Question Of The Day

What medication can be used to reverse some effects of tianeptine? Naloxone. Tianeptine is a full agonist of mu-opioid receptors. Therefore, naloxone has a theoretical and some real-world experience with reversal of tianeptine overdose. Dempsey SK, Poklis JL, Sweat K, Cumpston K, Wolf CE. Acute…

Historical QOD 3/31/09:True or False: Fluoroquinolones as a class are some of the most potent photosensitizers causing photosensitivity rashes. True. While tetracycline-class antibiotics are commonly associated with this phenomenon, they are at most weak photosensitizers, with the exception of doxycycline, which is much more potent….

What receptors does tianeptine interact with? According to the cited reference, tianeptine “was originally classified as a tricyclic antidepressant, but because it did not inhibit monoamine reuptake, this description is inaccurate… [Tianeptine is] more accurately described as a glutamatergic modulator and a µ-opioid receptor and…

What toxin(s) in what edible substance may have caused Ludwig van Beethoven’s deafness? Lead contaminated wine. Many historians and toxicologists have speculated on this problem. Many conditions may have contributed to Beethoven’s deafness. However, temporal bone analysis showed elevated levels of lead. Beethoven’s wine consumption…

In patients presenting with ethylene glycol toxicity, administration of pyridoxine and thiamine can shunt metabolism away from the formation of which toxic metabolite? Glyoxylic acid Gallagher N, Edwards FJ. The diagnosis and management of toxic alcohol poisoning in the emergency department: a review article. Adv…

What are the characteristics of pit vipers that distinguish them from non-venomous snakes? According to the cited source, these snakes have “two pits (with heat-sensitive organs that assist these poor-visioned reptiles to localize their prey) are located on each side of the head, between the…

Historical QOD 3/30/09: Describe the mechanim of lead-induced anemia. Lead interferes with a variety of heme biosynthetic enzymes, including delta-aminolevulinc acid (acting to synthesize porphobilinogen), and ferrochelatase (used to incorporate iron into protoporphyrin). In the latter case, zinc is inserted in the place of iron,…

What is the common presentation of the Loxosceles reclusa (brown recluse spider) bite? According to the cited source, “the bite is usually innocuous and may initially go unnoticed. The spectrum of reaction ranges from minor local reaction to severe necrotic arachnidism. The local reaction consists…

What is the treatment of envenomation by Centruroides sulpturatus scorpion in children? According to the cited source, “Treatment begins with general supportive care. Cryotherapy at the site of the sting has been advocated to reduce swelling and local indurations. Anascorp is the first ever FDA-approved…

What hematologic disorder has been reported in the literature as a complication NAC overdosing? Hemolytic uremic syndrome Mullins ME, Vitkovitsky IV. Hemolysis and hemolytic uremic syndrome following five-fold N-acetylcysteine overdose. Clin Toxicol (Phila). 2011 Oct;49(8):755-9. doi: 10.3109/15563650.2011.609821. PMID: 21970774.; Mahmoudi GA, Astaraki P, Mohtashami AZ,…