The Poison Lab
The Poison Lab is a podcast hosted by clinical toxicologist Ryan Feldman, who has over a decade of experience managing poisonings and drug overdoses. The show explores the history, science, and medical management of toxins from around the world. It features stories of those affected by poisons and insights from experts in poisoning treatment. Each episode aims to uncover the fascinating tales behind various poisons.
Episodes
A Morel Dilemma Episode 6...Is Coming
Hey everyone, it’s Ryan.I know many of you are patiently waiting for Episode 6 of A Morel Dilemma, and it is coming next week. I genuinely cannot wait for you to hear this one.But it is actually available right now for supporter members. You can go to www.thepoisonlab.com/support and get every single episode right now for as little as $1 a month. And full disclosure, I only get about half of that.
A Morel Dilemma Preview: Supporting Member Bonus Episodes
This preview features the opening conversations from two supporting member bonus episodes in The Poison Lab outbreak series.First, we head to Ontario, where a mass aconite poisoning unfolded after a restaurant spice was contaminated with one of the most dangerous plant toxins in the world. Then we travel to Australia, where the poppy seed supply was contaminated with thebaine, triggering seizures
A Morel Dilemma Bonus Radio Co-Broadcast: Ryan Feldman on WTMJ Conversations — Morels, Mushroom Poisoning, and the Story Behind A Morel Dilemma
In this bonus episode of A Morel Dilemma, Ryan shares his recent interview on WTMJ Conversations with Libby Collins.The conversation goes behind the scenes of the series and explores why Ryan spent two years investigating the 2023 Bozeman, Montana morel mushroom outbreak, one of the strangest poisoning outbreaks in recent history. Ryan discusses how the outbreak challenged long-held assumptions ab
A Morel Dilemma: Bonus — The Bradford Hill Criteria & The Morel
In Episode 5, we put the morel mushroom on trial. This bonus episode shows how we built the case.Dr. Grant Comstock joins me for the full, unfiltered causation breakdown using the Bradford Hill criteria, a public health framework used to separate true causation from simple association. We walk through the CDC data step by step, looking at strength of association, timing, dose response, plausibilit
A Morel Dilemma: Episode 5 — Trial of the Morel
The case against the morel mushroom is starting to come together, but there are still major problems. Not everyone who got sick ate morels, and not everyone who ate morels got sick. If the mushroom is really the culprit, those gaps have to be explained.In Episode 5 of A Morel Dilemma, we put the CDC data on trial with Dr. Grant Comstock and stress-test the evidence linking morels to the Bozeman ou
A Morel Dilemma: Episode 4 — A Familiar Shape
When every obvious test comes back negative, investigators have to look for another way to prove what caused the outbreak. So this episode takes a step sideways, from Bozeman, Montana to a small mountain village in the French Alps, where researchers faced a different kind of mystery: a cluster of ALS cases with no clear cause.What they found there may help explain how scientists can link a mushroo
A Morel Dilemma: Bonus — Calling in The CDC
In this bonus episode, we go deeper into the public health machinery behind a mass poisoning investigation.Dr. Michael Yeh, a medical toxicologist at the CDC’s National Center for Environmental Health, explains how the CDC gets pulled into unusual outbreaks, how poison centers and health departments help spot early signals, and what happens once a local cluster starts looking like something bigger
A Morel Dilemma: Episode 3 — Testing the Evidence
With the restaurant closed and the first interviews underway, investigators bring in the CDC and FDA to help answer the question at the center of the outbreak: what actually made people sick?The leading suspect is still the morel mushroom, but proving that is not simple. The symptoms could fit bacterial food poisoning, spoiled fish, a chemical contaminant, a mislabeled spice, or even a toxic mushr
A Morel Dilemma: Bonus — Who Treats Mushroom Poisoning
Who actually treats mushroom poisoning?In this short mini episode, we answer a surprisingly important question: when someone gets sick after eating a mushroom, who do they call, and who helps the doctors figure out what to do next?We break down the role of poison centers, medical toxicologists, emergency clinicians, and why the most important number to remember is 1-800-222-1222.A Morel DilemmaSup
A Morel Dilemma: Bonus — Remembering poisonous mushrooms (GOTTA PICCEM)
