Administrator Clintox - One

Historical QOD 1/6/09: A recent epidemic of melamine poisoning arose from tainted infant formula in China. This epidemic affected nearly 300,00 children in China with more than 50,000 hospitalized and a number of deaths. What was the basis of the pathology involved in these melamine…

How much melatonin are patients receiving in over-the-counter products? According to the cited reference, 88% of melatonin products analyzed were inaccurately labeled. Only 12% contained ±10% of the declared melatonin (or CBD) quantity on the label. Due to this, patients may receive 74% to 347%…

What is the mechanism of action through which hydroxychloroquine was believed to be indicated in COVID-19 treatment and in which patient population? Hydroxychloroquine increases lysosymal pH in antigen presenting cells decreasing toll like receptor signaling and inhibits glycosylation of ACE2 receptor which is thought to…

Historical QOD: 1/5/09: Q fever is a zoonotic infection caused by Coxiella burnetti.Over 30 cases have been reported among US military personnel deployed to Iraq and Afghanistan over the past few years and this disease is of concern as a potential terrorist weapon. Of special…

Based on the NJEM article “Treatment of Severe Chloroquine Poisoning”, what amount of chloroquine was determined to predict fatality in acute overdose? >5g of ingestion. Other variables including SBP <80, QRS >120ms and HR were not statistically significant in the 51 retrospective cases. Riou B,…

What is the main organ damage caused by MEKP (methyl ethyl ketone peroxide) ingestion? MEKP is a potent organic peroxide with both corrosive and oxidant effects. The most prominent toxic effects with ingestion are corrosion of GI tract due to lipid peroxidation. Hepatotoxicity and nephrotoxicity…

What specific therapy may augment the treatment of dysrhythmias in chloroquine (and HCQ) overdoses? Diazepam 2mg/kg IV over 30 mins followed by 2mg/kg/day for 2-4 days (patients may require intubation); epinephrine (or other vasopressors) may be used in conjunction Riou B, Barriot P, Rimailho A,…

What is another name for methylene chloride, a common cause of neurologic, GI, and hepatorenal injuries in automotive/industrial workers? What is it metabolized to, and by what? Dichloromethane, metabolized to carbon monoxide via CYP 2E1. Jaffe TA, Boyer EW, Erickson TB, Studley H, Hayes BD,…

Historical QOD: 11/4/08 What is the predominant histopathological finding in the livers of patients who have died from poisonings from phosphide-containing pesticides? Fine cytoplasmic vacuolization (seen in almost 95% of fatalities). This vacuolization was distributed uniformly in all hepatic zones in 75% of cases. Saleki…

What are the earliest symptoms that one would expect to see in a patient who presents after a recent ingestion of Aconitum napellus? The earliest symptoms one would expect to see after aconitine ingestion are numbness and burning in the perioral area. The patient then…