toxicology

When discussing methylene blue, management and treatment of methaemoglobinaemia is usually the first indication mentioned. But in this podcast, we challenge you to increase the size of your lense and focus on its benefits in other states (e.g., septic shock). Of course, we could not do this alone, so we invited a Flight Paramedic, Pharmacist, Toxicologist, and Professor to join us. And fortunately for us, they are all the same person.

Tune in as Will Heuser helps us discuss the pathophysiology of distributive shock, the pharmacodynamics and pharmacokinetics of methylene blue related to its effects on endothelial relaxation, and how this simple dye goes beyond that of salvage therapy when a patient has high vasopressor requirements.

Get CE hours for our podcast episodes HERE!

--------------------------------------------

Twitter @heavyhelmet

Facebook @heavyliesthehelmet

Instagram @heavyliesthehelmet

Website heavyliesthehelmet.com

Email contact@heavyliesthehelmet.com

Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.

-------------------------------------------- 

Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic
Music promoted by https://www.free-stock-music.com

Podcast summary of articles from the September 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include EMS cardiac rhythms, vasopressors, naloxone, hyperglycemia, DKA protocols, and spider bites.  Guest speaker is Dr. James O'Hora.

This podcast features a 101 episode on toxicology, featuring toxicologist Dr Pushpa Rao. With all the noise and confusion about product safety out in the zeitgeist, I thought this was an important topic to cover. We covered the basics of what toxicology is, how it’s applied to cosmetics, fundamental toxicology themes like hazard and risk, safety substantiation, misconceptions, and more!

Interested in supporting the podcast on Patreon? Find us at www.patreon.com/theecowell

Blood samples and health records for 15,000 pregnancies provides a wealth of scientific data. Add samples and records from the resultant children and grandchildren, and you have an invaluable cohort with which you can study the long-term results of events that occur during pregnancy. Barbara Cohn with the Public Health Institute is the Director of such a cohort and discusses it with co-hosts Anne Chappelle and David Faulkner, including what she and colleagues have discovered about the generational effects of exposure to DDT and other substances.

About the Guest
Barbara A. Cohn, PhD, is Director of the Child Health and Development Studies (CHDS) at the Public Health Institute. CHDS is home to a groundbreaking study, which originated in 1959, designed to shed light on the various factors impacting health during pregnancy and early childhood. Between 1959 and 1967, 15,000 pregnant women and their families were enrolled. Researchers continue to study these rich data and conduct important follow-up studies to further examine how events during pregnancy impact the subsequent health of fathers, mothers, and their children and grandchildren. Dr. Cohn consults with researchers around the world on the use of the CHDS data for health research.

In addition, Dr. Cohn directs research examining how pregnancy protects against breast cancer and influences other health problems in mothers and their children in order to identify natural protective mechanisms that can be used for prevention. She also investigates whether early life exposure to environmental chemicals during pregnancy affects obesity, immune function, reproductive health, cardiovascular disease, diabetes, neurodevelopment, cancer, and health disparities in mothers and their children across the life span.

Dr. Cohn holds a doctorate in epidemiology, a master’s degree in city and regional planning, a master’s degree in public health planning, and a bachelor’s degree in zoology, all from the University of California, Berkeley.

The fields of epidemiology and toxicology sometimes find themselves at odds, but Gradient’s Julie Goodman, an epidemiologist and toxicologist, shares how the two disciplines can complement each other to evaluate public health risks. Dr. Goodman also dives into the finer points of systemic reviews and meta-analyses in her conversation with co-hosts Anne Chappelle and David Faulkner.

About the Guest
Julie E. Goodman, PhD, DABT, FACE, ATS, is an epidemiologist and board-certified toxicologist with over 20 years of experience.  She is a Principal with Gradient and applies her multidisciplinary expertise to evaluate human health risks associated with chemical exposures in a variety of contexts, including products, foods, and medical applications, as well occupational and environmental exposures.  