In this bonus episode, Dr. Rob Bassett from Philadelphia Poison Control walks us through one of the most useful teaching tools in mushroom toxicology: GOTTA PICCEM.This mnemonic organizes toxic mushrooms by their clinical syndromes and, most importantly, by the timing of symptom onset. That timing can be one of the biggest clues toxicologists use to decide whether a mushroom exposure is likely to
A Morel Dilemma: Bonus — Muscarine Poisoning
This bonus episode takes a deeper look at the muscarine poisoning case discussed by Dr. Matthew Stanton. We break down how muscarine causes toxicity, why its symptoms can become life-threatening, and why its important for foragers to recognize so they can be treated.Select References:Dr. Stanton's case reportWisconsin Muscarine Case Series (Not yet available)A Morel DilemmaSupport the showReview t
A Morel Dilemma: Episode 2 — Investigations and Falsehoods
As reports of severe illness and death come in, the Bozeman outbreak moves from medical mystery to full public health investigation. Local and state investigators race to identify the source, shut down the risk, interview patients, collect food samples, and figure out whether anyone else could still be in danger.The early signal points toward one unlikely ingredient: morel mushrooms. But for toxic
A Morel Dilemma: Episode 1 — Outbreak in Bozeman
A deadly outbreak begins with a single meal at a sushi restaurant in Bozeman, Montana. Within hours, diners develop severe nausea, vomiting, and diarrhea. Some collapse. Two people die. At first, it looks like food poisoning, but investigators quickly notice one strange ingredient connecting many of the sick patients: morel mushrooms.In the first episode of A Morel Dilemma, we meet the people caug
Introducing: A Morel Dilemma
Available June 3rd- A deadly outbreak begins at a sushi restaurant in Bozeman, Montana. Diners develop rapid, severe gastrointestinal illness. Some collapse. Two people die. And the only clue pointing investigators toward a cause is also the hardest one to believe: morel mushrooms.A Morel Dilemma is a serialized outbreak investigation from The Poison Lab, following the story in real time as clinic
Gas Station Heroin? Kratom, Regulation, and Recovery — A Co-Broadcast with the Kratom Sobriety Podcast
In this special co-broadcast episode, The Poison Lab joins forces with The Kratom Sobriety Podcast for a deeper conversation about kratom, regulation, addiction, recovery, and what poison center data can tell us about real-world harm.Kratom is a plant-derived substance that contains mitragynine and 7-hydroxymitragynine, compounds with opioid-like effects. It is sold in many forms, including powder
Outbreak: 75 Fatalities After a Funeral Poisoning in Mozambique
In this episode of The Poison Lab Outbreak, Ryan talks with Dr. Alaina Steck about a devastating mass poisoning in Mozambique that began at a funeral and ultimately sickened more than 200 people, with a fatality toll of over 70.Early reports blamed crocodile bile. Others suspected intentional poisoning. But as the investigation unfolded, the clinical picture, timeline, and exposure history did not
Rebroadcast: Phenibut. The emerging drug you don’t know about (yet)
Phenibut is an emerging and unfamiliar drug taking hold in the US that is readily available online and legal to obtain. It acts as a GABA-B agonist and carries risks of dependency and withdrawal. In this episode Ryan interviews phenibut users as well as experts involved in phenibut treatment. They explore the history, current trends, toxicity, and management of phenibut, a novel GABA-B agonist. He
If I had a Nickel (Mystery Case) & Toxicologist vs The internet (#13) with Dr. Damilola Idowu-Ellsworth
In this episode of The Poison Lab, host Ryan Feldman is joined by medical toxicologist Damilola Idowu‑Ellsworth for a fast-moving, case-heavy conversation packed with clinical pearls, listener participation, and classic toxicology weirdness.The show opens with listener guesses for the previously released mystery case before diving headfirst into a rapid-fire series of Stump the Toxicologist cases
Poison Lab Update: Mushroom Poisoning Radio Roundup
Hey everybody, you’re listening to The Poison Lab—well, almost.We’ve got a new episode coming next week, but we’re running a little behind on our usual release schedule because… life happens. That said, if you’re looking for some toxicology content right now, I’ve got you covered.Recently, I had the chance to appear on two local and state radio shows talking about one of my favorite topics: mushro
Sick at Work? A Poisonous Cause of Coworker Illness?
