Administrator Clintox - One

The slang term, “goofball”, refers to what drug of abuse?   Goofballs is a slang term to describe methamphetamine and heroin mixed together. (Jenkins LM et al. Risk factors for nonfatal overdose at Seattle-area syringe exchanges. Journal of Urban Health. 2011. 88; 118-128. doi 10.1007/s11524-010-9525-6)

Ibogaine and its metabolite, noribogaine, cause cardiotoxicity. What do they cause?   Both ibogaine and its metabolite, noribogaine, cause QT prolongation and subsequent ventricular arrhythmias including torsade de pointes likely due to blockade of the HERG channel. (Litjens R et al. How toxic is ibogaine?Clin…

In Europe in the 1980s, patients exposed to sneezing powder had syncope, vomiting, bradycardia and hypotension. What was the culprit?   The sneezing powder manufactured in Germany was found to have 50% Panama wood and 50% Veratrum album. Veratrum is a sodium channel opener, which…

Two alkaloids, mitragynine and 7-hydroxymitragynine, has been identified to be the key active substances in Kratom for the plant’s pharmacological effect. How do these two alkaloids affect CYP enzyme activity?   According to the cited reference “Exploration of Cytochrome P450 Inhibition Mediated Drug-Drug Interaction Potential…

What is the role of capsaicin in managing cannabinoid hyperemesis syndrome?   According to the cited reference “Cannabinoid hyperemesis syndrome (CHS) is a disorder of cyclic and recurrent nausea, vomiting, and abdominal pain associated with high-frequency and extended-duration marijuana use. Standard antiemetic therapy is often…

In addition to tendon rupture; aortic aneurysm; valvular regurgitation and peripheral neuropathy, fluoroquinolones also have been associated with this endocrine abnormality?   The FDA added hypoglycemia to the list of warnings associated with fluoroquinolone use. (FDA Safety Warning. January 2018. https://www.fda.gov/drugs/drug-safety-and-availability/fda-reinforces-safety-information-about-serious-low-blood-sugar-levels-and-mental-health-side. Accessed December 3 2019)

Fluoroquinolones have a long list of adverse events associated with their use. What is the recent new concern?   Fluoroquinolones have recently been linked to increasing risk of aortic dissection and aneurysm. A recent case control study by Etminan et al show that patients receiving…

This antidote has been used in the treatment of refractory anaphylaxis?   Kelly KJ reported a case of a patient with refractory anaphylaxis without hypotension that received an infusion of methylene blue 1% at 1.5 mg/kg. Her dyspnea began to improve within 6 minutes of…

This toxin, named after its initial isolation from the Alaskan butter clam, causes rapid onset of perioral paresthesias, numbness, a sensation of floating as well muscular weakness and cranial nerve dysfunction was responsible for 31 cases and 2 deaths in the Philippines in 2013.  …

A patient presents with a 12 hour history of a pruritic papular eruption arranged in a linear or flagellate pattern over his trunk. He has no other symptoms. He is otherwise healthy and is not on any medications. What did he eat yesterday that is…