Dr. Goodman is a fellow of both the American College of Epidemiology and the Academy of Toxicological Sciences.  She was also an adjunct faculty member in the Department of Epidemiology at the Harvard T. H. Chan School of Public Health, where she taught a class on meta-analysis for several years.  Before joining Gradient, she was a Cancer Prevention Fellow at the National Cancer Institute.  

Dr. Goodman has authored numerous original peer-reviewed research articles, review articles (including systematic reviews, meta-analyses, and weight-of-evidence evaluations), and book chapters on a wide variety of chemicals and health outcomes. She has presented her work to a wide variety of audiences.

Dr. Goodman obtained her master's in epidemiology and PhD in toxicology from Johns Hopkins University.

When it comes to hormones, everyone has them all, but their levels are where things get interesting. How chemicals affect estrogen signaling in the brain is the research focus of Troy Roepke, Rutgers, who talks to co-hosts Anne Chappelle and David Faulkner about how gender is not easily defined biologically, what it is like to be a “fabulously queer” professor, and how science can better serve the LGBTQ+ and other marginalized communities.

About the Guest
Troy Roepke, PhD, is an Associate Professor in the Rutgers School of Environmental and Biological Sciences Department of Animal Sciences, where their research goal is for a greater understanding of the interaction between novel steroid (estrogen) signaling pathways, neuroendocrine functions, maternal and adult diets, and endocrine-disrupting chemicals on homeostatic functions controlled by the hypothalamus, as well as the long-term consequences of maternal exposures to low doses of endocrine-disrupting chemicals in model species and how these maternal exposures may affect normal adult offspring physiological functions.

In addition to their teaching and lab duties, Dr. Roepke serves as Associate Dean of Diversity, Equity, and Inclusion for the Rutgers School of Environmental and Biological Sciences. Dr. Roepke believes one of the most important aspects of being an openly queer professor is to create a lab environment that is supportive of all historically excluded students and trainees, especially LGBTQ+ students. They believe that great science happens when one creates a supportive, diverse, and inclusive environment that prioritizes teamwork, positivity, and respect wherein each team member feels welcomed and encouraged to bring their true authentic selves to the lab.

Dr. Roepke received a doctorate in physiology with a designated emphasis in reproductive biology from the University of California Davis in 2005. Their postdoctoral training was at Oregon Health & Science University, studying the neuroendocrinology of estrogens from 2005 to 2011 where they were the recipient of a K99/R00 Pathways to Independence Award from the National Institute of Diabetes and Digestive and Kidney Diseases to study how endocrine disruptors influence metabolism. 

Welcome to the Safer Chemicals Podcast, where we delve into the world of chemical risk management. In this episode, we speak with Tim Bowmer and Maria Ottati, Chairs of ECHA's Risk Assessment and Socio-Economic Analysis Committees. 

They update us on the universal PFAS restriction proposal, an ambitious initiative to minimise the release of persistent chemicals. Tim Bowmer also reflects on his impressive 11 years as Chair and sheds light on the evolving regulatory landscape. 

Join us as we explore the latest developments and discuss the future challenges faced by ECHA's committees.

What the committees do

The two committees prepare scientific opinions that are used by the European Commission and EU Member States when deciding how chemical risks need to be controlled. They are made up of scientists from EU Member States and have observers from EU organisations that represent different sectors and interests.

Useful links

• Episode transcript 
• More episodes on the committees for risk assessment and socio-economic analysis 
• Give us feedback 

More

• ECHA’s committees: EU-wide PFAS ban in firefighting foams warranted - ECHA news, 21 June 2023
• Agenda of RAC’s meeting  [PDF] [EN]
• Agenda of SEAC’s meeting  [PDF] [EN]
• REACH restriction process 
• Applications for authorisation 
• Harmonised classification and labelling 
• Occupational exposure limits 
• Risk Assessment Committee 
• Socio-Economic Analysis Committee

**************

• Subscribe to our YouTube channel
• Subscribe to our Safer Chemicals Podcast
• Subscribe to our news

Follow us on:

• Twitter
• Facebook
• LinkedIn

Visit our website 

Disclaimer: Views expressed by interviewees do not necessarily represent the official position of the European Chemicals Agency. All content is up to date at the time of publication. 

