Toxicity and drug interactions of herbs and dietary supplements.
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Dietary Supplements↗
Biomedical subjects
Susan Smolinske
Publications and source records attributed to Susan Smolinske.
Assessing poisoning risks related to storage of household hazardous materials: using a focus group to improve a survey questionnaire.
BACKGROUND: In fall of 2004, the authors began an investigation to characterize the correlations between the storage of Household Hazardous Materials and the associated health risks, particularly to children. The study area selected was Genesee County, Michigan, near Flint, with data to be collected by a phone survey of residents and through the acquisition of county hospital records containing procedure codes indicating treatment for poison emergencies, and review of poison control center data. METHODS: A focus group was used to identify key topics and relationships within these data for improving the phone survey questionnaire and its analysis. RESULTS: The focus group was successful in identifying the key issues with respect to all the data collection objectives, resulting in a significantly shorter and more topically focused survey questionnaire. Execution time of the phone survey decreased from 30 to 12 minutes, and useful relationships between the data were revealed, e.g., the linkage between reading food labels and reading labels on containers containing potentially harmful substances. CONCLUSION: Focus groups and their preparatory planning can help reveal data interrelationships before larger surveys are undertaken. Even where time and budget constraints prevent the ability to conduct a series of focus groups, one successful focus group session can improve survey performance and reduce costs.
Child↗
A foxy intoxication.
Foxy is the colloquial name for the hallucinogen 5-ethoxy-diisopropyltryptamine (5-MeO-DIPT). A non-fatality involving a 23-year-old Caucasian man who ingested a capsule containing 5-MeO-DIPT is described. He presented to the Emergency Department, not with visual nor auditory hallucinations but with sensory hallucinations, that of formication and paranoia. He was observed and given supportive care for 4 h, then discharged without any known sequelae. Blood and urine were collected for laboratory analyses. Foxy and its metabolites were identified in urine by gas chromatography-mass spectrometry. The concentrations of 5-MeO-DIPT in the serum and urine were 0.14 and 1.6 microg/mL, respectively. The drug undergoes oxidative deamination to form 5-methoxy-indole acetic acid. The urinary concentration of this metabolite was 0.17 microg/mL. Also, the urine contained three other related compounds. Two of them have been described in a previous case of 5-MeO-DIPT ingestion as 5-methoxy-isopropyltryptamine (5-MeO-IPT) and 5-methoxy-diisopropyltryptamine-N'-oxide (5-MeO-DIPT-N'-oxide). The third compound was substantially present in the urine and was tentatively identified as 5-hydroxy-diisopropyltryptamine (5-OH-DIPT). Only the parent drug, 5-MeO-DIPT was detected in the serum sample.
5-Methoxytryptamine↗
The severity of toxic reactions to ephedra: comparisons to other botanical products and national trends from 1993-2002.
OBJECTIVE: Ephedra is a botanical product widely used to enhance alertness, as a weight loss aide, and as a decongestant. Its reported adverse effects led the Food and Drug Administration (FDA) to ban ephedra-containing products in the United States in 2004. This study's purpose was to compare toxicity from botanical products containing ephedra to nonephedra products. METHODS: The Toxic Exposure Surveillance System (TESS), a national poison center database, was utilized to determine the number and outcomes of cases involving botanical products reported from 1993-2002. Cases listing both a botanical product and any other drugs or chemicals were excluded a priori. Ten-year hazard rates (moderate outcomes + major outcomes + deaths per 1000 exposures) were used to compare botanical product categories. RESULTS: There were 21,533 toxic exposures with definitive medical outcomes reported over the 10 yrs where a botanical product was the only substance involved. Of these, 4306 (19.9%) had moderate or major medical outcomes and there were two deaths, for an overall hazard score of 200 per 1000 exposures. The number of ephedra reports to poison centers increased 150-fold over the 10-yr period. The hazard rate for products that contained only ephedra was 250 per 1000 exposures and 267 per 1000 exposures for products that contained ephedra and additional ingredients; whereas the hazard score for only nonephedra botanical products was 96 per 1000 exposures. The rate ratios for multibotanical products with ephedra (RR 1.33; 95% C.I. 1.27-1.40) and for single-ingredient ephedra products (RR 1.25; 95% C.I. 1.11-1.40) were both two to six times higher than those of other common botanical products. Yohimbe-containing products had the highest hazard score (417) and rate ratio (2.08; 95% C.I. 1.59-2.80). CONCLUSION: Ephedra-containing botanical products accounted for a significant number of toxic exposures with severe medical outcomes reported to poison centers. Hazard rate analysis suggests poison center-reported events involving ephedra-containing botanical products were much more likely to result in severe medical outcomes than those involving nonephedra-containing botanical products. These data support recommendations by policymakers that the sale of ephedra should be prohibited to protect consumers. Our data suggest that the botanical product, yohimbe, may also be associated with unacceptably high risks of toxicity and should receive close scrutiny from health policymakers.
Data Collection↗