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Emergency Medicine News:
doi: 10.1097/01.EEM.0000368077.98733.7e
Toxicology Rounds

Toxicology Resources for Clinicians on the Internet

Gussow, Leon MD

Free Access

It's been almost two years since I last wrote about Internet resources for clinicians interested in toxicology. Since that time, new sites have been created, and I have discovered others that I find myself consulting regularly because they are informative and entertaining.

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DEA Microgram Bulletin (http://bit.ly/DEAmicrogram): This U.S. Department of Justice monthly publication explores some of the illegal drugs seized and analyzed by the Drug Enforcement Agency. In many parts of the country, for example, tablets in the shape of President Obama are being sold as Ecstasy. But what drugs are actually in these tablets? Consulting Microgram Bulletin reveals that these generally contain the sympathomimetic piperazines BZP and TFMPP, along with caffeine. A recent seizure in New York, however, found Obama-logo tablets that also contained Ecstasy (MDMA). There are great pictures in the June 2009 issue of similar tablets in the shape of Homer Simpson, Bart Simpson, Snoopy, Blue Smurf, Ninja Turtle, and Garfield. Other seizures recently described in DEA Microgram Bulletin include testosterone cypionate disguised as aromatherapy oil, heroin made to look like MoonPies, and cocaine concealed in religious plaques.

Toxnet (http://toxnet.nlm.nih.gov/): The National Library of Medicine posts a suite of databases relating to toxicology and environmental health. It contains the Hazardous Substances Data Bank, Toxline (a searchable collection of toxicology abstracts), and a number of other sections with information about toxic chemicals, hazardous material incidents, and first response. Unfortunately, much of the material seems geared toward chronic environmental exposures and basic science, giving short shrift to medical toxicology and clinically relevant information. Still, if you want to know the proof of Listerine Antiseptic Mouthwash, the Household Products Database at Toxnet is the place to look. (By the way, its 53.8 proof).

Medworm (www.medworm.com): Medworm is an aggregator and collector of RSS feeds related to medicine from more than 6000 sources. For those who find the previous sentence indecipherable, a translation: RSS (“Really Simple Syndication”) is a way for journals, blogs, popular media, and other web sites to distribute content easily over the web in a standard format called an RSS feed. For example, every week the Journal of the American Medical Association will send out an RSS feed with titles and abstracts of articles in its current issue. These feeds can be received into a feed aggregator such as Bloglines (www.bloglines.com) or Google Reader. Medworm collects feeds relevant to medicine and organizes them into a searchable database. Although I've found the Medworm interface somewhat unwieldy, the site collects updates from an incredibly wide range of sources, and spending a few minutes with it each day and using appropriate search terms (for example, “overdose” or “poison”) is a good way to find publications and events in the world of toxicology that would otherwise go unnoticed. A set of filters allows the user to narrow down to specific sources and topics.

DoseNation (www.dosenation.com): DoseNation provides daily critical and satirical commentary on the way human culture interacts with drugs and altered mind states. It was founded by former editors of Trip magazine (“The Journal of Psychedelic Culture”). Recent posts have covered the crustacean-themed hallucinations that the French existentialist Jean-Paul Sartre experienced when he used mescaline, the opening of a marijuana café (the first in the U.S.) in Portland, OR, and new research into the effects that cocaine has on bees. Not a lot of critical analysis, but there's always something interesting to read. This site has extensive coverage of the medical marijuana controversy and designer drugs. DoseNation is toxicology from the perspective of the user, but users are our patients, and it is valuable to see the drug culture from their point of view.

Toxipedia (www.toxipedia.org): This ambitious site aims to become the Wikipedia of toxicology. It is designed as a “wiki,” a site that can be easily edited, amended, and added to by multiple users in collaboration. According to the Wikipedia entry on “wiki,” the name comes from the Hawaiian word for “fast” and has been backronymed to stand for “What I know is….” While an excellent idea, Toxipedia is still in a very rudimentary stage, difficult to navigate, and very light on content. Their tox history section contains some interesting material, but many of their topics (for example, Cesare Borgia) simply link to the corresponding Wikipedia entry. Hopefully, with support from the toxicology community, this potentially helpful site will expand and become as vital to those seeking information on poisons and poisoners as Wikipedia is to those seeking information on almost anything.

These days, there are more and more medical blogs on the web. A few have a special interest in toxicology. One of the best is Life in the Fast Lane (www.lifeinthefastlane.com) published by an energetic group of Australian physicians. They are especially strong on the fascinating poisonous creatures found on that most toxic of all continents. They also have a section of “Toxicology Conundrums,” which includes actual cases posted in a question-and-answer format. “Life in the Fast Lane” is on my daily reading list.

Dr. Gussow is a volu...
Dr. Gussow is a volu...
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