Archive for category: Toxicology

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

25 May
May 25, 2017

Background: Salicylates are common substances that can be purchased over the counter. They are readily available, and in the setting of an overdose, can be fatal [1]. Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. This is then followed by an anion gap metabolic acidosis. Due to the metabolic derangements induced by […]

Local Anesthetic Systemic Toxicity (LAST)

18 May
May 18, 2017

Definition: A life-threatening adverse reaction resulting from local anesthetic reaching significant systemic circulating levels. Local Anesthetic Systemic Toxicity (LAST) is rare and almost always occurs within minutes of injection of the local anesthetic. Causes: Injection of local anesthetic into the systemic circulation (either errantly as part of a regional block i.e. Bier block) Rapid absorption […]

Baclofen Withdrawal

27 Oct
October 27, 2016

Definition: A dysfunctional condition in which removal of baclofen, an inhibitory neurotransmitter, from the central nervous system (CNS) causes CNS excitation.

Benzodiazepine-Refractory Alcohol Withdrawal

28 Apr
April 28, 2016

Background: Severe alcohol withdrawal syndrome (AWS) accounts for only 10% of the roughly 500,000 annual cases of AWS episodes that require pharmacologic treatment. AWS is characterized by an imbalance between inhibitory GABA and excitatory NMDA receptor stimulation secondary to chronic ethanol intake. Treatment is typically centered around supportive care and symptom-triggered benzodiazepines. However, some patients are refractory […]

Intravenous Fluids and Alcohol Intoxication

01 May
May 1, 2014

Frequently, patients with acute alcohol intoxication are brought to the emergency department (ED) for evaluation and treatment.  Although practice patterns vary, it is not an uncommon practice to give normal saline to these patients in the hopes that the saline will cause a dilution effect on the level of alcohol helping patients sober faster and […]

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