Discover and read the best of Twitter Threads about #Toxtweets

Most recents (5)

A 23yo male presents to the hospital after an overdose of unknown medications. He is watched for 24 hours, has no symptoms, and is sent home.

7 days later, he develops palpitations, tremor, sweating, and diarrhea. He denies taking any other meds.

What is going on?🤔☠️
7 days ago, this patient overdosed on LEVOTHYROXINE (aka synthroid). But why the delay in symptoms?

Levothyroxine contains T4 hormone which is inactive and requires conversion to the active form T3. This conversion can be delayed, and symptoms may take up to 10 days to appear!
Once T4 gets converted to the active T3 form, it can cause symptoms that resemble hyperthyroidism/thyroid storm. People have had hyperthermia, agitation, seizures, heart attacks, and multiorgan failure.

Some patients will have no symptoms or barely any symptoms at all.
Read 7 tweets
Had the opportunity to be part of a fascinating work. Americas Poison Center Annual report.

A comprehensive poisoning epidemiology study compiled of data from all 55 U.S. Poison Centers

Free 🔗➡️bit.ly/3wbIwWS
Pubmed🔗➡️bit.ly/3wdgeLP

A🧵on emerging trends
This year we highlighted two important trends in addition to baseline poisoning data.

Firstly, THC product exposures have been increasing since 2016, and the demographics are changing. In 2021, edible products (red line) eclipsed plant based marijuana (blue line) for products Image
The change in products also represents changing demographics. While Adults (gold) comprise the majority of exposures, pediatric<6 (green) is taking an ever increasing share of the THC exposure calls since 2016. Image
Read 12 tweets
A family of five arrives to the emergency department with "the flu." They all have headache, nausea, vomiting, and generally feel unwell. You are about to discharge them when they let you know that even their dog is sick with "the flu"!

What do you think is going on? 🤔☠️
This time of year can be tricky...because CARBON MONOXIDE toxicity can mimic things like the flu or a viral illness.

Carbon monoxide is an odorless, tasteless, invisible gas that comes from things like automobile exhaust, fires, fuel-burning heaters, gas stoves, generators, etc.
More than 1/3rd of deaths from carbon monoxide in the United Sates occur during winter months. Clusters of carbon monoxide cases are associated with ice storms/blizzards/hurricanes probably because people are crowded inside and using fuel-burning items.
Read 9 tweets
A 18-year-old male presents to the emergency department with confusion and hallucinations for over 24 hours. He keeps muttering that he was "bitten by the dragonfly."

What do you think is going on?☠️☠️ blue insect (damselfly I th...
Turns out it wasn't an actual dragonfly, but rather, the compound known as 1-(8-Bromobenzo[1,2-b;4,5-b]difuran-4-yl)-2-aminopropane!!!!!!

Because the structure of this compound kind of looks like a dragonfly and it has a bromine on it, it is also called Bromo-DragonFLY.🐉🪰 organic chemistry structure...
Bromo-DragonFLY was first synthesized in the lab in 1998. It was briefly looked into as a potential antidepressant. It works by being agonist at serotonin receptors (and this is likely what mediates the hallucinogenic effects). It can be a powder, liquid, or on blotter paper. plastic package containing ...
Read 6 tweets
You may have heard of the recent spate of hospitalizations linked to Daily Harvest ready-to-eat lentil/leek crumbles.

The exact cause remains a mystery, but several theories are swirling around. I'd like to explore a few of them. (1/n) 🧵⬇️

#ToxTweets #FOAMed #MedTwitter
Anecdotal reports on Twitter and Reddit share common elements. People:

1) Ate the lentil crumbles;

2) Rapidly developed severe stomach pain, dark urine, itchiness;

3) Had symptoms/labs consistent with acute liver failure (ALF) on hospitalization. (2/n)
The product has since been voluntarily recalled, and the FDA is currently investigating potential causes. Most speculation currently centers around a few possibilities:

1) Lectins
2) Aflatoxins
3) Other Pathogens

I'll mainly focus on the first two for this thread. (3/n)
Read 26 tweets

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