Beta-Blockers for Cocaine and other Stimulant Toxicity
The toxico-mythology of 'unopposed alpha stimulation' and the contra-indication of beta-blockers in the treatment of cocaine, amphetamine and other stimulant toxicity. Down with dogma!
Category Toxicology
Why so blue?
A 40-year-old man presented to the emergency department with shortness of breath, chest pain and reported a pre-syncopal episode. But why so blue?
Never Kiss a Jellyfish
Although I ‘love’ jellyfish from the point of view of a clinician, I try to avoid getting too ‘up close and personal’ with them. Unfortunately upon diving into the Indian Ocean last weekend – a maneuver described as ‘ungainly’ by…
Seizures, Sedation and Saliva
A 21-year-old male with a background of schizophrenia and previous intentional overdose, weighing 70kg, was brought to the ED via ambulance after having a witnessed seizure at home.
Stuffed, Speeding and Busted!
Just before being busted by the cops, your patient stuffed a package containing metamphetamines into his mouth and swallowed. How are you going to handle this one?
Another TCA overdose!
A classic overdose for you to ponder in classic Q&A style, which incidentally marks the 50th toxicology conundrum on LITFL!
Alprazoslammed
An ingestion of 100mg of alprazolam... Boring benzodiazepine or badness brewing? Find out in this case-based series of questions-and-answers.
Lithium, Vomiting And Diarrhoea
Your next patient has swallowed over 80 grams of lithium. What are you going to do about it?
Brain Dead?
A baffling case of apparent brain death... Can you work out what has happened? A 35-year old female with a history of multiple sclerosis and depression is found collapsed at home. She is known to have access to quetiapine.
A Fumbling, Mumbling Mess!
A 41-year old man is brought to ED after becoming drowsy while in police custody. He states that he has taken an overdose of diazepam tablets prior to being arrested. A puzzling case of drug-induced delirium. Can you solve the mystery?
Paracetamol-Induced Hepatotoxicity
A case of paracetamol-induced hepatotoxicity with a discussion of the Schiodt scoring system for predicting paracetamol-induced liver failure.
Propanolol Overdose
aka Toxicology Conundrum 044 A 27-year old female weighing 60kg presents to ED approximately one hour after swallowing 70 x 40mg propranolol tablets (= 2.8 grams) with suicidal intent. At the time of assessment she is drowsy (GCS 13) with…