Toxicology Rounds: Is Phenobarbital for Alcohol Withdrawal Ready for the Big Time?
No abstract available (Source: Emergency Medicine News)
Source: Emergency Medicine News - April 1, 2018 Category: Emergency Medicine Tags: Toxicology Rounds Source Type: news

Levetiracetam Bests Phenobarbital in Infantile Epilepsy (CME/CE)
(MedPage Today) -- Study addresses mismatch between clinical practice and regulatory approval (Source: MedPage Today Neurology)
Source: MedPage Today Neurology - February 13, 2018 Category: Neurology Source Type: news

Most commonly prescribed drug for infantile epilepsy may also be most effective
(Weill Cornell Medicine) Levetiracetam, the most commonly prescribed drug for US infants with epilepsy, may be significantly more effective than the second-choice drug phenobarbital, according to a new study by scientists from Weill Cornell Medicine, NewYork-Presbyterian and 16 other research institutions. The findings provide the first evidence to favor levetiracetam in infants. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - February 12, 2018 Category: International Medicine & Public Health Source Type: news

Donnatal Tablets (Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Tablets) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - November 28, 2017 Category: Drugs & Pharmacology Source Type: news

C.O. Truxton, Inc. Issues Voluntary Nationwide Recall of Amitriptyline HCL Tablets, USP 50mg and Phenobarbital Tablets, USP 15mg, 30mg, 60mg, 100mg Due to Potential Label Mix-Up
Bellmawr, New Jersey, C.O. Truxton, Inc. is expanding their 04/21/2017 voluntary recall, as a precaution to include the following C.O. Truxton, Inc. products, registered NDC numbers and corresponding lot numbers, to the consumer/user level. C.O. Truxton has not received any complaints for the products listed below. however, due to the initial recall resulting from a label mix-up error, out of an abundance of caution, we are recalling all products that were repackaged into a Truxton Incorporated label. (Source: Food and Drug Administration)
Source: Food and Drug Administration - May 8, 2017 Category: Food Science Source Type: news

C.O. Truxton, Inc. Issues Voluntary Nationwide Recall of Phenobarbital 15 mg Tablets, USP due to Labeling Error on Declared Strength
Bellmawr, New Jersey, C.O. Truxton, Inc. is voluntarily recalling lot 70952A of Phenobarbital Tablets, USP, 15 mg, to the consumer/user level. The manufacturer received a confirmed customer complaint that a bottle labeled as phenobarbital 15 mg was found to contain phenobarbital 30 mg tablets. (Source: Food and Drug Administration)
Source: Food and Drug Administration - April 21, 2017 Category: Food Science Source Type: news

Dying To Go To Heaven: What The Heaven’s Gate Suicides Teach Us About Islamic Martyrdom
It was 20 years ago this week, March 20-26, 1997, that 39 members of the Heaven’s Gate cult “graduated” from this life to ascend to the UFO mothership that they believed would take them to an extraterrestrial paradise. I’ll never forget it. I was on book tour for Why People Believe Weird Things, and neither I nor any of my peers who study belief systems had ever heard of the cult. It was hard to fathom. Now, as I look back 20 years later, I believe the mass suicide has a deeper lesson that goes far beyond the confines of New Age fringe cults, and has relevance to understanding the motivations o...
Source: Science - The Huffington Post - March 24, 2017 Category: Science Source Type: news

Donnatal Extentabs (Belladonna Alkaloids, Phenobarbital) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - February 3, 2017 Category: Drugs & Pharmacology Source Type: news

A Quick Guide to Getting Enough Vitamin D
Shanna R. Levine, MD Instructor of General Internal Medicine The Mount Sinai Hospital A Quick Guide to Getting Enough Vitamin D If you are like many of my patients, you may be wondering, "Am I getting enough vitamin D?" This is a valid concern, because vitamin D plays a very important role in overall health and, in fact, many people do not get enough. The Centers for Disease Control and Prevention estimates that about one-third of Americans have insufficient levels. The good news is that sources of this vitamin are easily accessible. Why Is Vitamin D Important? Vitamin D helps the body absorb calcium from the...
Source: Healthy Living - The Huffington Post - January 30, 2017 Category: Consumer Health News Source Type: news

