Keywords: ICP, intracranial pressure, antihypertensive, nitroprusside, nitroglycerin, hydralazine (PubMed Search)
Several antihypertensive agents raise intracranial pressure. Normal cerebral blood flow (CBF) is constant within normal cerebral perfusion pressure (CPP) ranges, recalling that CPP=MAP-ICP.
If CPP is outside the range in which autoregulation occurs, e.g. due to a structural lesion, ischemic stroke, or head trauma, CBF decreases and can adversely affect the patient.
In patients with ischemic stroke or intracerebral pathology, labetalol or esmolol may be used to lower blood pressure without raising ICP. Nicardipine is recommended for use in patients with ischemic stroke or SAH but not in patients with brain injury
If the patient has NO structural abnormalities, but has hypertensive encephalopathy, nitroglycerin, nitroprusside, labetalol, esmolol, or nicardipine may be used.
Keywords: melamine, infant, milk (PubMed Search)
Keywords: diphenhydramine, heroinI (PubMed Search)
Cheese Heroin: a slang term for the combination of heroin with an over-the-counter antihistamine
Keywords: latrodectus, black widow, spider (PubMed Search)
Latrodectus sp (Black Widow Spider)
Take a look at a picture of the black widow on the following attachment
Keywords: Lidocaine, pediatrics, anesthesia (PubMed Search)
Topical Lidocaine for local anesthesia
Disclosure: I have no financial or invested interest in the product or the company.
1. Pharmacist's Letter 2008 24(9):240912
2. Cregin R. Improving pain management for pediatric patients undergoing nonurgent painful procedures. ASHSP April 15 2008;Vol 65(8):723-7.
3. Kaweski S. Topical Anesthetic Creams. Plastic and Reconstructive Surgery. June 2008; Vol 121(6):2161-5.
Keywords: methadone, buprenorphine (PubMed Search)
Keywords: arsenic, diabetes (PubMed Search)
A recent landmark article has cited a connection between non-insulin dependent diabetes and low-level arsenic in our drinking water.
Keywords: drug interactions, disulfiram, bactrim, tinidazole, metronidazole (PubMed Search)
Other common medications that produce this reaction:
1. Sulfonylureas: chlorpropamide, tolbutamide, glyburide
2. Cardiovascular medications: Isosorbide dinitrate, nitroglycerin
Weathermon R, Crabb DW. Alcohol and Medication Interactions. Alcohol Research and Health. 1999 (23);1:40-54.
Keywords: mercury, poisoning (PubMed Search)
Keywords: Salicylate, aspirin, metabolic acidosisM (PubMed Search)
First Line Therapy: Urine Alkalinization (pH >7.5) by administrating NaHCO3
Other Indications for Hemodialysis in Salicylate Poisoned Patient:
Keywords: lactic acidosis, metformin, renal failure (PubMed Search)
Perrone et al. Occult metformin Toxicity in Three patients with profound lactic acidosis. J Emerg Med 2008, June 18.
Keywords: drugs of abuse, heroin (PubMed Search)
Keywords: dapsone, methemoglobinemia, methylene blue (PubMed Search)
Keywords: coumadin, vitamin K, anticoagulation (PubMed Search)
Here is a short list of medications that will actually prevent a patient from being anticoagulated by coumadin. These medications will make it difficult for the patient to reach therapeutic levels and need to be warned about this drug-drug interaction with coumadin:
Reference: Goldfrank's Textbook of Toxicologic Emergencies, 6th Edition
Keywords: transdermal, fentanyl, clonidine (PubMed Search)
Trandermal Delivery Systems
Keywords: sedation, propofol, ketamine (PubMed Search)
"Ketofol" (Ketamine plus propofol)
Keywords: chlorine, pneumonitis (PubMed Search)
Pool Cleaner Toxicity - Chlorine Gas Exposure
The "shock" treatment that is utilized in pool cleaner is often contained in a large plastic container and is calcium hypochlorite. Chlorine gas accumulates in the small amount of airspace found in the container. If a future patient opens the container either in an enclosed space or within close proximity of the face that allows for large inhalational exposure.
Keywords: cyanide (PubMed Search)
Toxicology Trivia for $1000 - These are in fruits of the "rose" family and in some roots that contain cyanogenic glycosides and other cyanide containing compounds. It would actually take a fair amount of work to ingest enough to reach toxicity:
Bass. Sudden Sniffing Death. JAMA 1970.
Keywords: prolonged QT, arrhythmia, adverse effect, antiarrhythmics, antibiotics, antipsychotics (PubMed Search)
Other factors that are associated with prolonged QT include: bradycardia, female sex, genetics, and electrolyte abnormalities.
Kannakeril PJ, Roden DM. Drug-Induced long QT and torsade de pointes: recent advances. Current opinions in cardiology. Jan 2007;22(1):39-43.
Horn JR, Hansten PD. Drug Interactions and QT Interval Prolongation. Pharmacy Times Dec 2004. pp66.