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1. Section Editors

Author

Michelangelo Bortolin, Srihari Cattamanchi, Edward W. Cetaruk, Alexander Hart, Attila J. Hertelendy, PhD, Fadi S. Issa, Irving 'Jake' Jacoby, J. Lee Jenkins, Shane Kappler, James M. Madsen, Selwyn E. Mahon, Ian Norton, Luca Ragazzoni, Michael Rubin, Leon D. Sanchez, Charles Stewart, and Eric S. Weinstein

Published
2024
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3. Contributors

Author

Axel Adams, Clara Affun-Adegbulu, Rakan S. Al-Rasheed, Yasser A. Alaska, Abdulaziz D. Aldawas, Saleh Ali Alesa, George A. Alexander, Abdullah Ahmed Alhadhira, Fahad Saleha Alhajjaj, Hazem H. Alhazmi, Zainab Abdullah Alhussaini, Nawfal Aljerian, Majed Aljohani, Khaldoon H. AlKhaldi, Eyad Alkhattabi, Bryant Allen, Austin Almand, Moza M. Alnoaimi, Mohammad Alotaibi, Evan Avraham Alpert, Yasir A. Alrusayni, Mai Alshammari, Loui K. Alsulimani, Siraj Amanullah, Arian Anderson, David Arastehmanesh, Ali Ardalan, Killiam A. Argote-Araméndiz, Andrew W. Artenstein, Olivia E. Bailey, Russell Baker, Satchit Balsari, Gregory T. Banner, Fermin Barrueto M, Susan A. Bartels, Joshua J. Baugh, Frederic Berg, Vijai Bhola, William Binder, Michelangelo Bortolin, Vincent Bounes, Michael Bouton, Natasha Brown, Frederick M. Burkle, Jr, Lynn Barkley Burnett, Michele M. Burns, Nicholas V. Cagliuso, Sr, John Cahill, David W. Callaway, Duane C. Caneva, Srihari Cattamanchi, Alejandra Caycedo, Edward W. Cetaruk, Sneha Chacko, James C. Chang, Crystal Chiang, David T. Chiu, Gregory R. Ciottone, Jonathan Peter Ciottone, Melissa A. Ciottone, Robert A. Ciottone, Robert G. Ciottone, Vigen G. Ciottone, Alexander Clark, Jonathan Clark, Sean P. Conley, Joanne Cono, Arthur Cooper, Scott B. Cormier, Michael F. Court, Cord W. Cunningham, Fabrice Czarnecki, Supriya Davis, Timothy E. Davis, Gerard DeMers, Sharon Dilling, Ahmadreza Djalali, Timothy Donahoe, Joseph Donahue, Caleb Dresser, Jason Dylik, Benjamin Easter, Alexander Eastman, Laura Ebbeling, Chigozie Emetarom, Nir Eyal, Andrew J. Eyre, David J. Freeman, Franklin D. Friedman, Christie Fritz, Frederick Fung, Fiona E. Gallahue, Stephanie Chow Garbern, Mark E. Gebhart, William A. Gluckman, Craig Goolsby, Robert M. Gougelet, Fredrik Granholm, P. Gregg Greenough, Jennifer O. Grimes, Steve Grosse, Shamai A. Grossman, John T. Groves Jr, Tee L. Guidotti, George Guo, Sarah Haessler, Matthew M. Hall, John W. Hardin, Mason Harrell, Alexander Hart, MD, Melissa Harvey, Attila J. Hertelendy, PhD, Nishanth S. Hiremath, Jordan Hitchens, Christopher P. Holstege, Simon T. Horne, Steven Horng, Amer Hosin, Hans R. House, Pier Luigi Ingrassia, Fadi S. Issa, Irving 'Jake' Jacoby, Rajnish Jaiswal, Gregory Jay, J. Lee Jenkins, Josh W. Joseph, Shane Kappler, Mark E. Keim, Julie Kelman, Andrew R. Ketterer, Anas A. Khan, Ramu Kharel, Chetan U. Kharod, Thomas D. Kirsch, Anita Knopov, Max Kravitz, J. Austin Lee, Jay Lemery, Evan L. Leventhal, Jesse Loughlin, Stephanie Ludy, Brian J. Maguire, Selwyn E. Mahon, Paul M. Maniscalco, Philip Manners, Leonard Jay Marcus, Colton Margus, Taha M. Masri, Jeff Matthews, Sean D. McKay, Zeke J. McKinney, Robert K. McLellan, Eric J. McNulty, Faroukh Mehkri, Mandana Mehta, Rebecca A. Mendelsohn, Ofer Merin, Andrew Milsten, Dale M. Molé, Michael Sean Molloy, Ilaria Morelli, Jerry L. Mothershead, John Mulhern, Nicole F. Mullendore, Nicholas J. Musisca, Sonya Naganathan, Larry A. Nathanson, Erica L. Nelson, Lewis S. Nelson, Bradford A. Newbury, Kimberly Newbury, Ansley O’Neill, Robert Obernier, Jacopo M. Olagnero, Leonie Oostrom-Shah, Catherine Y. Ordun, Scott Parazynski, Andrew J. Park, Robert Partridge, Jeffrey S, James P. Phillips, Emily Pinter, David P. Polatty IV, Patrick Popieluszko, William Porcaro, Lawrence Proano, Peter B. Pruitt, Moiz Qureshi, Luca Ragazzoni, Murtaza Rashid, Paul Patrick Rega, Michael J. Reilly, Marc C. Restuccia, James J. Rifino, Paul M. Robben, Joy L. Rosenblatt, Kevin M. Ryan, Heather Rybasack-Smith, Richard James Salway, Daniel Samo, Leon D. Sanchez, Shawn M. Sanford, Ritu R. Sarin, Deesha Sarma, Jesse Schacht, Valarie Schwind, Geoffrey L. Shapiro, Joshua Sheehan, Brian Shreve, Grigor Simonyan, Devin M. Smith, E. Reed Smith, MD, Jack E. Smith, MA, Montray Smith, Peter B. Smulowitz, Angela M. Snyder, Joshua J. Solano, Bryan A. Stenson, Charles Stewart, M. Kathleen Stewart, Patrick Sullivan, Jared S. Supple, Derrick Tin, Jonathan Harris Valente, Kathryn M. Vear, P.R. Vidyalakshmi, Faith Vilas, Gary M. Vilke, Janna H. Villano, Amalia Voskanyan, C. James Watson, Nancy Weber, Scott G. Weiner, Brielle Weinstein, Eric S. Weinstein, Jordan R. Werner, Roy Karl Werner, MD, James D. Whitledge, Sage W. Wiener, Lauren Wiesner, Kenneth A. Williams, Robyn Wing, Richard E. Wolfe, Wendy Hin-Wing Wong, Robert Woolard, Prasit Wuthisuthimethawee, and Nadine A. Youssef

