Archive for category: Toxicology

Do Patients with Opioid Dependence Benefit from Buprenorphine/Naloxone Treatment Initiation in the Emergency Department?

09 Oct
October 9, 2017

Background: North America’s current opioid crisis, much of it iatrogenic (2), has led to significant increases in ED visits associated with opioids (3). These patients often present after poisoning, in withdrawal, or with other health issues associated with their disease. It is well accepted that Opioid Replacement Therapy (ORT), namely, methadone and buprenorphine/naloxone, are successful harm […]

Should You Prescribe Oral Thiamine for Chronic Alcoholics?

07 Sep
September 7, 2017

Background: Alcoholism is a chronic disease with a staggering impact on society, costing the nation approximately 100 billion dollars per year, an expenditure greater than the costs associated with all cancers and respiratory diseases combined (Whiteman 2000). Large public hospital emergency department studies have demonstrated the enormous strain of alcohol use on resources, and the disproportionate […]

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.

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