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    Health & Fitness

    The Poison Lab

    Dive into the captivating world of poisons with The Poison Lab! Hosted by Clinical Toxicologist Ryan Feldman (@EMPoisonPharmD), who has over a decade of managing poisoning and drug overdose via poison centers and in the emergency department. Also occasional co-hosted by his robo cohost Toxo! (@LabPoison). This show unpacks the fascinating history, cutting-edge science, and life-saving medical management of toxins from around the globe. From stories of those impacted to expert insights from pioneers in poisoning treatment, each episode brings you closer to understanding the poisons that lurk in plain sight. Explore episodes, med videos, games, and more at thepoisonlab.com—every poison has a story to tell!

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    Copyright: © thepoisonlab

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    Latest Episodes:
    Open and Shut (Mystery case 31) with Guests Dr. Dan McCabe and Dr. Crissy Lawson Aug 02, 2024
    Show notes

    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 pharmacist).

    • SPOLIER ALERT
    • Mystery case from the show
    • Review Paper from Dr's Lawson, McCabe, and Feldman (PMID: 38613376)
    • Toxo's show note references

    1. TV special about Mary Yoder colchicine murder
    2. Colchicine potential arrhythmic effects
    3. Go fund me for Dr. Betty Bowman

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    The Poison Lab - Stump The Toxicologist Reel 2023 Jul 01, 2024
    Show notes

    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 Episode
    • Adam Blumenberg Episode

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    A Mysterious Case of Fatal Arrhythmia in a Newly Wed (Episode #31 Mystery Case) Jun 14, 2024
    Show notes

    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 Jun 06, 2024
    Show notes

    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 cannabanoids

    • Link to stream
    • Link to download

    Ryan on EMS2020 talking prehospital overdose

    • Link to episode
    • Show homepage
    • Support the show!
    • Rep the show!
    • Show website


    Bromazolam, Etonitazene, and Carfentanil Walk into a Bar – Trends in Novel Illicit Drugs with Dr. Alex Krotulski May 01, 2024
    Show notes

    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 Research and Education quarterly report on Novel Psychoactive Substances found in patients and drug products.

    The episode starts with a discussion of the novel benzodiazepines market, highlighting bromazolam and how long it may remain in the market. Then they discuss the opioids highlighting where we are seeing carfentanil, what is happening with Para Fluorofentanyl, and other super potent opioids emergening (such as N -pyrrolidino etonitazene). After a quick discussion of synthetic cathinone's and PCP/ketamine derivatives they jump to synthetic cannabinoids, examining the history of brodifacoum contamination and how regulation has led to market changes.

    1. Resources
    2. https://www.cfsre.org/
    3. Quarterly report discussed on this episode
    4. More on Dr. Krotulski
    5. Poster from Dr. Kortulksi on naming conventions for NPS
    6. Time stamps to jump to any portion of the episode you want to revisit
    7. Introduction-5:00-32:50

    • 06:30-25:16- Discussion CSFRE mission, history of NPS reports, and other available reports
    • 25:14- "Miscellaneous drugs: Furanyl UF17, medetomidine"
    • 28:15- Difference between GC/MS and LCqTOF

    1. Novel Benzodiazepines- 32:50
    2. Novel Opioids-43:00
    3. Stimulants and hallucinogens- 1:01:43
    4. Synthetic cannabinoids- 1:07:40
    5. Novel psychedelics markets, hemp products, phenibut, tianeptine, and kratom-1:25:12

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    Inefficient Heat (Mystery Case 29) & Toxicologists vs The internet (#10) with Dr. Ann Arens Feb 29, 2024
    Show notes

    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 case
    • Review paper cited by Dr. Arens
    • Interview with DNP user by Chubby Emu
    • Case 1
    • Some also contain CALCIUM NITRATE and can cause methemoglobinemia
    • Case 2
    • Case 3

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    A Mysterious Case of Fatally High Temperature and Organ Failure in a Young Woman (Episode #29 Mystery Case) Dec 22, 2023
    Show notes

    Do you think you know the cause of these symptoms? Send your guesses to toxtalk1@gmail.com to take part in episode 29

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    A very NACCT Holiday-2023 North American Congress of Clinical Toxicology High Yield Abstract Review Dec 21, 2023
    Show notes

    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 abstracts from some of Toxicology's best and brightest this year, tune in for a high yield review as well as clinical a break down of the studies and their relevance from the expert panel.

