Question Of The Day

What are some of the proposed mechanisms of oculogyric crisis? According to the cited reference, the exact mechanism of oculogyric crisis is unknown. Proposed mechanisms include striatal dopaminergic hypoactivity, striatal cholinergic hyperactivity, and striatal dopaminergic hyperactivity (rare). Non-drug induced oculogyric crises may be due to…

Historical QOD 2/19/2009:  What is the specific risk to the fetus associated with maternal use of benzodiazepines during the first trimester of pregnancy? How about during the late third trimester? Benzodiazepines should not be used in the first trimester because of the risk of oral…

What are the exam findings of oculogyric crisis? According to the cited reference, oculogyric crisis occurs acutely and lasts minutes to hours. It is a dystonic movement with conjugate, paroxysmal, and upward movement of the eyeballs. Other dystonic movements can also occur. The individual is…

What is the maximum daily dosing of Tizanidine and lowest dose that has been associated with coma? According to the cited reference, the maximum recommended daily dose of tizanidine is 36 mg per day. The lowest dose associated with coma was 60 mg. Spiller, H….

What are the three major metabolites of cocaine? What active metabolite is also created in the presence of ethanol? Approximately 5% of cocaine undergoes N-demethylation into norcocaine. Nearly half is both nonenzymatically and enzymatically hydrolyzed to form benzoylecgonine. Plasma cholinesterase and other esterases metabolize 32-49%…

What was the source of a recent methemoglobinemia outbreak in a neonatal ICU and maternity ward? Nitrite. A damaged valve lead to back-flow of water from the hospital heating system, containing an anticorrosion agent, into the hospital drinking and medical supply water. No adult patient…

Historical QOD 2/13/2009: Which statin drug is the most common cause for statin induced myopathy and why? Simvastatin is probably responsible for more cases of myopathy simply by virtue sof the fact that it is currently the best selling and most widely prescribed statin drug….

Consumption of mountain laurel by the North American Ruffed Grouse (Bonasa umbellus) in late winter and early spring has allowed them to acquire which toxin? Grayanotoxin is acquired by these birds through consumption of mountain laurel. According to the cited reference, “Grayanotoxin can bind to…

Dermal absorption of canthardin from the Spoor-winged goose (Plectropterus gambensis) can cause what symptoms? According to the cited reference, “Common skin manifestations include a dermatitis rash with blister formation. Specifcally, cantharidin causes release of serine proteases that cause desmosomal plaque disruption leading to acantholysis, intradermal…

What is the lethal dose of nicotine for adult humans? According to the cited reference, “0.5-1.0 mg/kg can be lethal doses for adults.” Kamble A, Khairkar P, Kalantri SP, Babhulkar S. Fatal Suicidal Attempt by Deliberate Ingestion of Nicotine-containing Solution in Childhood-onset Depression Mediated through…