1. A 50-year-old woman presents to the ED with fatigue, diarrhea, and vomiting and the following vital signs: BP, 95/65 mmHg; HR, 35/min (sinus). An inpatient workup is unrevealing and she improves clinically, but returns 2 days after discharge with chest pain, shortness of breath and allodynia of the hands. Her husband had a similar presentation 1 week prior to the first visit. 2. A 60-year-old man with a past medical history of obesity presents to the ED after ingesting a month's worth of his diltiazem and metoprolol. 3. A 26-year-old man is brought to the ED intubated after being found obtunded at home. Three days later, he is extubated and is noted to have auditory hallucinations.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

1. A 16-year-old girl presents to the ED after overdosing on medications she takes for rheumatoid arthritis. In the ED she has lightheadedness and runs of nonsustained ventricular tachycardia. 2. A 22-year-old man presents to the ED from prison after swallowing 50 bags of heroin and ten tablets of ecstasy. One hour after the ingestion, he is found unresponsive in his cell and requires naloxone. 3. A 66-year-old man presents to the ED with bilateral hand pain. He reports that earlier the same day he was cleaning coins at his home.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

1. Two individuals separately purchase the same health supplement online. After the first use, they both presented to the hospital after reading the accompanying information. 2. A 49-year-old woman with pulmonary hypertension and AUD presents to the ED after a suicide attempt with her sildenafil and ambrisentan. 3. A 28-year-old man presents to the hospital for shortness of breath. He develops progressive hypoxia requiring high flow nasal cannula and his chest imaging is remarkable for diffuse ground glass opacities.

1. A 52-year-old woman with a complex past medical history presents to the ED for altered mental status and seizure-like activity. During her hospitalization, she has several cardiac arrests. 2. A 64-year-old man presents with multiple self-inflicted stab wounds, shock, and a possible history of ingestion. He is taken emergently to the operating room, where he develops persistent metabolic acidosis and has a brief cardiac arrest. 3. A 40-year-old male bodybuilder with a history of palpitations presents to the ED in respiratory distress with tachycardia, hypertension, tachypnea, and hypoxia.

Buprenorphine & Methadone Protocols from the Toxicology Team in Detroit

1. A 15-year-old boy, admitted for toxic encephalopathy after a polypharmacy ingestion, develops recurrence of symptoms after complete resolution. 2. An 11-year-old girl is admitted with arthralgia, morbilliform rash, and severe headache unresponsive to typical analgesics. She has difficult to control hypertension and has a seizure. Other family members also developed a similar rash. 3. A 42-year-old man with a history of chronic LBP is found by EMS to have ventricular tachycardia, for which he received IV lidocaine. After conversion, his vital signs are: BP,144/76; HR,44; RR, 20; O2, 96%; Temp, 98.2

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

Cardiac Glycosides Poisoning : How to Optimize Digoxin Antibody Use?

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

Alcohol Withdrawal During COVID19; Iatrogenic Dependence and Withdrawal; Struggles with IVDU-Associated Infective Endocarditis and treatments related to valve replacement

An Adolescent Male with Acute Hypoxemic Respiratory Failure

Pharmacotherapy Considerations for Patients on ECMO

ECMO in the Acutely Poisoned Patient

This month's topic is Takotsubo Cardiomyopathy and toxicology. The articles will be reviewed by the Albert Einstein Program in Medical Toxicology, led by Dr. Serge-Emile Simpson.

Cardiac Safety of Anti-Seizure and Anti-Depressant Drugs in Patients with Long QT Syndrome

Cardiac Risk and Methadone: Clinically Significant Relationship?

This month's topic is Azithromycin and Cardiac Toxicity. The articles will be reviewed by the U Mass Medical Toxicology Program, led by Dr. Mak Neavyn.