Continuous Methylene Blue Infusions for Treating Recurrent Methemoglobinemia by Steve Curry Banner – University Medical Center Phoenix University of Arizona College of Medicine – Phoenix A 2012 report out of Oregon serves as one of many examples reminding us that some serious cases of methemoglobinemia require more than a single injection of methylene blue in […]
Tox and Hound – Blackout
by Chris Holstege In the practice of medicine at a public university, I often encounter the complaint from my patients that “someone must have slipped something into my drink”. Their rationale is that they have drunk this much on previous occasions, but this time they do not remember anything. I recently was […]
Tox & Hound – Pour Some Octreotide on Me
by Kavita Babu In 1999, a toddler encountered glipizide during an exploratory ingestion. When he wouldn’t wake up from a nap, the family called the EMTs, who found a fingerstick blood sugar of 13 mg/dL. He received several D25 boluses – each time his sugar would respond appropriately, then fall. His care […]
Tox & Hound – Small Poisoned Humans
by Diane Calello A patient is brought back from triage. He is uncooperative with your exam and it is difficult to obtain vital signs. His speech is mostly incoherent, and he is drooling. You notice with disgust that he is chewing on the bedrails. He is incontinent of urine and feces, but […]
Tox & Hound – aka AKA
by Dan Rusyniak Few things perk a toxicologist’s interest as much as a low bicarb and a high anion gap. To us an Anion Gap Metabolic Acidosis (AGMA, unlike MAGA) is a solvable mystery. You might remember from medical school the mnemonic MUDPILES or CAT MUDPILES. Looking at the list (from Wikipedia) […]