Question of the Day – Wednesday September 23, 2020
What factors were associated with repeated emergency department encounters for opioid usage? A retrospective study of four Indiana hospital systems from 2012-2017 evaluated patients with opioid-related ED visits. Factors associated with higher odds of repeat opioid-related encounters included number of previous opioid-related ED encounters,…
Question of the Day – Tuesday September 22, 2020
What abnormalities were identified on thromboelastography (TEG) for patients with copperhead (Agkistrodon contortrix) envenomation? None. A retrospective study of 16 patients with copperhead envenomation reported no abnormalities in coagulation parameters identified on laboratory evaluation. There were four patients that also received TEG, all with…
Question of the Day – Monday September 21, 2020
What was the most common clinical outcome for pediatric exploratory ingestions of lithium reported to US poison centers? No effect was reported in 88% of 1863 single-substance exposures in children < 6 years of age. Moderate or major effects were reported in approximately 2%…
Question of the Day – Friday September 18, 2020
What was the primary symptom reported in patients with tianeptine intoxication? Lethargy. A recent retrospective study of tianeptine exposures reported to a statewide poison center identified 17 cases of intoxication over a 2.5-year period. Lethargy was most commonly reported in 65% of patients. No…
Question of the Day – Thursday September 17, 2020
What thromboelastogram (TEG) value improved approximately 2-5 hours prior to recovery of fibrinogen concentrations after antivenom administration in a case report of severe Crotalus adamanteus (Eastern Diamondback) envenomation? Alpha angle which measures speed of fibrin build-up and cross-linking. The authors suggested potential benefit in…
Question of the Day – Wednesday September 16, 2020
What enzyme is used in the production of Crotalidae Immune Fab’2 (Equine) antivenom? Pepsin removes the Fc portion of the antibody leaving two fragment antigen-binding (Fab) portions connected by disulfide bonds. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a16596a5-e87e-40c2-8e34-cea5839849c3
Question of the Day – Tuesday September 15, 2020
What enzyme is used in the production of Crotalidae Polyvalent Immune Fab (Ovine) antivenom? Papain cleaves antibodies leaving solely the fragment antigen-binding (Fab) segment. Caution is advised in patients with documented allergies to papain, chymopapain, or bromelain (from pineapple) due to the risk of…
Question of the Day – Monday September 14, 2020
What is the mechanism of the venom for the snake pictured above? Eastern Coral Snake venom is an alpha-neurotoxin which inhibits acetylcholine at the nicotinic receptors of the neuromuscular junction causing descending muscle weakness/paralysis. https://en.wikipedia.org/wiki/Coral_snake; https://www.ncbi.nlm.nih.gov/books/NBK519031/
Question of the Day – Friday September 11, 2020
Which North American snake pictured above (left or right) is venomous? Right. North American pit vipers have a single row of subcaudal scales below the anal plate in contrast to a divided row in non-venomous snakes. http://www.kentuckyupclose.com/Venomous%20or%20Non-Venomous.html
Question of the Day – Thursday September 10, 2020
The venoms of which snakes are used in the production of Crotalidae Immune Fab’2 (Equine) antivenom? Bothrops asper (fer-de-lance) and Crotalus durissus (tropical rattlesnake). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a16596a5-e87e-40c2-8e34-cea5839849c3