Published
2024
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6. Massive Ethylene Glycol Ingestion Treated with Fomepizole Alone—A Viable Therapeutic Option

Author

Edward W. Cetaruk, Ken Kulig, Robert B. Palmer, Mohammed Alhelail, Jennie Buchanan, Tammi H. Schaeffer, and Jeffrey Brent

Subjects
Male, Ethylene Glycol, medicine.medical_specialty, Health, Toxicology and Mutagenesis, medicine.medical_treatment, Antidotes, Suicide, Attempted, Toxicology, chemistry.chemical_compound, medicine, Humans, Fomepizole, Dialysis, Ethanol, business.industry, Metabolic acidosis, Middle Aged, medicine.disease, Surgery, chemistry, Ethylene glycol poisoning, Anesthesia, Antifreeze, Injections, Intravenous, Pyrazoles, Hemodialysis, Toxicology Observation, business, Ethylene glycol, Blood Chemical Analysis, Half-Life, medicine.drug
Abstract

Fomepizole is used to treat and prevent toxicity from ethylene glycol poisoning. Treatment with fomepizole without hemodialysis in massive ethylene glycol ingestion has been rarely reported in the literature; however, published literature and practice guidelines recommend considering dialysis for ethylene glycol levels >50 mg/dL. We report a case of massive ethylene glycol ingestion resulting in the highest serum ethylene glycol concentration in a patient without ethanol co-ingestion who was treated with fomepizole and was not hemodialyzed. A 48-year-old male presented to the emergency department after reportedly ingesting >1liter of antifreeze in an attempt at self-harm. He denied concomitant ethanol consumption. His initial presenting serum ethylene glycol level was 700 mg/dL, with normal renal function, and a metabolic acidosis with a high anion gap. One hour after presentation, he was started on intravenous fomepizole. Treatment with fomepizole continued until the patient's plasma ethylene glycol concentration was 16 mg/dL. His metabolic acidosis quickly resolved, he had no adverse reactions to the treatment, and his renal function remained normal. Ultimately, he was discharged to a psychiatric unit without sequelae. Published literature and practice guidelines suggests considering hemodialysis initiation in patients with an ethylene glycol level >50 mg/dL. This recommendation is anecdotally, rather than evidence, based. With the potential risks inherent in hemodialysis, our case provides evidence that treatment with fomepizole without hemodialysis appears to be a viable alternative option in patients with even extremely high plasma ethylene glycol concentrations as long as their renal function is intact.

