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Specialty: Toxicology
Condition: Poisoning

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Total 16 results found since Jan 2013.

Does smoking marijuana cause stroke?
1.5 out of 5 stars Cannabis-related Stroke: Myth or Reality? Wolff V et al. Stroke 2013 Feb;44(2):558-63. doi: 10.1161/STROKEAHA.112.671347. Epub 2012 Dec 27. No abstract available There have been scattered reports in the literature claiming an association between the use of cannabis and ischemia and/or hemorrhagic stroke. Although no convincing mechanism has been postulated, some suggest that use of marijuana or hashish and the occurrence of stroke may stem from the ability of cannabis to cause orthostatic hypotension, or possibly vasoconstriction. If such an association is real, it must be exceedingly rare. The purpose...
Source: The Poison Review - January 27, 2013 Category: Toxicology Authors: Leon Tags: Medical cannabis cerebral vascular accident hashish marijuana neurotoxicity stroke Source Type: news

Stroke in a young patient? Ask about synthetic cannabinoids
3 out of 5 stars Ischemic stroke after use of synthetic marijuana “spice”. Freeman MJ et al. Neurology 2013;81:1-4. Abstract This interesting paper, from the University of South Florida in Tampa, describes a brother and sister who at different times both developed ischemic strokes shortly after smoking a synthetic marijuana product. The 26-year-old brother presented with dysarthria, expressive aphasia, and right-sided weakness after smoking “Spice” a few hours previously. Head CT showed a clot in the proximal middle cerebral artery. His symptoms resolved after treatment with thrombolytics. The 19-y...
Source: The Poison Review - December 11, 2013 Category: Toxicology Authors: Leon Tags: Medical cerebral ischemia jwh-018 spice stroke synthetic cannabinoid Source Type: news

Unlabeled amphetamine isomer in sports supplement “probably” caused hemorrhagic stroke
3.5 out of 5 stars Hemorrhagic Stroke Probably Caused by Exercise Combined With a Sports Supplement Containing β-Methylphenylethylamine (BMPEA): A Case Report. Cohen P et al. Ann Intern Med 2015 May 12 [Epub ahead of print] Reference Last month, the FDA sent letters to 5 companies that manufacture so-called “dietary” or “sports” supplements, warning them that their products were mislabeled because they contained an unlisted ingredient. That ingredient, β-methylphenylethylamine (BMPEA), is an isomer of amphetamine. Although the effects of BMPEA in humans have not been well studied, it has been ...
Source: The Poison Review - May 22, 2015 Category: Toxicology Authors: Leon Tags: Medical amphetamine beta-methylphenylethylamine BMPEA dietary supplement hemorrhagic stroke sports supplement Source Type: news

Maybe Pradaxa (dabigatran) does need blood monitoring after all
2.5 out of 5 stars The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients. Reilly PA et al. J Am Coll Cardiol 2014 Feb 4;63:321-8. Abstract A must-read article in yesterday’s New York Times described the internal battle at Boehringer Ingelheim, the maker of Pradaxa (dabiagtran etexilate), concerning the publication of this study. A major marketing point posited in favor of dabigatran over warfarin for the prevention of stroke in patients with atrial fibrillation was that it did not require monitoring with reg...
Source: The Poison Review - February 7, 2014 Category: Toxicology Authors: Leon Tags: Medical bleeding blood testing boehringer ingelheim dabigatran pradaxa stroke Source Type: news

Kratom Adulterated with Phenylethylamine and Associated Intracerebral Hemorrhage: Linking Toxicologists and Public Health Officials to Identify Dangerous Adulterants.
CONCLUSION: Medical toxicologists should form working relationships with laboratories and public health officials to aid in early identification of adulterated products that carry risk to the general population. PMID: 31713176 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - November 10, 2019 Category: Toxicology Authors: Nacca N, Schult RF, Li L, Spink DC, Ginsberg G, Navarette K, Marraffa J Tags: J Med Toxicol Source Type: research

