Administrator Clintox - One

Ingestion of bisphosphonates with little to no water and/or laying down shortly after or during administration has led to injury of what anatomical structure and what complication(s)? According to the cited reference, “Several cases of esophagitis with esophageal erosions or ulcerations associated with the use…

What administration counseling points should be given for patients taking oral bisphosphonates to mitigate what GI adverse reactions? According to the cited reference, patients should be counseled to take medication with a full glass of water (6-8 oz.) and to remain upright for at least…

Who was Nicholas Evans? Nicholas Evans was a British novelist and the author of “The Horse Whisperer.” He notoriously accidentaly ingested “lethal webcaps” Cortinarius Rubellus containing Orellanine while visiting family in Northern Scottland. He and family members, suffered ESRD from ATN and underwent kidney transplant….

Phenibut is commonly marketed in various OTC products, one specifically branded as “Za Za”. Ingredients of Za Za includes a proprietary blend of Phenibut, Tianeptine and Piper Methysticum (Kava). What are the mechanisms of actions of Tianeptine and Kava? According to cited reference, tianeptine is…

Historical QOD 10/30/08: Name the most significant dose-dependent side effect of therapy with ethambutol. Optic or retrobulbar neuritis may be seen with high-dose ethambutol therapy, typically only after 1.5 months. Dyschromatopsia is often the earliest indicator of toxicity, with blue-yellow color changes being the most…

During the “London Fog” or “Great Smog” incident of 1952, an estimated 4,000 deaths (a 2004 study suggests closer to 12,000 deaths) were attributed to smog-induced respiratory tract infections and hypoxia. What were the major components of the smog? Sulfur dioxide and oxides of nitrogen….

Vineyard sprayer’s lung is an occupational pulmonary disease described in 1969 that occurred among Portuguese vineyard workers applying Bordeaux solution. Patients developed interstitial pulmonary fibrosis and histiocytic granulomas. What are the major toxic components of this solution? Copper sulfate neutralized with hydrated lime. Patients were…

Which amatoxin-containing mushroom is responsible for the majority of mushroom-related fatalities in China? Amanita exitialis Li HJ, Zhang HS, Zhang YZ, et al. Mushroom poisoning outbreaks – China, 2021. China CDC Wkly. 2022;4(3):35–40. Contributed by: Kristin Reinaker, PharmD, DABAT on behalf of Richa Gavaskar, PharmD…

What was the main conclusion of a blinded, retrospective clinical trial from 2021 in patients presenting for antimuscarinic toxidrome comparing physostigmine vs lorazepam for the control of delirium and agitation? Physostigmine was superior to lorazepam in controlling antimuscarinic delirium and agitation. Wang GS, Baker K,…

In a case report published in 2014, of anticholinergic agitation refractory to 12mg of lorazepam over a 5 hour span what pharmacological agent was administered that resulted in improvement in anticholinergic induced agitation? Dexmedetomidine was given for 25 hours then discontinued, agitation returned and patient…