Published
2010
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7. Coxiella burnetii (Q Fever) Attack

Author

Teriggi J. Ciccone and Edward W. Cetaruk

Subjects
biology, business.industry, Medicine, Q fever, business, Coxiella burnetii, biology.organism_classification, medicine.disease, Virology
Published
2016
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8. Contributors

Author

Yasser A. Alaska, Abdulaziz D. Aldawas, Saleh Ali Alesa, George A. Alexander, Hazem H. Alhazmi, Nawfal Aljerian, Majed AlJohani, Khaldoon H. AlKhaldi, Bryant Allen, Bader S. Alotaibi, Mohammad Alotaibi, Evan Avraham Alpert, Rakan S. Al-Rasheed, Mai Alshammari, Asaad Alsufyani, Siraj Amanullah, Ali Ardalan, Andrew W. Artenstein, Miriam Aschkenasy, Matthew R. Babineau, Kavita Babu, Olivia E. Bailey, Gregory T. Banner, Fermin Barrueto, Susan A. Bartels, Bruce M. Becker, Paul D. Biddinger, Eike Blohm, Susan R. Blumenthal, Stephen W. Borron, Michelangelo Bortolin, Michael Bouton, Peter Brewster, Churton Budd, James M. Burke, Frederick M. Burkle, Lynne Barkley Burnett, Nicholas V. Cagliuso, John D. Cahill, David W. Callaway, Duane C. Caneva, David M. Canther, Srihari Cattamanchi, Edward W. Cetaruk, James C. Chang, Zeno L. Charles-Marcel, Anna I. Cheh, David T. Chiu, Teriggi J. Ciccone, Gregory R. Ciottone, Jonathan Peter Ciottone, Robert A. Ciottone, Diana Clapp, Raphael G. Cohen, Kathe M. Conlon, Joanne Cono, Hilarie Cranmer, Cord W. Cunningham, Steven O. Cunnion, Alison Sisitsky Curcio, Robert G. Darling, Neil B. Davids, Timothy E. Davis, Scott Deitchman, John B. Delaney, Francesco Della Corte, Gerard DeMers, William E. Dickerson, Sharon Dilling, Ahmadreza Djalali, Joseph Donahue, K. Sophia Dyer, Jason Dylik, Benjamin Easter, Laura Ebbeling, Nir Eyal, Andrew J. Eyre, Saleh Fares, Katherine Farmer, Denis J. FitzGerald, Elizabeth Foley, Kerry Fosher, David Freeman, Robert L. Freitas, Franklin D. Friedman, Frederick Fung, Fiona E. Gallahue, Lucille Gans, Stephanie Chow Garbern, Mark E. Gebhart, James Geiling, Brian C. Geyer, Mary Jo Giordano, William A. Gluckman, J. Scott Goudie, Robert M. Gougelet, Benjamin Graboyes, Michael I. Greenberg, P. Gregg Greenough, Ashley L. Greiner, Mark Greve, Stephen Grosse, Shamai A. Grossman, Tee L. Guidotti, Jason B. Hack, Matthew M. Hall, John W. Hardin, John L. Hick, Nishanth S. Hiremath, Steven Horng, Geoffrey D. Horning, Kurt R. Horst, Ali A. Hosin, Amer Hosin, Hans R. House, Pier Luigi Ingrassia, Patrick M. Jackson, Irving 'Jake' Jacoby, Rajnish Jaiswal, Adam J. Janicki, Gregory Jay, Miriam John, Shawn E. Johnson, James