ingestions were unintentional due to the candy like design of the pod. Most papers available are case reports, serious outcomes include: superficial partial thickness burns, seizures, respiratory failure requiring intubation.
Recently, there has been a surge in intentional ingestions among teenagers. “Tide ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Authored by Dr. Enola Okonkwo
Introduction
Artemether Lumefantrine is an oral medication which is used in treatment of chloroquine resistant uncomplicated malaria. Artemether Lumefantrine falls within the drug class of Artemisinin-based combination therapies which have been found to be highly effective in treating malaria and are substantially less toxic than quinoline antimalarials. Artemisins are derived from a Chinese medicinal herb which comes from the sweet wormwood plant (1). Artemether Lumefantrine, known by the brand name Coartem, is the most widely ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Authored by Dr. Kyle Roedersheimer
Introduction to ADHD
ADHD is the most well-known and researched neurodevelopmental disorder of childhood
Approximately 5-6% of children and 2-3% of adults
Both genetic and environmental factors are implicated
The genes that are thought to code for ADHD are involved in the heritability of autism spectrum disorders and Tourette’s disorder
In general, there are three types of ADHD; Inattentive, Hyperactive and Combined
History of Amphetamines
First synthesized in 1887 and then first marketed in 1932 as a nasal decongestant
Both amphetamine and met ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Authored By: Meredith Binford
Background:
Proton pump inhibitors (PPIs) inhibit H+K+ATPase proton pumps in the stomach to reduce acid excretion. Among the most frequently prescribed drugs worldwide and are generally well tolerated. Now they are available for long-term use without medical supervision. Often prescribed to circumvent GI side effects from dual antiplatelet agents used for cardiovascular disease secondary prevention. However recent observational studies have linked PPI use to increased cardiovascular risk (MI and stroke) even in patients not taking antiplatelet agents.
Mechan ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Authored by Dr. Natalie Wood
Soursop is the fruit of the evergreen tree, Annona muricata . This tree is native to tropical regions in the South and Central America. Often used in foods, also widely advertised as an anticancer agent.
Uses:
-The flesh of the fruit consists of an edible, white pulp , some fiber, and a core of indigestible, black seeds. Used in foods
-eaten as dessert
-smoothies, fruit juice drinks -candy
-sorbets and ice cream flavoring
-Traditional medicinal uses for diarrhea, liver disease, heart disease, intestinal parasites, diabetes, and cancer. -Pe ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
“Another product that power methadone is omeprazole…the methadone high I’m feeling is very pleasant.” -Adicted, member of drugs-forum.com
Authored by: Dr. B. Zach Hedges
Background
Omeprazole
irreversibly inhibits H+-K+ ATPase to lower gastric acid secretion
metabolized by 2C19, substrate of 3A4, time to peak 30min – 3hrs
plasma T1/2 30 min to 1hr, although effects on acid secretion lasts 3-5 days
excreted in urine (77%), T1/2 0.5-1hr
Methadone
-µ opioid receptor agonist
&n ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Introduction
Naturally-occuring plant-derived alkaloid; is a carbamate that reversibly inhibits cholinesterases in the PNS and CNS
Is a tertiary amine à allows CNS penetration (where the quaternary amine structure of neostigmine and pyridostigmine limits CNS penetration)
Used to treat anticholinergic effects of numerous medications and toxins incluiding, TCAs and phenothiazines
Single study found to address use as a diagnostic tool in suspected anticholinergic syndrome
Mechanism of action:
Reversibly binds to acetylcholinesterase
Is metabolized by acetylcholinesterase. While the tim ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Introduction
Withdrawal states can have a wide range of cardiovascular and neurological signs and symptoms
While neurological findings such as agitation, seizures, or lethargy are often the predominant focus in management, cardiovascular changes can have significant implications on a patient’s clinical course
Cardiomyopathies, specifically stress-induced cardiomyopathy, can accompany withdrawal states from multiple agents
Pathophysiology
Stress Induced Cardiomyopathy à Takotsubo Cardiomyopathy (TTC)
Transient LV dysfunction due to akinesia of midapical segments without primary coronary v ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Introduction
One of the most potent opioids created, known as Wildnil.
This was originally created to sedate large mammals.
Commonly used as positron emission tomography scan radioligand
Pharmacology
Carfentanil acts predominately on mu opioid receptors as a strong competitive agonist.
Opiate receptors are G-protein receptors in which binding of the opiate stimulates GTP -> GDP. This decreases the intracellular cAMP by inhibiting adenylate cyclase. This hyperpolarizes the cell and reduces neurotransmitter release.
Biological half-life 7.7 hours
Potency 10,000 times of morphine and 1 ..read more
Carolinas Electronic Compendium - Tox Blog
4y ago
Introduction
-Etomidate is an intravenous nonbarbiturate hypnotic
-Developed in the 1970s, found to be an effective hypnotic [1]
-Used as anesthesia induction agent and for first decade, used as sedative infusion
-Discovered to cause adrenal suppression and increased mortality in some critically ill patients
-Now predominately used as sedative medication in rapid sequence intubation (RSI)
Structure
- Available as 2mg/mL solution in 35% propylene glycol solution
- Available in lipid solution in Europe, reportedly less pain on infusion
- Sedative bolus at 0.2-0.4mg/kg, general anest ..read more