Question Of The Day

In a study of pediatric Han Chinese patients, which risk factor was associated with development of valproate toxicity (liver injury): age, sex, dose of valproate, or valproate concentration? Male patients had a higher percentage of liver injury (58.9%) compared to female patients (41.1%). Male patients’…

Historical QOD 3/20/09: What are three antiepileptic medications that have been reported to be causally associated with metabolic acidosis? Acetazolamide, zonisamide, and topiramate (Neurology, 2004 Nov 23, 63(10 Suppl 4):S24-S29)

In a retrospective review of patients treated with either oral or transdermal rivastigmine, which group required more additional doses of sedation to control antimuscarinic induced delirium? The group receiving transdermal rivastigmine required more doses of additional sedation compared to oral. Patients receiving the transdermal patch…

In a rodent study, liraglutide (flucagon-like peptide-1 receptor agonist) reduced self administration of what substance of abuse? Liraglutide reduced both cue-induced heroin seeking and drug-induced reinstatement of heroin seeking behaviors in rats. Evans B, Stoltzfus B, Acharya N, Nyland JE, Arnold AC, Freet CS, Bunce…

In a retrospective descriptive cohort study published in 2018 that evaluated the efficacy of naloxone in the reversal of clonidine toxicity in pediatric patients, what was the recommended naloxone dose and route? Naloxone 10 mg IV push Seger DL, Loden JK. Naloxone reversal of clonidine…

In the case report presented on ACEI toxicity what is the proposed mechanism of action of naloxone’s ability to reverse hypotension. Naloxone promotes the effect of enkephalinase, an enzyme responsible for endogenous opioid degradation (ie beta-endoprhin). Degradation of endogenous opioids inhibit angiotensin II which inhibits…

Historical QOD 3/19/2009: What are chemical reactivity sheets? They are consolidated tables of health-and-safety information for chemical agents. Although they were designed as improvements on Material Safety Data Sheets, they may still fail to identify critical information or falsely attribute hazards to chemicals. (J Chem…

In a retrospective study evaluating pulmonary edema following recreational opioid overdose, was there a correlation between total amount of naloxone received and degree of hypoxia? No there was not Kummer RL, Kempainen RR, Olives TD, Leatherman JW, Prekker ME. Naloxone-associated pulmonary edema following recreational opioid…

In the double-blind, randomized study of naloxone vs nalmefene, which group of patients experienced the greatest number of adverse events? Adverse events occurred with nearly twice as many patients in the 2-mg nalmefene group (17/55 [30.9%]) as either the 1-mg nalmefene group (10/63 [15.9%]) or…

What is the proposed mechanism by which carbapenem antibiotics decrease serum valproic acid concentrations? Carbapenems, like ertapenem and meropenem, and to a lesser extent imipenem/cilistatin, inhibit acylpeptide hydrolase in hepatocytes. This enzyme is responsible for deconjugating the glucuronic acid group from valproate acid glucuronide (VPAg)….