Dr. Gustin's Blog | Blog | Page 10 | Medical Toxicology Expert Witness

Does Tylenol Cause Asthma???

Details: Published: Wednesday, 01 February 2012 17:17

A recent report based on a series of studies suggests that acetominopen might contribute to the development of childhood asthma. Obviously, this is a major discovery as acetominopen is the most popular anti-pyretic and anti-analgesic in the pediatric population. You can read the full New York Times report by Clicking Here.

Darvon: Pulled from the Market in 2011

Details: Published: Wednesday, 18 January 2012 20:45

Darvon, generic name propoxyphene, is no longer. Several months ago, the FDA pulled it from the market. Some have called propoxyphene the worst drug in history. Read more to see why:

Energy Drinks Are Dangerous

Details: Published: Wednesday, 18 January 2012 20:25

The latest craze amongst kids is energy drinks. These drinks have high levels of caffeine. When combined with other stimulants or alcohol or other illicit drugs, they become toxic, and have resulted in a surge of emergency room visits; in some cases death has resulted.

The following news release points out some of the statistics and discusses this disturbing toxicologic phenomenon.

Lead Levels to be Lowered Again...

Details: Published: Thursday, 05 January 2012 17:25

Over the past 30 years the EPA and CDC have lowered the level of blood lead that has been considered acceptable based on newer and more sophisticated scientific studies demonstrating adverse health effects at lower and lower blood lead levels. Now for the first time in 20 years a federal committee is again recommending that the acceptable level of blood lead by less than 5 mcg/L a 50% drop from its current acceptable level of 10 mcg/L.

Lead in children at even extremely low levels can cause neurobehavioral abnormalities including attention deficit disorder and lower intelligence.

To read the latest press release, CLICK HERE

FDA Warnings on Dronedarone

Details: Published: Tuesday, 20 December 2011 10:47

Dronedarone, brand name Multaq, is an increasingly popular anti-arrythmic drug used by cardiologists and critical care physicians. The FDA has recently determined that this drug is dangerous in a certain subset of patients. Death has been reported in patients who have chronic atrial fibrillation. To see the full news report which was posted yesterday on a toxicology/pharmacology site, see the following article:

Chronic Acetaminophen Toxicity

Details: Published: Monday, 12 December 2011 20:55

Acetaminophen (Tylenol) is the most commonly consumed medication in the United States. Most people just assume that it is benign and can be taken with impunity. The truth, however, is that acetaminophen is toxic when taken in excess both acutely and chronically. The following blog discusses a recent study out of Britain that proves just how toxic acetaminophen is when consumed regularly. The dangers of this medication are clear and immediate.

Problems Arising From Poor Patient Communication

Details: Published: Friday, 18 November 2011 13:49

Medical malpractice lawsuits frequently arise because of misundertandings, poor communication, and the reactive emotions that naturally follow. When patients become angry, they are apt to escalate the situation, magnify the problems or bad outcomes, and become predisposed to blaming the doctor or the hospital. Much litigation can be avoided if situations are de-escalated early.

There are ways to deal with such encounters in which you work with the angry patient and guide them through their emotions, and the accompanying volatility, to the point where it is possible to have a constructive, or at least manageable discussion with them.

Can Vitamin Supplements Cause Death?

Details: Published: Thursday, 03 November 2011 22:41

The following article is from a recent issue of Medscape. Vitamin supplements are ubiquitous and are commonly taking by people who want to be health conscious and maximally healthy. But not all vitamins and minerals are benign. The Medscape summarizes a recent study in the Archives of Internal Medicine. The citation appears at the end of this report. The study has serious public health implications.

Substance Abuse: New DEA Emergency Ban for Bath Salts

Details: Published: Thursday, 06 October 2011 16:19

Recently the DEA took emergency action to ban for one year bath salts that are composed of PABS, methylenedioxypyrovalerone, which is structurally and toxicologically related to pyrovalerone and a-pyrrolidinophenone compounds that inhibit norepinephrine-dopamine reuptake and act as central nervous system stimulants. These salts are deadly, and are sold under the brand names: Ivory Wave and Vanilla Sky.

Users take it orally, intranasally, intravenously, or rectally and achieve a high that is similar to methamphetamine. It enhances alertness, increases energy, and is an aphrodisiac. On the street, it is being called "legal cocaine".

Doses as low as 3-5 mg will produce an effect. The average dose ranges from 5 to 20 mg, and the risk for overdose is high because packages contain up to 500 mg. In fact, it was the increase in overdose, emergency room visits, and death that prompted the DEA to take action. Orally, absorption is rapid, and the rush (euphoria) that is produced peaks at 1-2 hours after ingestion, and the total effect lasts about 3-4 hours.

The physical effects of PABS include tachycardia, hypertension, arrhythmias, hyperthermia, seizures, stroke, myocardial infarction, and even death. Behavioral and mental effects include panic attacks, anxiety, paranoia, hallucinations, psychosis, aggressive or violent behavior (such as self-mutilation, suicide attempts, and homicidal activity), insomnia, anorexia, and depression.

Emergency treatment consists of benzodiazepams for sedation and IV fluids to prevent hypercatabolic rhabdomyolysis. Metabolic acidosis, if present, is treated in the usual manner.

Click Here: to obtain the New England Journal of Medicine article in PDF format