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Toxicology

Stings and Envenomations

It is summertime, so the bees and bugs are out! In this episode, Dr. Ben Grebber, a pediatric resident at Boston Children’s Hospital/Tufts Children’s Hospital, discusses Bee Stings and Spider Bites. A very common pediatric summer complaint in emergency departments, urgent cares, and primary care offices, this episode covers common signs and symptoms, some pathophysiology, and recommended treatments.

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References

Arif F, Williams M. Hymenoptera Stings. [Updated 2022 Jun 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518972/

Bond, G. R. (1999). Snake, spider, and scorpion envenomation in North America. Pediatrics in review, 20(5), 147-151.

Pansare, M., Seth, D., Kamat, A., & Kamat, D. (2020). Summer buzz: All you need to know about insect sting allergies. Pediatrics in Review, 41(7), 348-356.

Shireen Banerji, PharmD, Alvin C. Bronstein, MD, 2016. “Envenomations”, American Academy of Pediatrics Textbook of Pediatric Care, Thomas K. McInerny, MD, FAAP, Henry M. Adam, MD, FAAP, Deborah E. Campbell, MD, FAAP, Thomas G. DeWitt, MD, FAAP, Jane Meschan Foy, MD, FAAP, Deepak M. Kamat, MD, PhD, FAAP, Rebecca Baum, MD, FAAP, Kelly J. Kelleher, MD, MPH, FAAP

Categories
Toxicology

Toxicology Season 3 Episode 3: Iron

Iron ingestions always show up on standardized tests and are definitely one of those “many kids are fine but some aren’t and it’s hard to figure out who’s fine and who isn’t” ingestions. Suzan Mazor from Seattle Children’s helps iron out the details…

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CME and MOC Part II

I am delighted to offer free CME and MOC Part II through Cincinnati Children’s for the entirety of Toxicology Season 3. Just listen to all three episodes and access the CME/MOC portal via this link.

References

Gumber MR, Kute VB, Shah PR, Vanikar AV, Patel HV, Balwani MR, Ghuge PP, Trivedi HL. Successful treatment of severe iron intoxication with gastrointestinal decontamination, deferoxamine, and hemodialysis. Ren Fail. 2013;35(5):729-31. PMID: 23635030.

Chang TP, Rangan C. Iron poisoning: a literature-based review of epidemiology, diagnosis, and management. Pediatr Emerg Care. 2011 Oct;27(10):978-85. PMID: 21975503.

Categories
Toxicology

Toxicology Season 3 Episode 2: Calcium Channel Blockers

Now this is a frightening ingestion! Calcium channel blockers are hard to manage with refractory shock being one of my main “please don’t let this come to the ED” nightmares. Suzan Mazor breaks it all down and discusses management of this challenging ingestion.

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CME and MOC Part II

I am delighted to offer free CME and MOC Part II through Cincinnati Children’s for the entirety of Toxicology Season 3. Just listen to all three episodes and access the CME/MOC portal via this link.

References

Bartlett, J. W., & Walker, P. L. (2019). Management of Calcium Channel Blocker Toxicity in the Pediatric Patient. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG24(5), 378–389. https://doi.org/10.5863/1551-6776-24.5.378

Chakraborty RK, Hamilton RJ. Calcium Channel Blocker Toxicity. [Updated 2022 Feb 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537147/

Categories
Toxicology

Toxicology Season 3 Episode 1: Bupropion

There are some scary ingestions out there and I think we’d all agree that bupropion (Wellbutrin) is on the short list of drugs that should make us worry. Learn how to recognize and manage toxicity, especially the neurogenic and cardiac effects of bupropion in the first episode of the third season of Toxicology podcasts from Suzan Mazor and I.

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CME and MOC Part II

I am delighted to offer free CME and MOC Part II through Cincinnati Children’s for the entirety of Toxicology Season 3. Just listen to all three episodes and access the CME/MOC portal via this link.

References

Huecker MR, Smiley A, Saadabadi A. Bupropion. [Updated 2021 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470212/

Farkas J. Bupropion intoxication. EMCrit. October 1, 2021. Accessed April 11, 2022. https://emcrit.org/ibcc/bupropion/

Categories
Toxicology

Toxicology Season 2 Episode 3: Nicotine

This is Season 2 of the Toxicology podcast series that Seattle Childrens’ Toxicologist Suzan Mazor, MD and I put together. This three episode season turns its focus to drugs of abuse – continuing with this episode on nicotine toxicity – the final episode of this #ToxTuesdays season.

I am now proud to offer CME through Cincinnati Children’s. To claim visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

American College of Medical Toxicology: Nicotine

CDC: Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products

Yale medicine – E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI). YaleMedicine.org

Categories
Toxicology

Toxicology Season 2 Episode 2: Marijuana

This is Season 2 of the Toxicology podcast series that Seattle Childrens’ Toxicologist Suzan Mazor, MD and I put together. It is a joint effort so to speak. This three episode season turns its focus to drugs of abuse – continuing with this episode on marijuana toxicity. So, let’s weed out the bad information, hash out the details, and learn about cannabinoid toxicity in this #ToxTuesdays episode.

