MedTox Fellows: Board review challenge. Match each number with a letter so that each letter is used only once. Do the easy ones first and the rest will follow quickly. Feel free to leave comments/questions. Answers in a couple days. The Tox And The Hound Jerry Snow

YOU CAN’T OVERDOSE FROM TOUCHING FENTANYL

MedTox Fellows. All of following can produce primary resp alkalosis/primary met acidosis, hypokalemia, hyperglycemia, hypophos, and ketosis EXCEPT: A. EtOH withdrawal with ketoacidosis B. salicylate C. isopropanol D. methamphetamine E. terbutaline @toxandhound Jerry Snow

Great talk by Dr. Ben Hunter! #IUEM THE FEST

MedTox Fellows, rattlesnake bite season is well underway in Arizona. A reminder to be aware of rapid onset shock and anaphylactoid reactions following snakebite, and following Gila Monster envenomations. toxandhound.com/toxhound/ff-ra… The Tox And The Hound Jerry Snow

At the Western Tox Conference at UC-Davis. Dr. Levine reviewing ILE and the evidence behind it. Steve Curry PhxMedToxFellowship

Indications for hyperbaric oxygen in CO poisoning: No one has any idea

Dietary Supplements kicking off day 2 at the Western Tox conference Steve Curry PhxMedToxFellowship. Where are you panic! at the digoxin?!

Click Here to support the Dime Academy Basketball Fundraiser 2024 verticalraise.com/fundraiser/dim…

Vets and Vets! Veterinary agents and Toxic exposures in US veterans at Western Tox Conference. Steve Curry PhxMedToxFellowship

MedTox Fellows: 28YOM, coma, friend says only drug used is gabapentin. Tachy and mydriasis. Urine stat mTOF/LC/MS screen below. Many agents used, some of which only metabolites are found. Which taken drug activates M4 muscarinic receptors but antagonizes all other M receptors?

MedTox Fellows: 13 YOM ingested "sleeping pills" after fight with parents. Suprapubic tenderness, dry axillae. Pupils normal. What might he have taken? The Tox And The Hound Jerry Snow

1/ I once heard that a fever in the ICU was a "fever of too many origins." Same can be said altered mental status/encephalopathy! We put together a comprehensive approach to these challenging patients for #SeminarsinNeurology A thread with our approach! pubmed.ncbi.nlm.nih.gov/39137901/

Adding suzetrigine to MS library. MedTox Fellows, this analgesic Na channel blocker is highly specific for Nav 1.8, mainly found in peripheral neurons. How else is blockade different from other Na channel blockers?

Currency Contamination II. It has been long recognized paper currency is contaminated with methamphetamine & cocaine. We recently just took 1 bill (gloves & forceps) from 8 physicians’ or students’ billfolds/ purses, washed bills with methanol, and screened for drugs by LC/qTOFF.

MedTox Fellows: Board review. Here is a photo from social media. The molecular action of the toxin contained in this animal is most similar to which one of the following? And how is the toxin delivered? A. saxitoxin B. ciguatoxin C. bungarotoxin D. batrachotoxin E. brevetoxin

MedTox Fellows: Don't be discouraged when you don't recognize a toxidrome in a comatose patient. This is a typical urine drug screen at our center. It is the exception to ever find a single substance. Meth, ketamine, fentanyl and PCP.

#truth Often times the rule not the exception

MedTox Fellows: 44YOM in ED c/o OD of new med. HR 129 noted, then seizures, hypotension, no pulses. Post ROSC, on epi: ABG- 7.26/40/65/18; Na 141, K 4.5, Cl 109, CO2 18, AG 14, lactate 4.7 mM. Glu 168 mg/dL. ECG post-ROSC & stat drug screen. What single agent best fits?