- Written by Ethan Abbott
Toxicology Update November 2018
The following study looks to see if targeted temperature management (therapeutic hypothermia) improved hospital survival from presumed overdose related cardiac arrest. Their secondary endpoint was neurological recovery. Although the study of 121 patients found improvement in survival, there was no statistical significant improvement in neurological recovery. This goes against the belief that therapeutic hypothermia protects the brain, and requires further study in this population.
This paper looks at the use of the medical record for toxicological studies, AKA chart reviews. It is not always easy, or ethical to perform studies on poisoned patients (you can’t ethically withhold an antidote), so chart reviews can serve as a way to study this population. It is important to understand the limitations of these studies. This is a great paper to read before undertaking a study of this type.
It is often difficult to obtain a confirmed medication history from our patients, and even more difficult during nights and weekends when pharmacies are closed. This leaves our population, especially geriatrics at risk of adverse drug reactions (ADRs). The following paper looks at a novel approach to medical reconciliation, which will help us to know a full medication list. The algorithm looks at patterns to help prevent these ADRs.
Toxicology in the News
I may not look like the most fashionable attending, seeing as my work wardrobe consists of blue scrubs, a ponytail and no makeup, but I truly love fashion! The following short article is a promotion for a new book on the history of clothing, “Green ball gowns tinted with arsenic. Top hats made with mercury. Flammable crinoline.” A great short read, with amazing pictures! Can’t wait to buy the book.
People will do anything to get intoxicated, although even this is a new one for me. Boiling, and then drinking used sanitary napkins! The article does not mention what substance is causing the hallucinations unfortunately. Thankfully, this just seems to be a trend in south east Asia . . . for now.
As marijuana becomes decriminalized and legalized in more states (and countries), incidents of misadventure are increasing. Edibles are often more potent than expected and have somewhat confusing dosing (e.g. 1/8 of a cookie may be a therapeutic dose). Would keep this ingestion in your differential in the right clinical setting.
Toxicology Toxin of the Month
The following blog post highlights medical interactions and an interesting historical account about the first non drowsy anti-histamine. Don’t forget to watch the amazingly creepy pharmaceutical commercial!
Don’t you want your patients free from allergy suffering? Just don’t worry about the potential QTc prolongation and dysrhythmias.