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in the next episodeA Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mu
Outbreak: Thebaine Poisoning from Poppy Seed Tea in Australia
In November 2022, hospitals across Australia began seeing patients with sudden rigidity, spasms, seizures—and in some cases cardiac arrest—after drinking homemade poppy seed tea. The source? Food-shelf poppy seeds contaminated with extraordinarily high levels of thebaine, an opioid alkaloid that acts nothing like morphine. In this Outbreak episode, host Ryan Feldman, clinical toxicologist and emer
Poisonous Fungus Amongus is Here— The Rhyming Kid (or Adult) Book For Mushroom Safety
Get your copy here! https://a.co/d/8QUBmQyWant to hear it with insights from the author?: • Poisonous Fungus Among Us | Full Children’... Don't have time for the full thing: check the highlights: • Poisonous Fungus Amongus Highlights Reel Want a clearer picture: Full reading large scale here: • P
LIVE from Chicago: 2025 NACCT Research Review – Insights from the North American Congress of Clinical Toxicology
Show NotesIn this special live episode from the 2025 North American Congress of Clinical Toxicology (NACCT), Ryan takes you inside the conference to hear directly from the researchers themselves. Covering 11 abstracts that span high-stakes management decisions, surprising case reports, and challenges to toxicology dogma, this year’s highlights feature everything from amlodipine overdoses to naturo
Toxicologist vs The internet (#12) with Dr. Joe Kennedy MD
In this episode of The Poison Lab, host Ryan Feldman is joined by Dr. Joe Kennedy, medical toxicologist at the University of Vermont and consultant for the Northern New England Poison Center. Together they work through real poisoning cases to sharpen toxic differentials, sum up practical resuscitation priorities, and connect first-principles pharmacology to bedside decisions. They also answer lis
GOTTA PICCEM is Here! — The Poisonous Mushroom Card Game Launch
GOTTA PICCEM: The Poisonous Mushroom Card Game👉 Order now right here OR go to www.gottapiccem.com and click "Buy GOTTA PICCEM"Why this is awesomeWhat started as a nerdy teaching tool made to teach mushroom poisoning by folks who treat mushroom poisoning is now a full-fledged card game—equally great for Friday game night and the classroom.What’s inside the deck58 Poisonous Mushroom CardsFull-color
Ryan is LIVE on the Radio Thursday July 17th 11:45AM-12:30 PM CST WPR Larry Meiller Show!
Listen here (https://www.wpr.org/shows/larry-meiller-show) to hear Ryan Live on AIR for the Larry Meiller show, Thursday July 17th 11:45AM-12:30 PM CST. Check this "Listen Live" link if your having trouble!