Case report: hemodialysis for dabigatran overdose
3 out of 5 stars Hemodialysis for the Treatment of Pulmonary Hemorrhage from Dabigatran Overdose. Chen BC et al. Am J Kidney Dis 2013 Apr 15 [Epub ahead of print] Abstract Dabigatran (Pradaxa) is a competitive direct thrombin inhibitor approved in the United States for stroke prophylaxis in patients with nonvalvular atrial fibrillation. Although dabigatran has certain advantages over coumadin related to issues of dosing and testing, there is no readily available test to measure its anticoagulation effect, and there is no antidote to reverse bleeding. Recommendations for treating a patient with dabigatran-associated hemorr...
Source: The Poison Review - April 24, 2013 Category: Toxicology Authors: Leon Tags: Medical dabigatran hemodialysis hemorrhage overdose Source Type: news

Toxic lipstick, carbon monoxide tragedy, laundry detergent pod death: Weekly Web Review in Toxicology
Meth Labs and the Pharmaceutical Industry: Jonah Engle’s article in Mother Jones — “Merchants of Meth: How Big Pharma Keeps the Cooks in Business” — is compelling reading. The piece details how some drug companies lobbying firms are fighting efforts to control sale of the  meth precursor pseudoephedrine: As law enforcement agencies scramble to clean up and dispose of toxic [meth] labs, prosecute cooks, and find foster homes for their children, they are waging two battles: one against destitute, strong-out addicts, the other against some of the world’s wealthiest and most politically connected ...
Source: The Poison Review - August 21, 2013 Category: Toxicology Authors: Leon Tags: Medical big pharma carbon monoxide heavy metals laundry detergent pod methamphetamine toxic lipstick Source Type: news

Was Arafat poisoned by radioactive polonium?
Yasser Arafat The Maybe-Murder of Yasser Arafat: In a must-read post on Wired Science Blogs, Deborah Blum points out that despite the recent confirmation of traces of radioactive polonium-210 in the exhumed remains of Palestinian Liberation Organization chairman Yasser Arafat, it is far from certain that he died of radiation poisoning. In October 2004, a month before he died, Arafat developed vomiting and abdominal pain. The symptoms were so severe that he was transferred from his home on the West Bank to a hospital in France. The direct cause of Arafat’s death — which occurred on November 11 — was a hemorrha...
Source: The Poison Review - November 12, 2013 Category: Toxicology Authors: Leon Tags: Medical acute radiation syndrome arafat cesium himalayan mountain salt hypokalemia pablo neruda poisoning polonium-210 radioactivity smacc 2013 weekly web review in toxicology Source Type: news

Emergency department visits in Colorado associated with smoking synthetic cannabinoids
3 out of 5 stars Severe Illness Associated with Reported Use of Synthetic Marijuana — Colorado, August-September 2013. MMWR 2013 Dec 13;62:1016-1017. Full Text In August and September of this year, it became apparent to the Colorado Department of Public Health and Environment (CDPHE) that there was a significant increase in the number of patients visiting emergency departments after smoking synthetic marijuana products. Therefore, the Department sent out a request to all EDs in the state to report patients seen on or after August 21 with altered mental status after using any form of synthetic marijuana. To study this pr...
Source: The Poison Review - December 13, 2013 Category: Toxicology Authors: Leon Tags: Medical colorado crazy clown denver spice synthetic cannabinoid Source Type: news

Does cannabis cause acute coronary syndromes?
2 out of 5 stars Is recent cannabis use associated with acute coronary syndromes? An illustrative case series. Casier I et al. Acta Cardiol 2014 Apr;69:131-136. Abstract Tetrahydrocannabinol (THC) has a number of well-documented effects on the cardiovascular system: increased heart rate increased blood pressure decreased peripheral vascular resistance orthostatic hypotension THC may also be associated in rare cases with induction of ventricular arrhythmias. In addition, smoking marijuana may decreased oxygen delivery to the myocardium because of elevated carboxyhemoglobin levels. This paper presents 3 cases in which, t...
Source: The Poison Review - June 25, 2014 Category: Toxicology Authors: Leon Tags: Medical cannabis cardiotoxicity coronary disease marijuana tetrahydrocannabinol THC Source Type: news