I am now proud to offer CME through Cincinnati Children’s. To claim visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Graham et al. Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome in Adolescents: A Case Series, PEDIATRICS, 2017.

Wang, Pediatric Concerns Due to Expanded Cannabis Use: Unintended Consequences of Legalization, J Med Toxicol. 2017 Mar; 13(1): 99–105.

Categories
Toxicology

Toxicology Season 2 Episode 1: Opioids

This is Season 2 of the Toxicology podcast series that Seattle Childrens’ Toxicologist Suzan Mazor, MD and I put together. This three episode season turns its focus to drugs of abuse – beginning with this episode on opioid toxicity. So, slow your breathing, constrict your pupils, and focus in for the return of #ToxTuesdays.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Allen, et al. Prescription Opioid Exposures Among Children and Adolescents in the United States, PEDIATRICS, 2017.

Boyer, Management of Opioid Analgesic Overdose, NEJM, 2012.

Forti, Opiate Overdose, Pediatrics in Review January 2007, 28 (1) 35-36; DOI: https://doi.org/10.1542/pir.28-1-35.

Matson et al. Opioid Use in Children, J Pediatr Pharmacol Ther. 2019 Jan-Feb; 24(1): 72–75.

www.takebackyourmeds.org

Categories
Toxicology

Toxicology Season 1 Episode 4: Salicylates

This is episode four of season one of the Toxicology series that Suzan Mazor, the Medical Director for Toxicology at Seattle Children’s, and I are putting together. This episode focuses on a worrisome intentional and accidental ingestion – salicylates. Learn about diagnosis, management, and more!

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Toce, Burns. The Poisoned Pediatric Patient. Pediatrics in Review May 2017, 38 (5) 207-220; DOI: 10.1542/pir.2016-0130

Calello, Henretig. Pediatric Toxicology: Specialized Approach to the Poisoned Child. Emerg Med Clin N Am 32 (2014) 29–52

Barrueto et al. Updates in the General Approach to the Pediatric Poisoned Patient. Pediatric Clinics. VOLUME 60, ISSUE 5, P1203-1220, OCTOBER 01, 2013. DOI:https://doi.org/10.1016/j.pcl.2013.06.002

Palmer, Clegg. Salicylate Toxicity. N Engl J Med 2020; 382:2544-2555. DOI: 10.1056/NEJMra2010852.

Categories
Toxicology

Toxicology Season 1 Episode 3: Acetaminophen

This is episode three of season one of the Toxicology series that Suzan Mazor, the Medical Director for Toxicology at Seattle Children’s, and I are putting together. This episode focuses on one of the most common intentional ingestions – Acetaminophen.

For those of you from across the ocean – this episode tackles paracetamol, and for you chemists out there, N-acetyl-p-aminophenol (APAP).

Suzan reviews toxicity and management and perhaps this one will help you care for an upcoming patient, and get a couple of questions right on your boards.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Toce, Burns. The Poisoned Pediatric Patient. Pediatrics in Review May 2017, 38 (5) 207-220; DOI: 10.1542/pir.2016-0130

Calello, Henretig. Pediatric Toxicology: Specialized Approach to the Poisoned Child. Emerg Med Clin N Am 32 (2014) 29–52

Barrueto et al. Updates in the General Approach to the Pediatric Poisoned Patient. Pediatric Clinics. VOLUME 60, ISSUE 5, P1203-1220, OCTOBER 01, 2013. DOI:https://doi.org/10.1016/j.pcl.2013.06.002

Categories
Toxicology

Toxicology Season 1 Episode 2: Decontamination and Elimination

This is episode 2 of season one of the Toxicology series that Suzan Mazor, the Medical Director for Toxicology at Seattle Children’s, and I are putting together. This follow up episode focuses on a decontamination and elimination in the poisoned pediatric patient and offers many pearls that will serve as a foundation for upcoming episodes – including why Ipecac is no longer prescribed to every 4 month old!

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

Follow me on Twitter @PEMTweets

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References

Toce, Burns. The Poisoned Pediatric Patient. Pediatrics in Review May 2017, 38 (5) 207-220; DOI: 10.1542/pir.2016-0130

Calello, Henretig. Pediatric Toxicology: Specialized Approach to the Poisoned Child. Emerg Med Clin N Am 32 (2014) 29–52

Barrueto et al. Updates in the General Approach to the Pediatric Poisoned Patient. Pediatric Clinics. VOLUME 60, ISSUE 5, P1203-1220, OCTOBER 01, 2013. DOI:https://doi.org/10.1016/j.pcl.2013.06.002