No episode today. Head here for the live radio show!

 Join us next show for Dr. Howard Greller of  Sirius XM Doctor Radio, Dantastic Mr Tox & Howard,  and Tox & Hound

Find the article about the poison lab here 

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

In this episode Ryan and Toxo dissect the fascinating underbelly of illegal cosmetic procedures and breakdown the toxicities that arise from them.

Intro

• Case report of hemolysis after sodium deoxycholate injection 
• History

Epidemiology

• ASPS stats
• Florida Unlicensed Activity Unit 
• Cost of surgeon fee for buttock implant 2018

Recent new stories

• Botox and Bubbles grifter
• Quick bio on cases mentioned in show

Common injection practices

• Feminizing body contouring (pumping parties)
• Synthol muscles
• Capsule face cosmetics

Toxicity

• Infection
• Self explanatory

Filler embolism

• Review 1, Review 2, Review 3
• Filler lodges in pulmonary vasculature->clotting, bleeding, inflammation
• 95% occur within 72 hours
• Primarily respiratory symptoms (cough/hypoxemia)
• Chest x ray ground glass opacity
• Treat with supportive care (oxygen all the way through ECMO) +/- steroids
• Filler Blindness
• CRAO from body filler
• No effective treatment (exception, can use hyaluronidase if filler is hyaluronic acid)

Granuloma

• Inflammatory nodules from prolonged filler exposure
• May occur months to year after injection
• Illegal cosmetic= frequently lipogranuloma due to oil being present in many illegal cosmetic
• Granulomatous hypercalcemia
• Excess calcitriol production from ganuloma causes hyperCA
• Can be extremely delayed (up to 28 years)
• Recurrence up to 45%
• Treat with standard therapies (fluid, bisphosphonate) + steroids and/or ketoconazole to turn down granuloma CYP27B1 calcitriol production

Case from the show

• Some details changed for educational purposes

Music in this episode from pixabay.com

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

Send in your guesses to [email protected]

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

In this episode of toxicologist vs internet guest Dr. Andrew Farkas, MD joins the show. This a great episode that covers everything from the drugs you would need in the apocalypse to what to worry about if your cats are dying. Complete with toxic sleuthing of fatal poisoning cases and answering questions from reddit.com/r/askdrugs.

• Research from Dr Farkas
• Additional information on toxins from Fatal poisoning cases 
• Toxin 1
• Toxin 2
• Toxin 3
• Toxin 4
• "Toxicologist vs the internet" segment
• Cocaethylene review
• Benzodiazepine urine drug screening - Blog post

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

In this episode Ryan and Toxo take a closer look at ketamine induced irreversible bladder damage.

History

• Discovery of Ketamine
• Melamine outbreaks

Clinical Effects

• Index cases
• Survey of Ketamine use prior to symptoms

Mechanism/Treatment

• Mechanism/Treatment systematic review
• Rat models

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

What substance could cause these symptoms? Send your guesses to [email protected] to participate in episode 10!

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

In this episode of toxicologist vs the internet Ryan Is joined by special guest Dr. Justin Corcoran, MD an emergency medicine physician and medical toxicologist. They take turns answering questions from reddit.com/r/askdrugs (the internet, really, really needs a toxicologist) and challenge each others toxic sleuthing by presenting cases of poisoning and allowing the other to determine the toxin responsible.

"Toxicologist vs the internet" segment

• Everythingisosm.com (Blog post)
• Biased Mu Receptor ligands
• Oliceridine mouse studies
• Opioid hearing loss (Blog post)
• Opioid hearing loss review
• Tox pupils  (Blog post)
• Why tramadol is awful (Blog post)

Additional information on toxins from Fatal poisoning cases 

• Toxin 1
• Toxin 2
• Toxin 3
• Toxin 4

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

Ryan and Toxo dive in to Delta 8 THC, a new (maybe?) legal drug sweeping the U.S.

• Comprehensive article on Delta-8 THC, its growing popularity, and concerns: https://www.nytimes.com/2021/02/27/health/marijuana-hemp-delta-8-thc.html

1. Systematic Review:
2. Summarizes findings from a single key study on Delta-8 THC. https://pubmed.ncbi.nlm.nih.gov/29385080/
3. Original Study (may not be accessible):
4. Investigates Delta-8 THC effects in humans.
5. https://www.karger.com/Article/Abstract/136375

• HPLC-MS/MS Strategies:
• Analytical methods for testing Delta-8 THC.
• https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaa184/6018445?redirectedFrom=fulltext

• Mechanism of Action:
• Study exploring how Delta-8 THC binds to cannabinoid receptors.
• https://pubmed.ncbi.nlm.nih.gov/27398024/

If you’re interested in learning more or exploring the impact of Delta-8 THC, these resources provide a great starting point. Thank you for listening!

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

Case from the show

• https://pubmed.ncbi.nlm.nih.gov/22163140/

Mithradates

• https://www.wemjournal.org/article/S1080-6032(11)00043-3/pdf

Case series on mad honey effects

• https://pubmed.ncbi.nlm.nih.gov/20575670/

Blog post on sodium channel openers

• https://emcrit.org/toxhound/ff-plant-sodium-channel-openers/

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website

In this second rendition of toxicologist vs the internet Ryan Is joined by special guest Dr. Jillian Theobald, MD, PHD an emergency medicine physician and medical toxicologist. They take turns answering questions from reddit.com/r/askdrugs (the internet, really, really needs a toxicologist) and challenge each others toxic sleuthing by presenting cases of poisoning and allowing the other to determine the toxin responsible. Listen in to hear about the clinical effects of benzodiazepine on TV watching, the patient side of ketamine, cocaine chest pain, heavy metals, flower petals and much much more!

• Patient Experience Blog:
• "30 Years of Depression Gone"
• https://humanparts.medium.com/30-years-of-depression-gone-3dffafabc7cf?fbclid=IwAR1gh08Kn3uSczlKbvMH54yjkWILzyA_6O3Y82q4hVqcAr3shozxwegCnmg

• Study on Cognitive Enhancers:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770454/#CR14

1. Hepatic Injury Risk:https://pubmed.ncbi.nlm.nih.gov/15114493/
2. Anti-Anxiety Effects:https://pubmed.ncbi.nlm.nih.gov/33207379/

1. Propranolol Effects on Coronary Constriction:https://pubmed.ncbi.nlm.nih.gov/1971166/
2. Labetalol Effects on Coronary Constriction:https://pubmed.ncbi.nlm.nih.gov/8506886/

• Clinical guidance for toxicity management:
• https://pubmed.ncbi.nlm.nih.gov/25724076/

• https://pubmed.ncbi.nlm.nih.gov/18802411/

Review the show where ever your listening

Get Messages from Toxo (Join the Newsletter!)

Join as a supporting member

• Ad free episodes
• Bonus content and early access
• Discounts and give aways on GOTA PICCEM Mushroom card game

The GOTTA PICCEM Poisonous Mushroom Game!

The Poisonus Fungus Amongus Children's Book!

• Full book reading (6 minutes!)

Tox trinkets (Rep the show at home!)

• Email: [email protected]

More Show Resources

• Ryan's Medical Games and Resources
• Show Website