    Check the show notes for a link to the published abstracts and the list of all studies discussed in the show

    Abstracts available here

    10:40- Abstract 1 (PDF #225) Methotrexate toxicity in the setting of therapeutic error, a multicenter retrospective review

    • Lead author: Andrew Chambers

    24:12- Abstract #2 (PDF #251) Oleander seeds in candlenut weight loss product strike again

    • Lead author: Masha Yemets

    31:16- Abstract #3 (PDF #2) Efficacy of sodium tetrathionate when administered intramuscularly for the treatment of acute oral cyanide toxicity in a swine model (Sus scrofa)

    • Lead author: Brooke Lajeunesse

    39:45- Abstract #4 (PDF #10) Is HOUR enough after out-of hospital naloxone for opioid overdose? Prospective preliminary data from real-world implementation of the modified St. Paul’s early discharge rule

    • Lead author: Stephen Douglas

    49:05- Abstract #5- Poster titles at NACCT 2013–2022: is NACCT experiencing a pun-demic?

    • Lead author: Dayne Laskey

    52:40- Rivastigmine discussion

    • Lead author: none

    58:40- Abstract #6 (PDF #5) Randomized controlled trial of ANEB-001 as an antidote for acute cannabinoid intoxication in healthy adults

    • Lead author: Andrew Monte

    1:08:00- Abstract #7 (PDF#216) Successful use of expired physostigmine to treat anticholinergic delirium in a pediatric patient

    • Lead author: Bryan Hayes

    01:20:00- Abstract #8 (PDF #202) Enough negativity? Clinically significant salicylism with first detectable concentration twelve hours )post-ingestion

    • Lead author: Stacey Bangh

    01:25:24 - Abstract #9 (PDF #267) High sensitivity troponin is frequently elevated after carbon monoxide exposure

    • Lead author: Abdullatif Aloumi

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    APAPalooza. A North American Congress of Clinical Toxicology 2023 Acetaminophen Research Highlight Nov 19, 2023
    Show notes
    • Support the show!
    • Rep the show!
    • Show website

    In 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 impact of fomepizole high risk acetaminophen overdose, as well as who gets fomepizole for acetaminophen overdose and dies. Then we evaluate the effectiveness of standard N-acetylcysteine (NAC) treatment in high risk patients and high dose NAC in high risk patients. Join us for an insightful discussion on these advancements that are reshaping the management of APAP toxicity. Guests include Dr. Masha Yemets PharmD, Dr. Molly Stott PharmD, Dr. Alexandru Ulici PharmD, and Dr. Michael Moss MD.

    • Link to published abstracts
    • (First guest) Abstract #126 Characterizing fomepizole use in acetaminophen deaths reported to US poison centers- Dr. Yemets
    • (Second guest) Abstract #125 Clinical impact of fomepizole as an adjunct therapy in massive acetaminophen overdose- Dr. Stott
    • (Third guest) Abstract #131 Comparison of low-risk and high risk acetaminophen ingestions using the standard prescott protocol of intravenous N-acetylcysteine- Dr. Ulici
    • (Fourth guest) Abstract #130 High-risk acetaminophen overdose outcomes after treatment with standard dose vs. increased dose N-acetylcysteine- Dr. Moss
    • Other studies discussed regarding NAC dosing
    • ATOM 2 Angela Chiew
    • Outcomes of massive APAP treated with regular NAC (Virginia group, lead author Dr. Downes)

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


    AHA 2023 Management of Poisoning Cardiac Arrest or Life-Threatening Toxicity Guidelines with Co-Author Dr. Eric Lavonas MD Oct 15, 2023
    Show notes

    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 2023 AHA treatment recommendations and the rationale behind each decision point. A great review to discover how to effectively apply these guidelines in real-world scenarios and find out what knowledge gaps exist in the realm of toxin resuscitation. Be sure to also check out the accompanying mini-episode for a high-yield review of the major treatment recommendations.

    • Link to guidelines
    • Link to high yield review
    • Cyanide paper mentioned in the show
    • Adult calcium channel blocker toxicity guidelines

    A Morel Dilemma

    Support the show

    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!)

    Reach the show

    • Email: Toxtalk1@gmail.com

    More Show Resources

    • Ryan's Medical Games and Resources
    • Show Website


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