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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] 6] Action of local anesthetics is dependent upon the molecule crossing the plasma membrane in a unionized form. [2] Poisoning & Drug Overdose. McGraw Hill; 2022. J Med Toxicol.

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Popular Antiobesity Medications Bring New Challenges to Emergency Physicians

ACEP Now

There have been documented cases of overdose, and of note, there is no known antidote. Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose. Updated December 11, 2022. Diabetes Care. 2018;41:258–66. CNN website. Published December 18, 2023. 2006;47(12):2207.

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ToxCard: Diethylene Glycol

EMDocs

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Accessed August 2022. Accessed August 2022. McGraw Hill, 2019.

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Case Report: Acute Kratom Withdrawal

ACEP Now

He was admitted for a suspected kratom overdose and acute kratom withdrawal. In 2022, the National Poison Data system reported 1,278 cases involving kratom; about 45 percent of those cases required health care facility management. A dexmedetomidine (Precedex) 400 mcg in 0.9 He was discharged the next day. Am J Health Syst Pharm.

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ToxCard: Naloxone – Pearls and Pitfalls

EMDocs

Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. A prospective study of 453 patients who were admitted after receiving naloxone reported life-threatening complications in over 1% of heroin-overdosed patients. Clinical Pearls: Naloxone is lifesaving in opioid overdoses.