Question of the Day – Friday, May 12, 2023
What is high dose methotrexate? High-dose methotrexate (HD-MTX) is the term for doses higher than 500 mg/m2. Although higher doses of MTX are often more beneficial in the treatment of some diseases, such as rheumatoid arthritis, they can produce toxicity and side effects such as…
Question of the Day – Wednesday, May 10, 2023
What findings are seen on brain imaging in patients with suspected paradichlorobenzene-induced leukoencephalopathy? Imaging of the brain is standard of care in cases of toxic leukoencephalopathy, but imaging findings in toxic leukoencephalopathy secondary to PDCB consumption are nonspecific and can include involvement of periventricular and…
Question of the Day – Thursday, May 11, 2023
Historical QOD 12/03/08: Finding trichloroethanol on autopsy toxicology tests suggests abuse of what drug? Chloral hydrate is metabolized to trichloroethanol and commonly causes positive trichloroethanol levels at autopsy. Jones GR, Singer PP. An unusual trichloroethanol fatality attributed to sniffing trichloroethylene. J Anal Toxicol. 2008 Mar;32(2):183-6….
Question of the Day – Tuesday, May 9, 2023
What tests are useful in the diagnosis of paradichlorobenzene (PDCB) toxicity? High urine concentration of the metabolite 2,5-dichlorophenol, high serum concentrations of PCDB, along with history and signs/symptoms of toxicity often guide the decision making. The diagnosis can be challenging due to overlap in clinical…
Question of the Day – Monday, May 8, 2023
What signs and symptoms are specific for paradichlorobenzene-induced neurotoxicity? According to the cited reference, PDCB toxicity can affect any part of the nervous system and there are no signs or symptoms specific for PDCB-induced neurotoxicity. Clinical manifestations can include psychomotor retardation, cognitive decline, memory issues,…
Question of the Day – Friday, May 5, 2023
True or false: breastmilk from mothers receiving MOUD treatment with methadone or buprenorphine has high levels of these medications False. Buprenorphine and methadone concentrations are very low in breastmilk when the parent is on MOUD and pose little risk to infants Trebach J. Breastfeeding and…
Question of the Day – Thursday, May 4, 2023
According to the fentanyl study group, a prospective study of patients with suspected opioid overdose in 9 emergency departments in 7 US states, was the presence of xylazine associated with more severe intoxication? No. Outcomes (death, LOS, ICU admits, ED discharge, total dose of naloxone,…
Question of the Day – Wednesday, May 3, 2023
According to data compiled by the fentanyl study group, a prospective study of patients with suspected opioid overdose in 9 emergency departments in 7 US states, were patients with xylazine exposure more or less likely to experience bradycardia? There was no difference in the rates…
Question of the Day – Tuesday, May 2, 2023
What is the difference between a cutting agent and an adulterant? A cutting agent is an inert filler added to a drug to add bulk. An adulterant is a pharmacologically active, non-scheduled drug added to a drug to add bulk or for contributory affect. Examples…
Question of the Day – Monday, May 1, 2023
Which adulterant, associated with rash, blurred vision, tinnitus, dizziness, headache, and edema has recently been identified in illicit drug samples? Phenylbutazone. Additional complications may include nausea, vomiting and diarrhea, stomach/abdominal pain, ulcers, GI bleeding, hepatitis, kidney failure, and congestive heart failure, agranulocytosis, leukopenia, thrombocytopenia, and…