Using Drug-Intoxicated Deaths as Potential Organ Donors: Impression of Attendees at the American College of Medical Toxicology 2014 Annual Scientific Meeting.
CONCLUSIONS: Medical toxicologists have some reservation in recommending solid organs for transplantation from deaths from cocaine and carbon monoxide. Given the decrease in potential organ donors from typical methods of death, further work is needed to promote organ donation in deaths related to acute poisoning. PMID: 25023224 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - July 15, 2014 Category: Toxicology Authors: Wood DM, Chan WL, Dargan PI Tags: J Med Toxicol Source Type: research

Saturday with SMACC: The Art and Science of Fluid Responsiveness
Haney Mallemat – The Art and Science of Fluid Responsiveness from Social Media and Critical Care on Vimeo. From SMACC Gold: In a great talk, Haney Mallemat from the University of Maryland discusses the limitations of static indices of fluid responsiveness such as blood pressure and respiratory-induced changes in inferior vena cava diameter. He argues persuasively that dynamic indices — such as change in stroke volume with passive leg raise — are more accurate and precise, although measurement is technically more difficult.  
Source: The Poison Review - September 7, 2014 Category: Toxicology Authors: Leon Tags: Medical dynamic indices fluid responsiveness haney mallemat SMACC ultrasound Source Type: news

Delayed seizure after exposure to a synthetic cannabinoid product
PB-22 3 out of 5 stars Delayed seizure-like activity following analytically confirmed use of previously unreported synthetic cannabinoid analogues. Schep LJ et al. Hum Exp Toxicol 2015 May;34:557-60. Abstract Exposure to s0-called synthetic cannabinoid products, which may consist of any of 100s of specific compounds — of a combination of these chemicals — have been associated with a wide range of signs and symptoms, including anxiety and agitation, drowsiness, vomiting, tachycardia, hallucinations, and seizures. Diagnoses associated with such exposure have included myocardial infarction, ischemia stroke, and acute kid...
Source: The Poison Review - September 1, 2015 Category: Toxicology Authors: Leon Tags: Medical 5F-PB-22 AM-2233 JWH-122 seizure spice synthetic cannabinoid Source Type: news

Review: recreational marijuana use
Stanimir G. Stoev/Shutterstock.com 3 out of 5 stars Recreational cannabis use: Pleasures and pitfalls. Rella JG. Cleve Clin J Med 2015 Nov;82:765-72. Full Text This somewhat superficial but relatively well done review article gets extra credit for being available via open access. The author covers the history, pharmacology, toxicology, and acute and chronic effects of cannabis use, as well as withdrawal and the cannabinoid hyperemesis syndrome. My main problem with this paper involves the author’s casual use of references. For example, he states that previous literature had reported “a fivefold increased risk ...
Source: The Poison Review - November 10, 2015 Category: Toxicology Authors: Leon Tags: Medical recreational marijuana Review THC Source Type: news

All bleeding stops — but does idarucizumab (Praxbind) make it stop faster?
3.5 out of 5 stars Persistent life-threatening hemorrhage after administration of idarucizumab. Alhashem HM et al. Am J Emerg Med 2016 June 30 [Epub ahead of print] Reference Dabigatran (Pradaxa) is a direct thrombin inhibitor approved for stroke and embolism prophylaxis in patients with non-valve-related atrial fibrillation. When it was first released in 2008, a major disincentive to widespread use was the lack of a reliable reversal agent to treat major bleeds, or to administer before necessary invasive procedures. In October 2015, the U.S. Food and Drug Administration approved idarucizumab (Praxbind), a monoclonal ant...
Source: The Poison Review - July 27, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical anticoagulant hemorrhage idarucizumab pradaxa praxbind reversal agent Source Type: news