Poisoning Outbreak: Aconite Poisoning at Markham, Ontario Restaurant
A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)R
MURDER for Lunch: Toxicologist vs The internet (#11) with Dr. Amy Zosel MD
In this episode of The Poison Lab, host Ryan Feldman is joined by Dr. Amy Zosel, a medical toxicologist, emergency physician, and educator. Together, they use real poisoning cases to practice identifying toxins and flexing their toxic differential The conversation dives into intriguing and challenging toxicology cases, with a focus on educating listeners about real-world poisoning scenarios, myth
A Mnemonic For Poisonous Mushrooms and Their Effects- GOTAA PPICEM
A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)R
Leafy Greens & Injured Beans: Natures Nephrotoxins – A Poison Lab & NephMadness Collaboration
In this special collaboration with NephMadness, we're diving into the world of nephrotoxins with an expert panel from Virginia Commonwealth University. NephMadness is an educational competition modeled after March Madness, and this year, one of the featured regions focuses on plant-based nephrotoxins. Together, with our expert panel we break down the competing nephrotoxin teams: Tubular Toxins vs
A Mysterious Case of Weakness, Low Potassium, and Kidney Injury
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in the next episode Support the show!Rep the show!Show website
Should we Give Naloxone in Cardiac Arrest? Insights From the Authors of Three Key Studies
Finally, the journal club to rule ALL journal clubs. In this episode of The Poison Lab, we tackle one of the biggest topics in emergency medicine and toxicology: Should naloxone be given during opioid-associated cardiac arrest? With three fantastic studies published in 2024, we’re diving into the data and hearing directly from the authors themselves.Join host Ryan Feldman as he interviews Dr. Eric
The Poison Lab Holiday Bonus- Stump The Toxicologist Reel 2022
In this special holiday bonus episode, Ryan takes a look back at some of the most captivating episodes of The Poison Lab from 2022. Get ready for an ultimate test of your toxicology differential diagnosis skills as we compile all the "Stump the Toxicologist" segments into one streamlined, binge-worthy episode. Explore eight unique poisoning cases, be sure to check the show notes for a description
What Should We Do About Forever Chemicals? With Dr John Downs (The Wizard of PFAS)
Join host Ryan Feldman in an insightful episode of "The Poison Lab" as he sits down with Dr. John Downs, Director of the Virginia Poison Center, and one of the leading experts on per- and polyfluoroalkyl substances (PFAS), commonly known as "forever chemicals." Known for their persistence in the environment and human body, PFAS have raised significant public health concerns over the past few decad
Poison Updates: Newsletter, Poison Ads?, and Guest Spots on 22 at the Lips and The Continuing Studies Podcast
Ryan on others showsRyan on "22 at the Lips"Ryan on "Continuing Studies"A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Child
LIVE from Denver: 2024 NACCT Research Review – Insights from the North American Congress of Clinical Toxicology
In this exciting live episode from the 2024 North American Congress of Clinical Toxicology (NACCT) in Denver, Ryan dives into 12 of the most impactful research abstracts presented at the conference directly with the authors themselves. Covering a wide range of toxicology topics—from the NACSTOP2 trial on acetaminophen overdose, ECG intervals, cannabis toxicity in young children, and more—each gues
The Poison Letter To The Editor: Listener Critiques and Author Responses for The AHA 2023 Life Threatening Poisoning Guidelines with Dr. Michael Mullins, Dr. Donna Seger, Dr. Leon Gussow, and Dr. Eric Lavonas
In this episode the poison lab hosts scientific discourse . Three listeners (Dr. Michael Mullins, Dr. Donna Seger, and Dr. Leon Gussow) write in their critiques surrounding specific recommendations and language used with the AHA 2023 Management of Poisoning Cardiac Arrest or Life-Threatening Toxicity guidelines. Lead author of the guidelines Dr. Eric Lavonas then responds to and addresses their po
Send in Your Questions For "Ask a Toxicologist"
Have a burning question you have always wanted to ask a toxicologist? What are tips for managing an anticholinergic overdose? What is the deadliest poison? Why are they called lead pencils if there is no lead?! Send your questions in to toxtalk1@gmail.com to take part in a future episode! (If you would like to be anonymous simply state it in the email)A Morel DilemmaSupport the showReview the show
Open and Shut (Mystery case 31) with Guests Dr. Dan McCabe and Dr. Crissy Lawson