Learn how naloxone can be used in the setting of an ACE-I overdose. Who would have thought?

Need a new logo for your brand or company? Click HERE
Tell him ER-Rx Podcast sent you for a 10% discount!

Follow HERE!

References:
All references for Episode 92 are found on my Read by QxMD collection

Find ER-Rx:

- On Instagram: @ERRxPodcast
- On the website: errxpodcast.com
- On YouTube

Disclaimer:

The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.

Nick talks to board-certified toxicologist Dr. Echo Rufer. The conversation starts with a brief overview of what the science of toxicology is all about & a little bit about alcohol toxicity. They then discuss: differences between vaping and smoking; what toxins are produced through the combustion of plant material, especially tobacco & marijuana; cannabinoids like THC & CBD, as well as cannabis terpenes; relationship between dose, method of consumption & toxicity of chemical compounds; causes of the vaping-associated pulmonary injury (VAPI) associated with the vitamin E acetate that was found in some illicit market cannabis vape products; best ways to minimize toxin exposure for people who inhale plant-based consumer products such as tobacco or nicotine products or marijuana.

Find all podcast & written content at the M&M Substack

Learn how to further support the podcast

Try Athletic Greens: Comprehensive & convenient daily nutrition. Free 1-year supply of vitamin D with purchase.

Try SiPhox Health—Affordable, at-home bloodwork w/ a comprehensive set of key health marker. Use code TRIKOMES for a 10% discount.

Try the Lumen device to optimize your metabolism for weight loss or athletic performance. Use code MIND for $50 off.

New podcast! This week, we tried something a little different with a Toxicologist Reacts episode, featuring Tony Simion, Ph.D. Industry veteran and adjunct professor. You guys sent in media headlines and posts, and we responded. Disclaimer, before I go on here; all the views expressed in this post and podcast are all in our honestly held opinions. I hope by the end of this episode, it’s clear who that is for when it comes to cosmetic product safety.

Interested in supporting the podcast? Find us on Patreon.com/theecowell

Podcast summary of articles from the January 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include lumbar punctures, intralipid, neutropenic fever, renal infarcts, allergic reactions, and airway foreign bodies.  Guest speaker is Dr. Steffen Simerlink.

In this podcast, Dr. Jon Cole - an emergency medicine physician with Hennepin Healthcare and medical director with Minnesota Poison Control Center and Samantha Lee, PharmD - managing director with Minnesota Poison Control Center discuss the poison control system - past and present; along with a disscusion around toxicology - the big, the bad, and the ugly.

Enjoy the podcast.

Objectives:
Upon completion of this podcast, participants should be able to:

• Describe the purpose of the Minnesota Poison Control Center, and how it works.
• Name the most common call types coming into MN Poison Control Center.
• Summarize the management of toxicological exposures for APAP, bupropion and calcium channel blockers.

This activity has been planned and implemented in accordance with the accreditation criteria, standards and policies of the Minnesota Medical Association (MMA). Ridgeview is accredited by the Minnesota Medical Association (MMA) to provide continuing medical education for physicians. 

CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at Education@ridgeviewmedical.org.

Click the link below, to complete the activity's evaluation.

CME Evaluation

(**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) 

DISCLOSURE ANNOUNCEMENT 

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws. 

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.

Thank-you for listening to the podcast.

SHOW NOTES: 
*See the attachment for additional information. 

HISTORY of MN POISON CONTROL CENTER

TOXICOLOGY
Calcium Channel Blockers
- Diltiazem, Verapamil, Amlodipine
- Causes bad distributive shock
- Pulmonary edema is an issue
- Norepinephrine infusion is recommended in setting of shock with high dose insulin simultaneously
- "Red, white and blue" therapy for refractory Ca++ blocker overdose
- Activated charcoal - not for all patients, give if patient not at risk of aspiration for potentially lethal ingestions

Bupropion
- Chemical structure similar to amphetamine and bath salts
- Sympathomimetic effects (tachycardia, agitation, seizures, ultimately cardiogenic shock)
- Treatment with benzodiazepines - usually high dose - may need intubation
- Norepinephrine for cardiogenic shock
- ECMO may be needed

