🚨#ThePoisonLab @nephmadness.bsky.social🚨 @nephrotox.bsky.social + the Bean Doctors at VCU crack the mystery case and dive into nephrotoxic herbals! 🌿⚠️ 🏆 Who will advance in #NephMadness? 💥 Vote for Tubular Toxins vs. Oxalate Offenders Listen: Anywhere you get a pod or thepoisonlab.com #EMIMCC

New Episode! We discuss the twisted case of Dr. Michael Swango, a serial killer who lead a poisonous rampage across the US and beyond. With @caulimovirus.bsky.social & @nephrotox.bsky.social (and Lee Richman) Links! iTunes: t.co/ZgMvh33v6w Spotify: t.co/AmpwZBIH8A

Don't miss out on this month's Nation Case Conference on Thur., Febr. 20 at 1pm ET! Dr. Josh King (@nephrotox.bsky.social) moderates as we discuss three new medtox cases on the subject "Missed Diagnoses and Misleading Drugs". This webinar is for ACMT members only. Learn more >> bit.ly/acmt-ncc

Dosing insulin for calcium channel blocker overdose:

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Had a fantastic time visiting the awesome nephro group at Ochsner! Thanks again @juancarlosqvelez.bsky.social and company for a warm welcome!

Sadly, it’s a good time to once again share this amazing infographic that we ran at @science.org more than 7 years ago 🧪 #IDsky www.science.org/content/arti...

I see there's a massive influx of people and some are silly enough to follow me. Never managed to figure out which wolf to feed: serious education versus something-posting

To my fellow nephrologists: we should try to get the #nephrosky tag going here (even if the # character is not special)

Was really disappointed to find out this wasn't about dextromethorphan or the perils of using methylene blue with SSRIs

Popping in after a long hiatus to say: here's a thing on toxicology history through antiquarian textbooks I did, you might enjoy if: 1) you like old books 2) you like poisoning 3) you like poison books (arsenic containing book cloth makes a quick appearance) toxichistory.com/2023/09/22/e...

You know, I've been thinking about this. It's almost as if the super-wealthy, elite, political ruling class in this country don't WANT the rest of us to be educated, well-paid, secure, healthy, fulfilled, or happy with our lives. I mean... am I just CRAZY, or IMAGINING things, or - you know?

Rocket launch from NASA's Wallops Island site earlier this week. Fun trip! If you need a toxicological correlate, the hydrazine involved in rocket fuel can give intractable seizures due to inhibition of conversion of glutamate to GABA. If you need a renal correlate, heat exhaustion and aki!

I haven't posted any toxicology for a while, so this is a good time to serve as a reminder that if you drink Earl Grey to the extent that Picard does, you might not be able to walk due to muscle cramps and neuropathy https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)08436-2/fulltext

Reskeet with a time you looked cool

I am genuinely concerned about young kids drinking this. It's gonna happen. Who decided this was a good idea!?

From Steve Curry, a superb rundown of NAPQI: deep dive into molecular mechanisms of what makes everyone's least favorite APAP metabolite awful. From inactivated ETC to ROS to the MPTP to how fomepizole *really* works for APAP poisoning (not CYP2E1!), such a great read. https://t.co/RjJxcKuArc

They cracked the case y’all. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2807049

This is good fun - trick the computer https://gandalf.lakera.ai/

A reminder that Bookshop offers free shipping today and tomorrow.

the ancient secrets of posting

Must admit some trepidation about the "BAT-GUANO detection of a long burst" given the whole rabies and histoplasmosis concerns

Happy birthday to Thomas Ligotti! He's nihilistic and depressing but a writer for the ages if you're okay with the subject matter.

The AHRQ Report on Diagnostic Errors in the Emergency Department: The Wrong Answer to the Wrong Question | @AnnalsofEM w/ Dr. Gabor Kelen @JohnsHopkinsEM https://www.sciencedirect.com/science/article/pii/S0196064423002238

Today kidneys navigate between Scylla (high purine intake with uric acid formation and risk for uric acid kidney stones - looking at you, hot dogs) and Charybdis (high salt intake leading to increased urinary calcium excretion risk for calcium containing kidney stones - looking at you, hot dogs)

Remember, don't eat fireworks. That would probably cause you to have smoking stool due to the yellow phosphorus (mixture of red + white phosphorus) involved in the manufacture of the fireworks. Also please do not explode your hands, and I mean this completely unironically

I worry that my skeets are already assuming a level of ridiculousness unbecoming to my professional image. Then I remembered that when we resume toxicology teaching rounds after the 4th, I'm probably going to make up a story about me eating fireworks and developing yellow phosphorus poisoning.

Replacing your PVC with copper pipe? You're phthalate limited

Very recently we had someone hospitalized for lactic acidosis after eating apricot seeds. (They contain cyanide precursors). You can still buy them, or the purified cyanide precursor amygdalin, under the guise of "vitamin B17" for health. This s*** shouldn't be legal

Been told that posting is crucial, so I'll mention that sodium monofluoroacetate - used to kill coyotes and other large animals - inhibits the Krebs cycle (via formation of fluorocitrate which blocks aconitase) and is a highly potent poison. Follow me for more reasons why you need the Krebs cycle

If you are wondering about me: I'm a nephrologist and medical toxicologist. I like doing both of those things. Right now there are three of us (which I'm aware of) in the world. I am the weirdest one. Also I like bad jokes and a wide variety of nerdy things. Books are good too.

I am glad to be here in the Other Place. It's likely that posts to come will continue my progression from (semi) respectable medical professional to nerdloaf extraordinaire, but to be honest that's who I've always been anyway