In this episode Ryan is joined by two expert guests to help read listener guesses for the cause of this poisoning murder and shed light on the toxin involved in the case, which puzzled medicolegal investigators. Ryan is joined by Dr. Dan McCabe, MD (emergency medicine physician, medical toxicologist, medical director of Iowa poison center) and Dr. Crissy Lawson PharmD (emergency medicine pharmacis
The Poison Lab - Stump The Toxicologist Reel 2023
In this bonus episode Ryan highlights some of the great episodes done in 2023 and compiles ALL of the stump the toxicologist segments from 2023 into one easy to consume episode. Test your toxicology differential skills with more than six poisoning cases. Check out the actual episodes for more information in the show notes on each of the poisonings. Frank Paloucek EpisodeAdam Blumenberg Episod
A Mysterious Case of Fatal Arrhythmia in a Newly Wed (Episode #31 Mystery Case)
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in the next episode Support the show!Rep the show!Show website
Where is Episode #31 and Bonus Episodes- Ryan Joins "The Larry Meiller Radio Show" and The "EMS2020" Podcast
A quick update to share some other shows Ryan has been on in the last few weeks! Check the show notes for links to each episode!Ryan on "The Larry Meiller Show" discussing delta cannabanoidsLink to streamLink to downloadRyan on EMS2020 talking prehospital overdoseLink to episode Show homepageSupport the show!Rep the show!Show website
Bromazolam, Etonitazene, and Carfentanil Walk into a Bar – Trends in Novel Illicit Drugs with Dr. Alex Krotulski
In this episode Ryan interviews Dr. Alex Krotulski PhD from the Center for Forensic Science Research and Education. Together take a look at trends in novel opioids, benzodiazepines, stimulants, hallucinogens, synthetic cannabinoids, and "hemp products" that are showing up in your patients, drug products, and fatal overdoses. The conversation takes places around the Center for Forensic Science Rese
Inefficient Heat (Mystery Case 29) & Toxicologists vs The internet (#10) with Dr. Ann Arens
Dr. Ann Arens, MD an emergency medicine physician and medical toxicologist with Oschner Medical center in New Orleans, LA joins the show to educate us on some HOT toxins, solve toxic cases, and opine on the philosophical and existential reasons drugs even exist. Tune in for a fantastic discussion with Dr. Arens and to hear the answer to our mystery case. Case report for mystery caseReview pap
A Mysterious Case of Fatally High Temperature and Organ Failure in a Young Woman (Episode #29 Mystery Case)
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in episode 29A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom
A very NACCT Holiday-2023 North American Congress of Clinical Toxicology High Yield Abstract Review
In this episode Ryan is joined by a guest panel (Dr. Grant Comstock MD, Dr. Joshua Trebach MD, Dr. Emily Kiernan DO, and Dr Frank Paloucek PharmD, DABAT) to review nine of the most interesting or clinically impactful research abstracts that were presented at the 2023 North American Congress of Clinical Toxicology (NACCT) in Montreal Canada. If you didn't get a chance to read all 363 research abstr
APAPalooza. A North American Congress of Clinical Toxicology 2023 Acetaminophen Research Highlight
Support the show!Rep the show!Show websiteIn this episode, Ryan dives into cutting-edge research on the treatment of acetaminophen (APAP) overdose, featuring interviews with authors of several key abstracts from the North American Congress of Clinical Toxicology (NACCT) in Montreal Canada (Abstracts and posters available in the show notes). We get first looks insights into research evaluating the
AHA 2023 Management of Poisoning Cardiac Arrest or Life-Threatening Toxicity Guidelines with Co-Author Dr. Eric Lavonas MD
In this episode, Ryan sits down with Dr. Eric Lavonas MD, a seasoned EM resuscitation guideline writer, emergency medicine physician, medical toxicologist, and lead author of the latest update to the American Heart Association's guidelines for the management of cardiac arrest and life-threatening toxicity due to poisoning. They have an in-depth discussion as they explore the key aspects of the 202
High Yield Highlight- 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning
In this episode Ryan does a high yield "just the facts" break down of the recently released "2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Tune in to learn about the most recent
The Poison Lab Does Psilocybin- A Deep Dive with Psilocybin Research Pharmacist Dr. Paul Hutson
In this enlightening episode, Ryan engages in a deep conversation with Dr. Paul Hutson, PharmD, a renowned researcher in the field of psilocybin and director of the Transdisciplinary Center for Research in Psychoactive Substances at the University of Wisconsin Madison. Dr. Hutson shares his extensive knowledge and insights into the promising role of psilocybin in the treatment of depression and su
New Podcast Artwork & Tox Trinkets!