Seizures in the Preterm Neonate
Preterm infants are at high risk for central nervous system injury, with seizures occurring in 6% to 48% of this population. Seizures are more likely to contribute to adverse neurodevelopmental outcomes in preterm infants. Preterm infants are also more likely to have subclinical seizures; therefore, electrographic detection is essential for their diagnosis. Once identified, seizures are traditionally treated with phenobarbital, but newer-generation antiepileptic medications have growing evidence for safety and efficacy. The treatment of seizures may also affect neurodevelopmental outcome. (Source: NeoReviews recent issues)
Source: NeoReviews recent issues - January 2, 2017 Category: Pediatrics Authors: Rao, L. M., Marcuccilli, C. J. Tags: Pediatric Drug Labeling Update Articles Source Type: news

Feline Pancreatitis
Feline pancreatitis is inflammation of a cat's pancreas that can disrupt its normal functions and cause other symptoms as well. An inflamed pancreas is a serious problem, because the organ serves two vital functions in the body. It produces hormones -- insulin and glucagon -- that balance blood sugar. It also produces digestive enzymes such as amylase, lipase, and proteases, which enable the body to use carbohydrates, fats and proteins for energy. Symptoms of Pancreatitis in Cats In cats with pancreatitis, there are few overt symptoms. The most common signs are lethargy and lack of appetite. Since cats naturally sleep a ...
Source: Healthy Living - The Huffington Post - August 2, 2016 Category: Consumer Health News Source Type: news

Severe bupropion overdose and ECMO: two great saves
ChaNaWiT/ 3.5 out of 5 stars Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrance Oxygenation. Heise CW et al. J Med Toxicol 2016 Feb 8 [Epub Ahead of Print] Abstract This awesome, exciting paper from Banner University Medical Center in Phoenix describes two teenagers with severe bupropion overdose who survived refractory cardiac arrest after veno-arterial extracorporeal membrane oxygenation (VA-ECMO): Case 1: A 15-year-old girl was brought to hospital after ingesting up to 90 150-mg bupropion tablets. She had a seiz...
Source: The Poison Review - February 12, 2016 Category: Toxicology Authors: Leon Tags: Medical burpropion ECMO extracorporeal membrane oxygenation Source Type: news

Donnatal Tablets (Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Tablets) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - January 11, 2016 Category: Drugs & Pharmacology Source Type: news

What is the Epidemiology of SMA Syndrome?
Discussion Superior mesenteric artery syndrome (SMAS) is caused by the compression of the superior mesenteric artery (SMA) against the 3rd part of the duodenum creating a proximal intestinal obstruction. It is relatively rare and can be hard to distinguish from other causes of intestinal obstruction. Normally the SMA arises from the anterior aorta around the L1 vertebra. It extends anteriorly and caudally into the mesentery of the small bowel. The angle between the SMA and aorta is called the aortomesenteric angle and is usually 38-65°. The distance between the SMA and aorta is usually 10-20 mm. Within the aortomesent...
Source: - June 1, 2015 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

“I got a bike!”: Adaptive bike brings freedom to boy with cerebral palsy
Seven-year-old Hunter Ripley is a boy of few words. There’s a rare “bye-bye” to his mother as he sets off for school and an occasional “whee” when he’s pushed on his adaptive swing.  So when Hunter screamed, “I got a bike!” at the local pool where he does aquatic therapy every Thursday evening, everyone in the pool went silent. “Then the cheering started,” recalls his mother Bekah Ripley. In February, Bekah and her husband Bart learned about The Great Bike Giveaway, a national contest in which children with special needs can win their own adaptive bike. In or...
Source: Thrive, Children's Hospital Boston - May 5, 2015 Category: Pediatrics Authors: Lisa Fratt Tags: Orthopedics Our patients’ stories Source Type: news