Sodium Nitrite
- Salt used to cure meats
- Internet suicide phenomenon
- Effect: Life threatening methemoglobinemia (chocolate colored blood, pallor, low O2 sats)
- Very rapid onset of symptoms
- Methylene Blue use

N-acetylcysteine (NAC) for acetaminophen poisoning
- Transitioning from 3 bag Prescott regimen to a 2 bag regimen
- Rumack-Matthew nomogram is the same

Article Resources:
Cole JB, Lee SC, Prekker ME, Kunzler NM, Considine KA, Driver BE, Puskarich MA, Olives TD. Vasodilation in patients with calcium channel blocker poisoning treated with high-dose insulin: a comparison of amlodipine versus non-dihydropyridines. Clin Toxicol (Phila). 2022 Nov;60(11):1205-1213. doi: 10.1080/15563650.2022.2131565. Epub 2022 Oct 25. PMID: 36282196.  

Cole JB, Olives TD, Ulici A, Litell JM, Bangh SA, Arens AM, Puskarich MA, Prekker ME. Extracorporeal Membrane Oxygenation for Poisonings Reported to U.S. Poison Centers from 2000 to 2018: An Analysis of the National Poison Data System. Crit Care Med. 2020 Aug;48(8):1111-1119. doi: 10.1097/CCM.0000000000004401. PMID: 32697480.

Coralic Z, Kapur J, Olson KR, Chamberlain JM, Overbeek D, Silbergleit R. Treatment of Toxin-Related Status Epilepticus With Levetiracetam, Fosphenytoin, or Valproate in Patients Enrolled in the Established Status Epilepticus Treatment Trial. Ann Emerg Med. 2022 Sep;80(3):194-202. doi: 10.1016/j.annemergmed.2022.04.020. Epub 2022 Jun 17. PMID: 35718575.

Kline JA, Tomaszewski CA, Schroeder JD, Raymond RM. Insulin is a superior antidote for cardiovascular toxicity induced by verapamil in the anesthetized canine. J Pharmacol Exp Ther. 1993 Nov;267(2):744-50. PMID: 8246150.

Thanks to Dr. Jon Cole and Samantha Lee, PharmD for their knowledge and contribution to this podcast.

Please check out the additional show notes for more information/resources.

Researchers reported finding microplastics in drinking water nearly 5 years ago, prompting California lawmakers to require monitoring of the state’s drinking water for the tiny particles. But in 2018, there were no standard methods for analyzing microplastics. So California regulators reached out to chemists and toxicologists from all sectors to develop those methods. They also sought assistance in developing a health-based limit to help consumers understand what the monitoring results mean for their health. In this episode of Stereo Chemistry, we will hear from some of the scientists leading those groundbreaking efforts.

A transcript of this episode is available at https://bit.ly/41g6uPa.

Credits

Executive producer/host: Kerri Jansen

Writer: Britt Erickson

Audio editor: Mark Feuer DiTusa

Story editors: Jyllian Kemsley, Michael McCoy, Ariana Remmel

Audience editor: Dorea I. Reeser

Copyeditor: Sabrina Ashwell, Heather Holt

Logo design: William A. Ludwig

Episode artwork: Shutterstock

Music (in order of appearance): “The Process” by Kevin Graham, “Goodness Gracious” by Louis Adrien

Contact Stereo Chemistry: Tweet at us @cenmag or email cenfeedback@acs.org.

Podcast summary of articles from the November 2022 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include race and gender disparities in academic medicine and pain management in the ED, POCUS lawsuits, VPA overdose, pediatric stridor, and hidradenitis suppurativa.  Guest speaker is Dr. Tyler Hughes.

Podcast summary of articles from the October 2022 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include chest wall blocks, atrial fibrillation disposition, sepsis bouncebacks, pneumothorax, jellyfish envenomation, and digital blocks.  Guest speaker is Dr. Steffen Simerlink.