New Art and New Tox Trinkets. If you want to share your tox joy in the real world, find some trinkets here: https://www.etsy.com/shop/thepoisonlabA Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GO
Acetaminophen Poisoning Management: US & Canada Consensus Statement with Co-Author Dr. Richard Dart, MD, PhD
Mini episode- High-yield over view of Management of Acetaminophen Poisoning in the US and Canada Consensus Statement In this Ryan sits down with Dr. Richard Dart MD, PhD. He is the lead author of the recently released "Management of Acetaminophen Poisoning in the US and Canada Consensus Statement" from the American Academy of Clinical Toxicology, American College of Medical Toxicology, Americ
High Yield Highlight-Consensus Statement on Management of Acetaminophen Poisoning in the US and Canada
This episode is a a high yield "just the facts" break down of the recently released "Management of Acetaminophen Poisoning in the US and Canada Consensus Statement" from the American Academy of Clinical Toxicology, American College of Medical Toxicology, Americans Poisons Centers, and the Canadian Association of Poison Centers. Listen to be informed on the most recent treatment recommendations. Th
Toxicologists vs the Internet (#9) With Guest Dr Frank Paloucek PharmD DABAT FAACT
Dr. Frank Paloucek, PharmD, DABAT (@itsalltox) joins the show. He was one of the very first emergency medicine pharmacists and one of the original board-certified clinical toxicologists (DABAT). He is now a proudly retired professor emeritus at The Univeristy of Illinois at Chicago. In his tenure there he spent nearly 20 years as the program director for their clinical pharmacy residency, was an i
The Undead Patient: The Complexity of Brain Death Determination in Drug Overdose
In this episode Ryan explores the concept of brain death and the implications of drug overdoses causing false positive diagnosis of brain death. He is joined by an author of the ACMT Position statement on brain death in overdose (Dr. Andrew Stolbach MD) as well as authors of two case reports (neuro critical care physician Dr. Ranier Reyes and emergency physician Dr. Doug Stranges) involving buprop
Toxicologists vs the Internet (#8) With Guest Dr Adam Blumenberg MD
Dr. Adam Blumenberg, MD (@ABlumenbergMD) Join's the show. He is an emergency medicine physician, medical toxicologist, and Assistant Professor at Columbia University Medical Center in New York City. He hosts his own toxicology youtube series (www.ToxicHistory.com) and has developed multiple free medical education software programs in toxicology (www.toxicrunner.net) and medical simulation (www.med
High yield highlight- Managing a Bupropion overdose
Ready for a high-octane dose of knowledge? 🔥🧠 Ryan's got you covered with this electrifying mini-episode on managing a bupropion overdose! 💊💥 Beware - there are plenty of pitfalls you'll want to avoid. Check out the full episode and other mini-episodes for even more tips and tricks! 🎧👀Bupropion is the #1 antidepressant cause of major (life threatening) reported to U.S. Poison CentersIt is di
A Prescription for Heartache (& Seizures) (Bupropion)
What Do Bath Salts, Face-Eating Zombies, and Antidepressants Have in Common?In this episode of The Poison Lab, Ryan is joined by Dr. Filip, Dr. Olives, and Dr. Reyes to discuss a unique and heartbreaking poisoning scenario involving an antidepressant now recognized as the #1 cause of major life-threatening effects in antidepressant overdoses in the U.S. Check out the mini-episodes for more details
Mini Episode: Bridging the Gap- Bupropion's not your average wide QRS with Dr. Travis Olives
