Administrator Clintox - One

What is the onset of fomepizole for the treatment of disulfiram-ethanol reaction?   A retrospective case series of 10 patients admitted to an ICU with acute disulfiram-ethanol reaction used a single dose of fomepizole 7.5 mg/kg IV. All patients had rapid symptom improvement and vasopressors…

What is the antidote for patient with toxicity secondary to piperidylthiambutene?   Naloxone. Piperidylthiambutene is a recently identified synthetic opioid. It is structurally different than fentanyl or other synthetic opioids. Limited data suggests that it has potency at the mu-opioid receptor similar to morphine. (https://www.npsdiscovery.org/wp-content/uploads/2019/09/Piperidylthiambutene_091819_NMSLabs_Report.pdf…

Fentanyl and fentanyl analogs may result in a false positive immunoassay for what drug?   Fentanyl and at least one select analog have been implicated as the cause of a false positive LSD immunoassay. (Clin Chem 2002;48:205-206 https://doi.org/10.1093/clinchem/48.1.205 and Toxicology Letters 2020;320:109-112 https://doi.org/10.1016/j.toxlet.2019.11.025) Submitted by…

The top ten single agents implicated as the cause of drug induced liver injury registered in the Drug Induced Liver Injury Network (DILIN) between 2004 and 2013 were from what therapeutic class?   The top ten individual drugs were all antimicrobials, with amoxicillin-clavulanate the most…

What is the mechanism of toxicity when consuming immature ackee fruit, the national fruit of Jamaica?   Hypoglycin A, found in arils of immature ackee fruit, is metabolized to methylenecyclopropane acetyl CoA (MCPA-CoA). MCPA-CoA impairs gluconeogenesis through coenzyme A dehydrogenase inhibition and may lead to…

Mitomycin C has resulted in reduction in symptoms and fewer dilations in patients with caustic ingestions. What is the proposed mechanism for this?   In a recent review article by Hoffman RS et al., additional therapies for caustic ingestions was described including sucralfate and mitomycin…

In children with grade 2B esophageal injury from a caustic ingestion, this therapy resulted in a significant benefit on endoscopy or barium swallow and reduced the duration of parenteral nutrition?   As noted in a recent review paper by Hoffman RS et al, Usta and…

What is the onset of fomepizole for the treatment of disulfiram-ethanol reaction?   A retrospective case series of 10 patients admitted to an ICU with acute disulfiram-ethanol reaction used a single dose of fomepizole 7.5 mg/kg IV. All patients had rapid symptom improvement and vasopressors…

What is the survival rate of patients receiving VA-ECMO for drug-induced cardiogenic shock?   A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) case registry identified 104 adult patients with drug-induced cardiogenic shock managed with VA-ECMO over 15.5 years. Overall, 53% of patients survived….

A patient presents with painful burns on his scalp. The wounds are waxy and yellow under natural light and fluorescent under Woods lamp. What is the likely culprit? a. Dinitrophenol b. White Phosphorous c. Nitric acid d. Trinitrophenol   White phosphorous. Conner JC and Bebarta…