Archive for category: Toxicology

The HOUR Trial: Clinical Decision Rule for Opioid Overdose Patients in the Emergency Department

21 Jan
January 21, 2019

Background Information: In 2017, more than two-thirds of the 70,000 drug overdose deaths in the United States involved an opioid.1 Many emergency departments are affected as opioid overdoses increased 30% from July 2016 through September 2017 in 52 areas in 45 states.2 With the half-life of naloxone being between 60-90 minutes the appropriate disposition and […]

Journal Abstracts and Why You Should Continue to Use Phenobarbital in Alcohol Withdrawal Syndrome for Patients Requiring Admission

10 Jan
January 10, 2019

Background: The mainstay of treatment for alcohol withdrawal syndrome is a symptom-triggered approach using benzodiazepines. Phenobarbital, however, is an interesting agent in this scenario for several reasons. It is famous for  it is long duration of action. IV Phenobarbital has an onset of action of over 15 – 20 minutes, a duration of action of 10 […]

REBEL Core Cast 2.0 – Cardiotoxic Drugs

09 Jan
January 9, 2019

Take Homes Calcium Channel Blocker (CCB) toxicity usually present with bradycardia and hypotension, but with preserved mental status. This can help differential from Beta Blocker (BB) toxicity, where the patients often have altered mental status. Hyperglycemia is the other hallmark of CCB toxicity, which can help you differentiate from BB. This hyperglycemia may be a […]

Salicylate Toxicity

17 May
May 17, 2018

Definition: Salicylate toxicity is characterized by a constellation of symptoms caused by acute or chronic overdose of salicylate containing compounds. The most common salicylate is aspirin, but the group also includes topical forms of salicylates, methyl salicylate (Oil of Wintergreen), and bismuth subsalicylate (such as in Pepto-Bismol).

Wernicke Encephalopathy

14 May
May 14, 2018

Definition: Encephalopathy that occurs secondary to thiamine (vitamin B1) deficiency. While Wernicke encephalopathy is reversible with treatment, it can progress to the irreversible Korsakoff’s syndrome if left untreated.