Rohr 2004- Gap junction blockade can cause a wide QRS Vink 2004 Connexin 43 is the most important protein for connexon formation and cardiac signal transmissionCallier 2012- Bupropion does not block sodium channels, and does exhibit similar effects on the cardiac action potential as known gap junction Burnham 2014 Bupropion has an IC50 for connexin 43 >50 uMol, larger than other drug
Mini Episode: Who Seizes in Bupropion Overdose with Dr Ari Filip MD
Seizure Risk: Patients can seize 8–24 hours post-ingestion. Neurologic symptoms and tachycardia often precede seizures.Delayed Symptoms: Co-ingestions may mask tachycardia, and symptoms can be significantly delayed.Key Management Advice:Do not discharge patients without consulting a toxicologist or poison center about observation times.Do not dismiss tachycardia and anxiety as situational in cases
2022 North American Congress of Clinical Toxicology (NACCT) High Yield Abstract Review
All published abstracts can be found here AbstractsCategory 1: Amlodipine VasoplegiaAbstract 1: Vasodilation in patients with calcium channel blocker poisoning treated with high dose insulin: a comparison of amlodipine versus non-dihydropyridinesStudy of HDI on propranolol poisoned pigsStudy of Minnesota HDI protocolAbstract 2: Amlodipine anxiety: a 10-year review of amlodipine associated fat
Episode 19 Mystery Case
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in episode 19A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom
Toxicologists vs the Internet (#7) With Guest Dr Emily Kiernan DO
Dr. Emily Kiernan, DO (@em2kiernan) an emergency medicine physician and medical toxicologist with Emory university school of medicine joins the show to solve toxic cases, opine on recent healthcare related poisoning, and dive head first into the bongwater on this episode. (Remember friends, don't drink the bong water). Recent Healthcare poisoning in the newsNurse reportedly feeding children insu
Phenibut. The emerging drug you don’t know about (yet)
Phenibut is an emerging and unfamiliar drug taking hold in the US that is readily available online and legal to obtain. It acts as a GABA-B agonist and carries risks of dependency and withdrawal. In this episode Ryan interviews phenibut users as well as experts involved in phenibut treatment. They explore the history, current trends, toxicity, and management of phenibut, a novel GABA-B agonist. H
Episode 16 Mystery Case
Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in episode 16A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom
Toxicologists vs the Internet (#6) With Guest Dr Joshua Trebach MD
Dr. Joshua Trebach, MD (@jtrebach) joins the show for some toxic sleuthing of fishy poisonings and answers questions from reddit.com/r/askdrugs. Case report Ryan Feldman wrote about himselfStump the Tox casesCase #1Case #2case series from Dr Jillian TheobaldCase #3Case #4Ask drugsFanconi syndrome in expired tetracyclineA Morel DilemmaSupport the showReview the show where ever your listeningGet M
Fast and Fatalurious
In this episode Ryan and Toxo dive into a widely available prescription poison with a frightening ability to cause rapid neurologic and cardiovascular decline, and the best part, it looks like candy! Digoxin kineticsAmiodarone overdosePost market safety reviewReview of published exposures and severe outcomes from US poison centerCase from the showA Morel DilemmaSupport the showReview the show whe
A Mysterious Case of Rapid Coma and Ventricular Arrythmia in a Young Man (Episode #14 Mystery Case)
Send in your guesses to toxtalk1@gmail.com A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 min
Toxicologists vs the Internet (#5) With Guest Dr Howard Greller MD (Sirius XM Doctor Radio Emergency Medicine Show, Dantastic Mr Tox & Howard, Tox & Hound)
