Nat Ketone

Canisters in the large intestine? A body packer(/stuffer)?

Does cyanide actually smell like almonds? YouTube video by NileRed

Cyanide doesn’t actually smell of almonds. It’s supposed to smell of bitter almonds, which have been conflated with smelling like almonds. However, it’s probably more accurate to say that bitter almonds smell like cyanide.

youtu.be/WYagO-nup6c

Fortunately, methanol poisoning is quite rare in the UK. Because it’s rare, it’s not worth it for most hospitals labs to maintain the ability to test for it, so when it does happen the sample typically has to be sent by courier to one of five or six labs in the country that can do it

Because ethanol blocks its metabolism, while you still have booze in your system you don’t suffer any toxicity. So if you’ve had a Big Night, it will be hours later (once the ethanol is out of your system) that you know anything is wrong - and often this will be when you’re sleeping the booze off

One of the issues with drinks spiked with methanol is that there are no early identifiable symptoms of poisoning. You go to bed drunk and you wake up blind…

Next year, I’m going as incorrect or missing units

I cannot find anyone who said “my patient ingested 42 g camphor”, but that is consistently quoted as the highest survived dose

This Hallowe’en, I’m going as a paper whose authors did not read their sources

Eating even a single flake of old lead paint is potentially harmful to a small child. Lead poses a serious threat to children’s development.

During International Lead Poisoning Prevention Week we’re highlighting sources of lead, such as pipes, soil, imported foods & traditional remedies #ILPPW2025

https://www.gov.uk/government/publications/lead-poisoning-advice-for-the-public-and-healthcare-professionals/lead-information-for-the-public

People have tried nutmeg to get high. My understanding is that both the taste of the large quantities needed and the hallucinations themselves are unpleasant

Eugenol looks similar to paracetamol, so it makes sense that it would have analgesic effects. It also causes a very similar liver toxicity when taken in excess.

Glycyrrhyzin inhibits metabolism of cortisol, which can lead to a Cushing-like Syndrome - notably, potassium can get dangerously low

Not very permanent

4) although this situation is safer than the others, the presence of lead deposits anywhere can cause raised lead levels, particularly if the granuloma around the fragment is later disturbed (e.g. by trauma) or migrates to a higher risk area; therefore
5) any lead in the body is potentially an issue

1) lots of fluid moving over the fragment promoting dissolution
2) lots of bone turnover; as a large 2+ ion, lead looks similar to calcium to a lot of body processes
3) many small fragments have a higher surface area than one larger piece

I’m at the #AWTTC / #YellowCardWales Best Practice Day. Come and say hello if you’re here too!
@mhragovuk.bsky.social @toxbase.bsky.social @cavuhb.bsky.social

Which, to be clear, I am happy to do and I know it can be quite intimidating when you have a lot of them - but it’s quite funny

It’s only slightly tongue-in-cheek when I say my job is doing maths for people. When I’m not talking to the ICU consultant about a patient who is melting from the inside out, I’m doing sums for the triage clinicians at 111

Argyria! The silver deposits under the skin (gets oxidised or somehow fixed by sunlight? Or do all tissues get pigmented?) turning it this silver-blue colour

I ask about GLP-1RA exposure when considering whether to give late charcoal, but I’m going to try to start asking about them for all patients where it might matter

Most species of inkcap mushrooms appear only fleetingly before self-digesting themselves into a black liquid. They do this to spread their spores. Inkcaps break themselves down by producing the enzyme chitinase in their cells. Chitinase breaks down chitin, the sugar in fungi cell walls that holds them in shape, causing the mushroom to disintegrate into a black goo. This process is called deliquescence. The black liquid produced by inkcaps’ self-digestion can be used as an ink due to melanin pigment. Coprinopsis atramentaria, the common inkcap, is not considered edible due to the presence of coprine, which can cause unpleasant symptoms if it is consumed with alcohol. Our bodies metabolise coprine into aminocyclopropanol and glutamic acid. Aminocyclopropanol interferes with alcohol metabolism. It inhibits the aldehyde dehydrogenase enzyme, inhibiting breakdown acetaldehyde formed from ethanol. Acetaldehyde causes a flushed face, racing heart rate, nausea and vomiting.

Infographic on fly agaric mushrooms, with an image of the mushrooms in the middle (red with white spots). The chemical structures of the mushroom's pigments are shown, including muscarufin, the primary pigment responsible for their red colour. The compounds behind the mushrooms' psychoactive properties, ibotenic acid and muscimol, are also shown. These compounds imitate neurotransmitters in the brain to exert their effects.

Today is the #DayOfTheMushroom 🍄

Here are graphics on why common inkcaps and alcohol don't mix, and colourful and poisonous compounds found in fly agaric.

Inkcaps: www.compoundchem.com/2024/09/19/i...

Fly agaric: www.compoundchem.com/2024/11/11/f...

#ChemSky #FungiFriends 🧪

And lead is an even bigger problem when combined with iron deficiency, which is COMMON (tinyurl.com/JAMAFe)

Iron deficiency increases lead absorption
Lead decreases iron absorption and iron utilization.

And the same kids are often at risk for both.

A vicious cycle.

**Not Montelukast, but ranitidine, valsartan, and others

Your breathy bois are safe! My memory is not

bsky.app/profile/natk...

To be clear, apart from a specific few old batches of tetracycline, there have been no cases of toxicity from out-of-date medications and the highest risk remains that the medication has degraded and no longer works.

Addressing the saga of nitrosamine contamination in drugs Scientific and regulatory progress is helping minimise the impact of mutagenic impurities

As it turns out, I should have checked my sources. I was thinking of this story www.chemistryworld.com/news/address... and somehow has linked Montelukast in with the affected drugs in my mind. Montelukast remains low risk

I would guess it comes down to cost again. A few pence per lorry/shipping container vs a few pence per box or blister pack are very different calculations. Would be useful though, particularly for heat where the blister packs are not necessarily good barriers

Fully with you there

HOWEVER, storage outside of a pharmacy environment hasn’t really been studied and carries greater risks of degradation. Fortunately, there aren’t many cases of toxicity from expired medications (tetracycline famously, but also e.g. Montelukast more recently)

Pharmaceutical companies are required to do stability testing on their products, which is expensive - so they set the expiration dates for the minimum time. If stored in cool, dark, dry conditions, there’s no reason they can’t last for a long while - there was a big US Army study about this

Before reading the paper, I was under the impression that one of the requirements was low did intake before drinking large volumes of slushie, but that doesn’t seem to be the case! Maybe glycerol does just block glucose utilisation?