Episode #4: Poisoning and the diagnosis of brain death
Conclusion: unclear how long to wait before pronouncing brain death as many factors such as pharmacogenetics can alter normal metabolism   Summary Drug overdose can mimic brain death Be especially cautious in overdose involving the scary B’s: baclofen, barbiturate, benzodiazepine The 3-5 half life rule for drug clearance cannot be applied in the cases of overdose Half lives are measured at therapeutic levels Multiple other factors can alter metabolism in overdoses, such as pharmacogenetics, and cross reactivity with other ingestants Consult a toxicologist if there is any question regarding possible overdose...
Source: The Poison Review - May 21, 2014 Category: Toxicology Authors: LeonThe Poison Review Tags: Podcast Source Type: news

Case Conference: agitated delirium from snorting “bath salts”
This article is part of the New England Journal of Medicine‘s “Case Records of the Massachusetts General Hospital” series. There is a very good discussion of the initial approach and differential diagnosis for a patient who presents with “agitation, delirium abnormal vital signs, and reports he had taken a toxic substance.” However, I find some of the management decisions puzzling. The patient was initially treated with fomepizole and sodium thiosulfate. Although toxic alcohols and cyanide are certainly in the differential for metabolic acidosis, that seems to me a case of treating the lab val...
Source: The Poison Review - December 27, 2013 Category: Toxicology Authors: Leon Tags: Medical agitated delirium bath salts case records of the massachusetts general hospital methcathinone Source Type: news

July eFactor
Birnbaum headlines Detroit Community Forum Leaders address Association of Public Health Laboratories NIEHS spurs investigation into the health effects of e-waste recycling Scholars Connect program welcomes class of 2013-2014 Agencies award $100,000 to winner of health and technology challenge Office of Scientific Information Management takes shape NIEHS launches website redesigned for mobile devices WETP workshop identifies strategies to promote effective safety cultures Former postdoc named chief research officer for NIH research partner NIEHS brings public health perspective to climate change policy forum Keyno...
Source: Environmental Factor - NIEHS Newsletter - July 10, 2013 Category: Environmental Health Source Type: news

How to survive the shortage of injectable sodium bicarbonate
Sodium bicarbonate is probably the most versatile antidote in the medical toxicologist’s armamentarium. The list of poisons for which bicarb is indicated lincludes: Sodium-channel blockers (including tricyclic antidepressants) Salicylates phenobarbital methotrexate ethylene glycol methanol chlorine gas inhalation It is, therefore, distressing that bicarb is among the many pharmaceuticals that have recently been in short supply. To read my Emergency Medicine News column on this problem — and find out what to do when sodium bicarbonate is simply not available, click here. (Source: The Poison Review)
Source: The Poison Review - July 9, 2013 Category: Toxicology Authors: Leon Tags: Medical drug shortage Emergency Medicine News sodium bicarbonate toxicology rounds Source Type: news

Prolonged toxic coma and anisocoria secondary to doxepin, lorazepam and phenobarbital poisoning--case study - Kołodziej M, Majewska M, Krajewska A, Szponar J.
Doxepin is a tricyclic antidepressant from the group of dibenzoxepines. Apart from the antidepressant effect, it has also the sedative and anxiolytic effect, so it is used in the treatment of anxiety disorder in the course of psychosis, organic diseases an... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - June 26, 2013 Category: Global & Universal Tags: Poisoning Source Type: news

UK firm halts sale of convulsion drug to Arkansas over death row use
UK-based pharmaceutical company Hikma has stopped supplying convulsion drug phenobarbital to Arkansas in the US to prevent it being used in state executions. (Source: Pharmaceutical Technology)
Source: Pharmaceutical Technology - May 17, 2013 Category: Pharmaceuticals Source Type: news

