Dr. Gustin's Blog

Methamphetamine and New Legislation

Several states are considering new legislation that will make decongestants prescription medication requiring a doctor's signature.  The main ingredient of these medications is pseudoephedrine, an essential ingredient in the production of Methamphetamine.  In one state alone, Tennessee, police shut down over 2000 Methamphetamine labs last year, about a 50% increase from the year before.

Methamphetamine is an extremely dangerous street drug.  Once an individual becomes habituated, studies show that their life expectancy is less than 10 years.  Once hooked, because of its effects on dopaminergic receptors of the brain, it is extremely difficult to stop use, and relapse is the rule rather than the exception.

Methamphetamine damages the brain, central nervous system, heart and other organs.  It not only destroys the life of the user, but often seriously impacts those closest to the person including friends and family.  Methamphetamine has become a serious public health problem in the U.S., and state legislation will be a big step in helping to curb access to this substance.

Adverse Drug Reactions: Terbutaline and Preterm Labor

Normally, I would put information like this in my "Latest News" section, but this is too important not to be on my front page where my blog is located. Terbutaline, given orally or intravenously, is routinely used to treat preterm labor.  It has now been shown to significantly increase the risk of maternal heart problems and sudden death.  You can read more about this by clicking my link, and you can also read more about this on the FDA website: http://www.fda.gov/Drugs/DrugSafety/ucm243539.htm

Read more: Adverse Drug Reactions: Terbutaline and Preterm Labor

De-escalating the Toxicologically Altered Aggressive Individual

Toxicologists when reviewing cases are often faced with a subject in question that had altered mental status as a consequence of the effects of illicit substances.  In this setting, dealing with aggressive patients can make a big difference in outcome. Patient death or injury resulting from the use of restraint and seclusion is an increasing concern in the field and in prison. Excessive and inappropriate TASER use has also been associated with sudden death.  A well-known 1998 article documented 142 restraint-related deaths nationwide over a decade, 40% of which were attributed to unintentional asphyxiation during restraint. Restraint not only poses a risk for patient harm but also is physically and emotionally traumatizing for staff involved in the incident. Many have pointed out that high restraint rates are now understood as evidence of treatment failure. Since the Joint Commission began tracking sentinel events in 1996, it has reviewed the deaths of 20 patients who were physically restrained. Since then, the Joint Commission has advocated standards based on prevention as an intervention and the use of restraint as a last resort only after the least restrictive measures are exhausted.

Read more: De-escalating the Toxicologically Altered Aggressive Individual

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