R. Johnston, Jerrilyn Jones, Michael D. Jones, Josh W. Joseph, Patrice Joseph, Alexis Kearney, Donald Keen, Mark E. Keim, Elizabeth Kenez, Katharyn E. Kennedy, Anas A. Khan, Chetan U. Kharod, Sylvia H. Kim, Kevin King, Mark A. Kirk, Leo Kobayashi, Lara K. Kulchycki, Rick G. Kulkarni, Joseph Lauro, Benjamin J. Lawner, David V. Le, Debra Lee, Terrance T. Lee, Jay Lemery, Jeanette A. Linder, Lawrence S. Linder, Michael A. Loesch, Heather Long, Kate Longley-Wood, Michael D. Mack, John M. Mackay, Laura Macnow, James M. Madsen, Brian J. Maguire, Patrick J. Maher, Selwyn E. Mahon, John D. Malone, Marco Mangini, Paul M. Maniscalco, David Marcozzi, Pietro D. Marghella, Jeff Matthews, Peter McCahill, Sean D. McKay, C. Crawford Mecham, Mandana Mehta, Patricia L. Meinhardt, Laura Diane Melville, Angela M. Mills, Andrew M. Milsten, Clifford S. Mitchell, Dale M. Molé, Michael Sean Molloy, John Moloney, Ilaria Morelli, Jerry L. Mothershead, John Mulhern, Nicole F. Mullendore, Larry A. Nathanson, Amelia Marie Nelson, Erica L. Nelson, Lewis S. Nelson, Carey Nichols, Mariann Nocera, Erin E. Noste, Catherine Y. Ordun, Peter D. Panagos, Robert Partridge, Jeffrey S. Paul, Catherine Pettit, James Pfaff, James P. Phillips, Jason Pickett, William Porcaro, Thérèse M. Postel, Charles N. Pozner, P.R. Vidyalakshmi, Lawrence Proano, Peter B. Pruitt, Jeffrey S. Rabrich, Jeffrey D. Race, Luca Ragazzoni, Najma Rahman-Kahn, Kristin Allyce Reed, Wende R. Reenstra, Paul P. Rega, Michael J. Reilly, Andrew T. Reisner, Marc C. Restuccia, James J. Rifino, James Michael Riley, Paul M. Robben, Kevin M. Ryan, Heather Rybasack-Smith, Leon D. Sanchez, Ritu R. Sarin, Debra D. Schnelle, Valarie Schwind, Malcolm Seheult, Kinjal N. Sethuraman, Geoffrey L. Shapiro, Marc J. Shapiro, Sam Shen, Suzanne M. Shepherd, William H. Shoff, Craig Sisson, Alexander P. Skog, Jonathan E. Slutzman, Devin M. Smith, E. Reed Smith, Jack E. Smith, Peter B. Smulowitz, Angela M. Snyder, Joshua J. Solano, John Sorenson, Kimberly A. Stanford, Charles Stewart, M. Kathleen Stewart, Carol Sulis, Robert J. Tashjian, Elizabeth S. Temin, Andrea G. Tenner, Craig D. Thorne, Jason A. Tracy, Milana Trounce, Jonathan Harris Valente, Alice Venier, Faith Vilas, Gary M. Vilke, Janna H. Villano, Barbara Vogt, Amalia Voskanyan, Scott G. Weiner, Brielle Weinstein, Eric S. Weinstein, Scott D. Weir, Roy Karl Werner, Sage W. Wiener, Kenneth A. Williams, Robyn Wing, Wendy Hin-Wing Wong, Richard E. Wolfe, Stephen P. Wood, Robert H. Woolard, Prasit Wuthisuthimethawee, Kevin Yeskey, Sami A. Yousif, Nadine A. Youssef, and Brian J. Yun