British maker of death penalty drugs adds new restrictions for US buyers
Hikma Pharmaceuticals moves to avoid 'unintended purposes' for drugs amid growing European boycott on sale to the USA drug manufacturer based in Britain has vowed to add new restrictions to sales of its products in the US after it was revealed that it sold a batch of barbiturate to the Arkansas department of corrections, which intended to use it in executions.Hikma Pharmaceuticals has promised to put in place "concrete steps to restrict the supply of its products for unintended uses" following the disclosure by the legal action charity Reprieve that a wholly owned subsidiary in the US had sold injectable phenobar...
Source: Guardian Unlimited Science - May 15, 2013 Category: Science Authors: Ed Pilkington Tags: United States Capital punishment World news Pharmaceuticals industry Europe Drugs UK news Arkansas Source Type: news

[Perspective] Old Dance with a New Partner: EGF Receptor as the Phenobarbital Receptor Mediating Cyp2B Expression
The direct interaction of phenobarbital with the epidermal growth factor receptor reveals a new network interface in nuclear receptor signaling. (Source: Signal Transduction Knowledge Environment)
Source: Signal Transduction Knowledge Environment - May 12, 2013 Category: Science Authors: Sharon A. Meyer, Randy L. Jirtle Source Type: news

[Research Article] Phenobarbital Indirectly Activates the Constitutive Active Androstane Receptor (CAR) by Inhibition of Epidermal Growth Factor Receptor Signaling
The epidermal growth factor receptor is an unexpected target of the barbiturate phenobarbital. (Source: Signal Transduction Knowledge Environment)
Source: Signal Transduction Knowledge Environment - May 7, 2013 Category: Science Authors: Shingo Mutoh, Mack Sobhany, Rick Moore, Lalith Perera, Lee Pedersen, Tatsuya Sueyoshi, Masahiko Negishi Source Type: news

What Causes Constipation?
Discussion Constipation generally is defined as infrequent or painful defecation. Constipation can be very disturbing to the patient and family who believe the stools are too infrequent, too hard or too difficult to pass. Most children develop constipation after the child begins to associate pain (e.g. a hard bowel movement) with defecation. The child then begins to withhold the stools trying to decrease the defecation discomfort. As stool withholding continues, the rectum dilates and gradually accommodates with the normal defecation urge disappearing. Passing large hard stools infrequently reinforces the defecation pain. ...
Source: - February 25, 2013 Category: Pediatrics Authors: Donna M. D'Alessandro, M.D. Tags: Uncategorized Source Type: news

What enhanced elimination techniques are useful in critical toxicology patients?
3 out of 5 stars Enhanced Poison Elimination in Critical Care. Ghannoum M, Gosselin S. Adv Chronic Kidney Dis 2013 Jan;20:94-101. Abstract This survey of methods available for enhanced elimination in toxicology cases gives a good overview, but unnecessarily wastes time discussing modalities that now are never used (e.g., forced diuresis and urine acidification). The information would have been more accessible if it had been streamlined to reflect current practice. For instance, the authors list 20 poisons “amenable” to multidose activated charcoal, but in fact the indications for this treatment are limited...
Source: The Poison Review - February 17, 2013 Category: Toxicology Authors: Leon Tags: Medical critical care enhanced elimination hemodialysis multidose activated charcoal overdose poisoning toxicology Source Type: news

FDA Updates Atazanavir Sulfate Capsule Labeling
“Recently [February 4, 2013] FDA approved changes to the Reyataz (atazanavir sulfate) capsule labeling to include the following changes. “Section 5 Warnings and Precautions was revised to include cholelithiasis ...   “In section 6 Adverse Reactions: Postmarketing Experience, interstitial nephritis was added. “In section 7 Drug Interactions: information regarding coadministration with boceprevir, carbamazepine, phenytoin, phenobarbital, lamotrigine and voriconazole was added.” The updated labeling will be available at the FDA website. More information is available: FDA: Press releas...
Source: AIDSinfo At-a-Glance: Offering Information on HIV/AIDS Treatment, Prevention, and Research, A Service of the U.S. Department of Health and Human Services (DHHS) - February 12, 2013 Category: Infectious Diseases Source Type: news