Exposure to azide compounds causes inhibition of cytochrome c oxidase in the mitochondria, leading acute lethal poisoning. Although urgent pharmaceutical intervention is required for rescue from poisoning, no antidote exists worldwide. We hypothesized that methemoglobin (metHb) can be a promising material as an poisoning because metHb strongly bind azide. However, administration not feasible ow...

Although rodenticides historically have been among the most toxic substances available to the public and have been implicated as agents in both unintentional and suicidal exposures, the anticoagulant agents currently in use, such as coumadin and their long-acting derivatives (e.g., brodifacoum), are relatively safe. In 1995, most persons who reported exposure to anticoagulant rodenticides did n...

MMWR / October 20, 2017 / Vol. 66 / No. 41 1119 US Department of Health and Human Services/Centers for Disease Control and Prevention multiagency press conferences on June 6 to notify the public about the presence of the dangerous counterfeit pills. A counterfeit Percocet cluster case was defined as 1) an opioid toxidrome (i.e., with central nervous system depression, respiratory depression, an...

CONTEXT Previous reports of acute toxicity/harm associated with mephedrone use have been based on self-reported mephedrone use; toxicological screening has not been undertaken in these cases to determine whether mephedrone has been used. OBJECTIVE To report the first case series of analytically confirmed mephedrone-related acute toxicity. MATERIALS AND METHODS Serum samples were collected f...

Toxicity resulting from excessive intra-synaptic serotonin, historically referred to as serotonin syndrome, is now understood to be an intra-synaptic serotonin concentration-related phenomenon. Recent research more clearly delineates serotonin toxicity as a discreet toxidrome characterized by clonus, hyper-reflexia, hyperthermia and agitation. Serotonergic side-effects occur with serotonergic d...

OBJECTIVES Carbon monoxide (CO) exposure does not produce a classical toxidrome and so it is thought that it may easily be missed, allowing patients to continue to be exposed to CO. The aim of this study was to determine the proportion of raised carboxyhaemoglobin (COHb) levels in a targeted population of patients presenting to four emergency departments (EDs) in England. DESIGN A prospective...

A 60-year-old man had just enjoyed a summer meal that included hamburgers, fruit, and lettuce salad. He finished it off with some ice cream, and to make it healthier he threw on it a handful of seeds from the cupboard that he understood to be flax seeds. What he had eaten instead was a handful of Datura inoxia, or Moonflower seeds (Figure 1). Within 30 minutes he felt “drugged,” and shortly the...

Synthetic Cannabinoids are a street drug that is widely attainable and cheap compared to natural cannabis, and has variable potency and unpredictable effects with no commercially available diagnostic test to confirm its presence. Similar to natural cannabis, Synthetic Cannabinoid intoxication can present in several ways with the most common emergency room presentations to be of neurologic and p...

Medical toxicology is the clinical specialty that treats toxic effects of substances, for example, an overdose, a medication error, or scorpion sting. The volume toxicological knowledge and research has, as with other medical specialties, outstripped ability individual clinician to entirely master stay current it. application machine learning/artificial intelligence (ML/AI) techniques challengi...

In 2013 and 2014, more than 700 deaths were attributed to fentanyl and fentanyl analogues in the United States. Of recent concern is the cluster of unintentional fentanyl overdoses because of tablets thought to be "Norco" purchased on the street in Northern California. U-47700 (trans-3,4-dichloro-N-[2-(dimethyl-amino)cyclohexyl]-N-methylbenz-amide) is a nonfentanyl-based synthetic opioid with 7...