Published
2016
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11. Hazards of Nonprescription Medications

Author

Edward W. Cetaruk and Cynthia K. Aaron

Subjects
Sympathomimetics, Drug, medicine.medical_specialty, Accident prevention, business.industry, media_common.quotation_subject, Poison control, Dextromethorphan, Emergency Medicine, medicine, Herbal preparations, Drug intoxication, Intensive care medicine, business, Self prescription, media_common, medicine.drug
Abstract

There are hundreds of nonprescription medications available to the consumer. Among these are a number that have potential for toxicity when taken in overdoses or in combination with other medications. This article addresses the pathophysiology, diagnosis, and treatment of selected over-the-counter medication intoxications including antihistamines, dextromethorphan, sympathomimetics, nutritional supplements, and herbal preparations. Language: en

Published
1994
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12. CONTRIBUTORS

Author

Cynthia K. Aaron, Jawaid Akhtar, Steven E. Aks, Timothy E. Albertson, Alfred Aleguas, Linda G. Allison, Angela C. Anderson, Juan C. Arias, Alexander B. Baer, Frèdèric J. Baud, Carl R. Baum, Martin Belson, John G. Benitez, Neal L. Benowitz, David P. Betten, Brian Christopher Betts, Lawrence Stilwell Betts, Michael Beuhler, Steven B. Bird, Carolyn M. Blume-Odom, Stephen W. Borron, Edward W. Boyer, Sally M. Bradberry, Jeffrey Brent, D. Eric Brush, Michael J. Burns, Javier R. Caldera, Thomas R. Caraccio, Edward W. Cetaruk, Andrew Chan, Peter B. Chase, James Cisek, Richard F. Clark, Kirk L. Cumpston, Steven C. Curry, Paul I. Dargan, G. Patrick Daubert, João Delgado, Valerie A. Dobiesz, J. Ward Donovan, Robert P. Dowsett, Antonio Dueñas-Laita, Judith M. Eisenberg, Timothy B. Erickson, Michele Burns Ewald, Susan Farrell, Tania M. Fatovich, Miguel C. Fernàndez, J.W. Fijen, Chris Foley, R. Brent Furbee, Ann-Jeannette Geib, Robert J. Geller, Carl A. Germann, Melissa L. Givens, Ronald E. Goans, Nora Goldschlager, Andis Graudins, Michael I. Greenberg, Tee L. Guidotti, Alan H. Hall, Christine A. Haller, Daniel A. Handel, Philippe Hantson, Matthew W. Hedge, Fred M. Henretig, Michael G. Holland, Knut Erik Hovda, Dag Jacobsen, Alison L. Jones, David N. Juurlink, Ziad N. Kazzi, Nicholas J. Kenyon, Fergus Kerr, Daniel C. Keyes, Edwin M. Kilbourne, Richard Kingston, Mark A. Kirk, Laura J. Klein, Kurt C. Kleinschmidt, Wendy Klein-Schwartz, Edward P. Krenzelok, Melisa W. Lai, Frèdèric Lapostolle, Eric J. Lavonas, Michael Levine, William J. Lewander, Ivan E. Liang, Erica L. Liebelt, James G. Linakis, Christopher H. Linden, Richard Lynton, Rebekah C. Mannix, Jack Maypole, R.B. McFee, Charles McKay, Jude McNally, Bruno Mégarbane, J. Meulenbelt, Dana B. Mirkin, Brent W. Morgan, Brian Morrissey, Allison A. Muller, Nancy G. Murphy, Kristine A. Nañagas, Jeffrey B. Nemhauser, Heikki Erik Nikkanen, Kent R. Olson, John D. Osterloh, Wesley Palatnick, Robert B. Palmer, Alberto Perez, Holly E. Perry, Scott D. Phillips, David C. Pigott, Heidi Pinkert, Alex T. Proudfoot, Rouhollah Prueitt, Lawrence S. Quang, James W. Rhee, William H. Richardson, Jon C. Rittenberger, Steven D. Salhanick, Anthony J. Scalzo, Heather K. Schuller, Michael D. Schwartz, Donna Seger, Michael W. Shannon, Mahesh Shrestha, Leo J. Sioris, Marco L. Sivilotti, Sara Skarbek-Borowska, Susan C. Smolinske, Curtis P. Snook, David G. Spoerke, Jeffrey R. Suchard, Young-Jin Sue, Matthew D. Sztajnkrycer, Sharon Ternullo, Dung Thai, R. Steven Tharratt, Jerry D. Thomas, Karen E. Thomas, Josef G. Thundiyil, Anthony J. Tomassoni, Stephen J. Traub, John Harris Trestrail III, J. Allister Vale, Jason Vena, Frank G. Walter, Richard Y. Wang, Sharita E. Warfield, Paul M. Wax, Suzanne R. White, James F. Wiley, Saralyn R. Williams, Alan David Woolf, Mark Yarema, and Luke Yip

Published
2007
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13. Extended-Release Acetaminophen Overdose

Author

Richard C. Dart, Katherine M. Hurlbut, Edward W. Cetaruk, and Rivka S. Horowitz

Subjects
Acute overdose, acetaminophen overdose, business.industry, Acetaminophen poisoning, Poison control, General Medicine, medicine.disease, Drug overdose, Acetaminophen, Anesthesia, medicine, Time to peak, Medical emergency, Extended release, business, medicine.drug
Abstract

To the Editor. —There were 102 619 cases of ingestion of acetaminophen-containing products, including 100 deaths, reported in the United States in 1994.1Management of acute acetaminophen overdose is guided by the Rumack-Matthew nomogram, which assumes acetaminophen absorption in acute overdose is complete by 4 hours after ingestion.2In August 1994, McNeil Pharmaceuticals (Fort Washington, Pa) introduced Tylenol Extended Relief, the first extended-release formulation of acetaminophen available in the United States. Patients presenting after overdose with extended release (ER) acetaminophen (Tylenol ER) which contains 325 mg of immediate-release acetaminophen and 325 mg of extended-release acetaminophen per tablet, pose a dilemma because the kinetics of acetaminophen ER in overdose are unknown, and it is not known whether physicians can rely on the nomogram to facilitate treatment. Douglas et al3found no difference in time to peak concentration between acetaminophen ER and immediate-release acetaminophen in volunteers who ingested 75

Published
1996
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