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Josh Trebach, MD

Nov 28 • 6 tweets • 3 min read

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?☠️☠️

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.🐉🪰

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.

Unfortunately, despite having a fun/cute name, the effects from Bromo-DragonFLY are NOT fun/cute. The adverse effects include:
-hallucinations for up to DAYS at a time
-vasoconstriction/limb ischemia
-seizures
-death

Treatment is supportive care.

Those who have taken this drug say:

"It was like being dragged to hell and back again...It is the most evil [thing] I've ever tried. It lasted an eternity."

“bromo dragonfly makes my dick shrink like I am running from the police”

“this is what I would assume toxic tastes like”

There's always new drugs coming out, and part of being a toxicologist is making sure we know about these drugs so we can best help our patients.

Thanks for tuning in. And don't get bitten by the dragonfly! #ToxTweets

Ref=Goldfranks Tox 11th ed, PMIDs: 19091499, 21592070, Erowid

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More from @jtrebach

Josh Trebach, MD

@jtrebach

Nov 30

After taking tons of tests over the years, I have honed a study technique that works well for me.

And hopefully, it works for you too!

A thread on the study technique that got me through med school, residency, fellowship, and one of the hardest board exams I’ve ever taken:🧵📚

Step 1: Gather materials

This technique requires a white board (or a wall with paper on it), sticky notes, a pen, and your study material. Ideally, the white board would be in a place you are studying in each day such as your bedroom, office, or cubicle.

Step 2: Create categories

For me, the categories were either lectures (Lecture #1, Lecture #2, etc) or subjects (Endocrine, Hematology, etc). It doesn’t matter how many categories there are. I have had anywhere from 6 to 30 categories depending on the test. Put 'em on the board.