Ever feel lost and confused when it comes to antibiotic choice? Feel like you are making a mistake by giving this instead of that? Giving too much? Giving too little? If so, you’re not alone. So let's branch out from just vanc and zosyn and dive into the top 10 antibiotic mistakes today with pharmacy guru Dr. Bryan Hayes.

Wrapping up the two-part series discussing poisonous mushrooms. This week, we focus on treatment with agents like silibinin.

To obtain silibinin (Legalon SIL):
- Contact the FDA at 301-796-3400 (8AM- 4:30 PM on weekdays/ after 4:30 PM or on weekends, contact the emergency call center at 866-300-4374) OR email druginfo@fda.hhs.gov. They will provide you with an Expanded Access IND number.
- In Canada, use the Special Access Program (613-946-8711 OR email hc.sap.devices.mdb.sc@canada.ca). Outside normal hours call 613-410-9186.
- Contact the manufacturer (Emergency_Legalon@marken.com or call 484-754-7500) and  complete the request form. If you have any questions on the form, contact Marken Customer Service at 484-754-7500 (monitored 24/7). 

Click HERE to leave a review of the podcast!

Subscribe HERE!

References:
All references for Episode 82  are found on my Read by QxMD collection

Disclaimer: 
The information contained within the  ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution,  seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of,  any medical institutions, educational facilities, or other healthcare programs.

Find ER-Rx:

- On Instagram: @ERRxPodcast
- On the website: errxpodcast.com
- On YouTube

Disclaimer:

The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.

The first of a two-part series discussing poisonous mushrooms. This week, we focus on amatoxin toxicity and presentation.
 
Click HERE to leave a review of the podcast!

Subscribe HERE!

References:
All references for Episode 81  are found on my Read by QxMD collection

Disclaimer: 
The information contained within the  ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution,  seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of,  any medical institutions, educational facilities, or other healthcare programs.

Find ER-Rx:

- On Instagram: @ERRxPodcast
- On the website: errxpodcast.com
- On YouTube

Disclaimer:

The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.

What do scorpions and meth have in common? Tune in as Drs. Rebecca Gragg and Daniel Brooks share their insights in this tox episode
 
Click HERE to leave a review of the podcast!

Subscribe HERE!

References:
All references for Episode 79 are found on my Read by QxMD collection

Disclaimer: 
The information contained within the  ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution,  seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of,  any medical institutions, educational facilities, or other healthcare programs.

Find ER-Rx:

- On Instagram: @ERRxPodcast
- On the website: errxpodcast.com
- On YouTube

Disclaimer:

The information contained within the ER-Rx podcast episodes, errxpodcast.com, and the @errxpodcast Instagram page is for informational/ educational purposes only, is not meant to replace professional medical judgement, and does not constitute a provider-patient relationship between you and the authors. Information contained herein may be accidentally inaccurate, incomplete, or outdated, and users are to use caution, seek medical advice from a licensed physician, and consult available resources prior to any medical decision making. The contributors of the ER-Rx podcast are not affiliated with, nor do they speak on behalf of, any medical institutions, educational facilities, or other healthcare programs.

Season 2, we are here! Welcome back, Imposters, to the You're Not Qualified podcast.

Season 2 will be very fun and I can't think of a better way to kick it off than talking about toxicology, science and science-fiction writing, mad cow disease, writing to fuflill your needs, and so much more.

Join Courtney as she chats with Alan Kolok, PhD Professor with a toxicology discipline and wealth of knowledge on all things pandemic, biology, and very famous American singer-songwriters. Yea, we cover it all.

You are more than welcome to reinvent yourself whenever you want. In fact, it's encouraged.

Find Alan:

Alan's first science fiction novel, Twist: https://www.amazon.com/Twist-Alan-S-Kolok/dp/1643071645

Email: akolok@uidaho.edu

LinkedIn: https://www.linkedin.com/in/alan-kolok-08657a29/

Find Courtney:

Website: https://www.yourenotqualifiedpodcast.com/

IG: @ynqpod

Email: ynqpod@gmail.com

Twitter: @ynqpodcast