Patient knowledge of the paracetamol content of over-the-counter (OTC) analgesics, cough/cold remedies and prescription medications.

Aims: To test, by completion of a simple questionnaire, patient knowledge of whether 15 commonly used over-the-counter and prescription analgesics and cough/cold remedies contained paracetamol and patient knowledge of the 4 g maximum daily dose of paracetamol.

Methods: Patients in the emergency department triage waiting area of a busy London teaching hospital were asked to complete a standardised one-page questionnaire. From a list of 15 commonly used over-the-counter and prescription products, patients were asked which contained paracetamol, responding 'yes', 'no' or 'not sure' for each.

Availability of and use of Intralipid (lipid rescue therapy, lipid emulsion) in England and Wales.

There is increasing evidence for the use of Intralipid in the management of acute local anaesthetic toxicity. This is supported by the recent Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines for the management of local anaesthetic toxicity. Acute hospitals in England and Wales were surveyed to determine the proportion that currently stocked Intralipid, the locations of stocks within the hospital, guidelines related to its use and previous use in the last 12 months.

Propafenone poisoning--a case report with plasma propafenone concentrations.

Propafenone is an anti-arrhythmic drug used in the management of supraventricular and ventricular arrhythmias. It is metabolised through cytochrome P450 2D6 pathways; the major metabolites possess anti-arrhythmic activity. The cytochrome P450 CYP2D6 is coded by more than 70 alleles resulting in great genetic polymorphism of CYP2D6 isoenzymes, and up to 7% of Caucasian population are poor metabolisers.

Recreational use of mephedrone (4-methylmethcathinone, 4-MMC) with associated sympathomimetic toxicity.

Introduction: Cathinone is a pharmacologically active alkaloid that can be extracted from the leaves of the khat plant (Catha edulis). There are synthetic derivatives of cathinone entering the recreational drug market, including mephedrone (4-methylmethcathinone, 4-MMC). There are discrepancies in the legal status of both the khat plant and its extracted alkaloids between the UK and the USA.

First case report of recreational use of 2,5-dimethoxy-4-chloroamphetamine confirmed by toxicological screening.

Routine toxicological screening is generally not undertaken in patients with recreational drug toxicity. We report here the benefits of toxicological screening in confirming drugs that have been ingested and potentially detecting drugs that have not previously been reported in the medical literature. In this case, the patient was reported to have ingested a combination of 2,5-dimethoxy-4-iodoamphetamine and methylenedioxymetamphetamine and developed sympathomimetic toxicity, but on extended toxicological screening he was shown to have actually ingested 2,5-dimethoxy-4-chloroamphetamine and methylenedioxymetamphetamine.

Severe iatrogenic bismuth poisoning with bismuth iodoform paraffin paste treated with DMPS chelation.

Background: Bismuth iodoform paraffin paste (BIPP) is used for the packing of wound and surgical cavities. Features of both bismuth and iodoform toxicities have been associated with the use of BIPP, but there are no previous reports of 2,3-dimercaptopropane-1-sulphonate (DMPS) chelation therapy for bismuth poisoning secondary to its use.

Case Report: A 67-year-old man presented with a pelvic tumor requiring extensive surgical resection.