Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations.

We report here the case of a child with a known muscular abnormality and susceptibility to malignant hyperthermia who abruptly died after receiving a therapeutic dose of ondansetron. Also, we discuss the pharmacodynamic relationship of ondansetron to malignant hyperthermia in a susceptible host.

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The popularity of the Internet and online media has led to the increased availability of prescription-strength, skin-lightening products contributing to a rise in their use among people with various skin pigment disorders. These products may contain a wide variety of active ingredients such as heavy metals, hydroquinone, and corticosteroids that can be highly toxic, especially after prolonged application. For decades, there have been case reports of both corticosteroid and heavy metal toxicity related to skin-lightening cream use. We report a case of a child who developed status epilepticus after ingesting a skin-lightening solution containing 2% hydroquinone. The toxicodynamics of hydroquinone and its effects on the central nervous system are discussed.

Hydrocarbons (HCs) are organic compounds that contain primarily hydrogen and carbon atoms. Although most HC exposures occur in occupational settings dealing with various solvents, they can be found in products in every household. Therefore, the risk of exposure in everyday life is high. This review discusses the toxicokinetics, pathophysiology, common clinical presentation, and management of HCs. The three major classes of HCs (aliphatic, aromatic, and halogenated) are closely examined. An in-depth look is taken at commonly encountered HCs with unique toxicologic characteristics. The principles of toxicity, immediate stabilization, diagnosis, definitive management, disposition, and outcomes of these specific HCs are defined. Tables describe HCs commonly found in the household, toxic metabolites and viscosities of common HCs, and target organs of the toxic effects of common alihepatic, halogenated, and aromatic HCs both early and late after exposure. Figures show the structure of the various HCs described in the review. This review contains 13 highly rendered figures, 6 tables, and 116 references.