Administrator Clintox - One

Historical QOD 10/29/08: Name common medications responsible for phencyclidine false-positive results on urine drug screen immunoassays. Common medications causing phencyclidine false-positives include dextromethorphan, diphenhydramine, ibuprofen, ketamine, meperidine, tramadol, venlafaxine, imipramine, and doxylamine. Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians….

In a case report published in 2022, what treatment was provided to a patient with persistent anticholinergic delirium despite physostigmine administration, that resulted in resolution in symptoms after no additional physostigmine doses were available? Rivastigmine 9.5 mg transdermal patch, patch was applied at hour 24…

In a retrospective cohort study of hospitalized patients who received physostigmine to reverse an anticholinergic toxidrome what percentage of patients had no documented adverse effects? 182 (95.3%) patients Arens AM, Shah K, Al-Abri S, Olson KR, Kearney T. Safety and effectiveness of physostigmine: a 10-year…

In a retrospective cohort study of bupropion overdoses what was the median change in QRS duration after sodium bicarbonate administration? -2 milliseconds, which was not statistically significant (P=0.42) Simpson M, Johnson L, Goldfine C. Sodium bicarbonate treatment for QRS widening in bupropion overdoses. Clin Toxicol…

Historical QOD 12/28/08: What is the metabolite responsible for hepatotoxicity in acute valproate overdose? 4-en-VPA, a byproduct of omega oxidation, is the toxic metabolite that accumulates in acute valproate overdose once carnitine depletion occurs. 4-en-VPA is responsible for hyperammonemia seen in toxicity. Lheureux PE, Penaloza…

In an observational study investigating the incidence and onset of delated seizures after overdoses of extended-release bupropion, what was the most frequently associated clinical finding in patients that had a seizure? Tachycardia was found in 92% of patients who had a seizure and was found…

Lewisite is said to have a smell reminiscent of which flowering plant? Lewisite is a colorless vesciant with a smell said to be similar to Geraniums. https://emergency.cdc.gov/agent/lewisite/basics/facts.asp#:~:text=Lewisite%20is%20an%20oily%2C%20colorless,has%20an%20odor%20like%20geraniums.      

Identify the toxic chemical below. Lewisite. https://pubchem.ncbi.nlm.nih.gov/compound/Lewisite#section=Structures      

What is “seal finger?” “Seal finger is an occupational injury that occurs to those who work directly or indirectly with seals.” The causative organism is Mycoplasma phocacerebrale and is best treated with oral tetracycline. White CP, Jewer DD. Seal finger: A case report and review…

Historical QOD 12/24/08: Name medications implicated in drug-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome. This list is quite extensive, but can include ticlopidine, clopidogrel, ciprofloxacin, cephalexin, piperacillin, metronidazole, penicillin, famotidine, cimetidine, certain statins, antineoplastic agents, cyclosporine, tacrolimus, interferon, and quinidine. Dlott JS, Danielson CF, Blue-Hnidy DE,…