Dr. Howard Greller, MD (Sirius XM Doctor Radio Emergency Medicine Show, Dantastic Mr Tox & Howard, Tox & Hound) joins the show. A FANTASTIC episode complete with toxic sleuthing of fatal poisoning cases and answering questions from reddit.com/r/askdrugs. Music from PixabayAdditional information on toxins from fatal poisoning cases Toxin 1Toxin 2Toxin 3Toxin 4Popper article reference
Where is Episode 13 ? Bonus Episodes AND Next Episode Guest Dr. Howard Greller MD (Sirius XM Doctor Radio Emergency Medicine Show, Dantastic Mr Tox & Howard, Tox & Hound),
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 & HoundFind the article about the poison lab here A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonu
Lethal Buttock Injection (And Other Toxicities of Illegal Cosmetic Body Fillers)
In this episode Ryan and Toxo dissect the fascinating underbelly of illegal cosmetic procedures and breakdown the toxicities that arise from them. IntroCase report of hemolysis after sodium deoxycholate injection HistoryEpidemiologyASPS statsFlorida Unlicensed Activity Unit Cost of surgeon fee for buttock implant 2018Recent new storiesBotox and Bubbles grifterQuick bio on cases mention
A Mysterious Case of Hypercalcemia and Subdermal Nodules in a Transgender Patient (Episode #12 Mystery Case)
Send in your guesses to toxtalk1@gmail.com A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 min
Toxicologists vs the Internet (#4) With Guest Dr Andrew Farkas MD
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 FarkasAdditional information on toxins from Fa
You Left Your Bladder in The K-Hole?
In this episode Ryan and Toxo take a closer look at ketamine induced irreversible bladder damage. HistoryDiscovery of KetamineMelamine outbreaksClinical EffectsIndex casesSurvey of Ketamine use prior to symptomsMechanism/TreatmentMechanism/Treatment systematic reviewRat modelsA Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join
A Mysterious Case of Bloody and Painful Urination in a 24 Year Old Male (Episode #10 Mystery Case)
What substance could cause these symptoms? Send your guesses to Toxtalk1@gmail.com to participate in episode 10!A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Gam
Toxicologists vs the Internet (#3) With Guest Dr Justin Corcoran MD
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
Mini Episode: Setting The Record Straight on Delta 8 (THC)
Ryan and Toxo dive in to Delta 8 THC, a new (maybe?) legal drug sweeping the U.S. Delta-8 THC: Key Resources and StudiesNew York Times CoverageComprehensive article on Delta-8 THC, its growing popularity, and concerns: https://www.nytimes.com/2021/02/27/health/marijuana-hemp-delta-8-thc.htmlStudies of Delta-8 THC in HumansSystematic Review:Summarizes findings from a single key study on Delta-8 T
More Bitter than Sweet (Mad Honey and Grayanotoxin)
Case from the showhttps://pubmed.ncbi.nlm.nih.gov/22163140/Mithradateshttps://www.wemjournal.org/article/S1080-6032(11)00043-3/pdfCase series on mad honey effectshttps://pubmed.ncbi.nlm.nih.gov/20575670/Blog post on sodium channel openershttps://emcrit.org/toxhound/ff-plant-sodium-channel-openers/A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join t
Toxicologists vs the Internet (#2) With Guest Dr Jillian Theobald MD, PHD
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 deter
Mini Episode: Managing Crashing Hydroxychloroquine/Chloroquine OD
Quick Review: Chloroquine and Hydroxychloroquine ToxicityToxic DoseChloroquine: >5 g is associated with severe toxicity (though toxicity can occur at lower doses).Hydroxychloroquine (HCQ): Toxic dose is less well-defined.Clinical EffectsSeizures: Due to sodium channel blockade.Arrhythmias: Resulting from sodium channel blockade.Hypotension: Caused by alpha-adrenergic blockade.Hypokalemia: Often
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