Case Presentation: A 42 year old gentleman with past medical history of anxiety and depression presented with acute psychosis, hypertensive urgency, tachycardia and worsening agitation ultimately needing sedation and intubation. He was found to be oliguric with an elevated creatinine of 6.69 with a baseline normal kidney function. After failing a diuretic challenge, the patient [...]

Case Presentation: Loperamide is an over-the counter anti-motility opioid agonist considered to be specific to the intestinal µ receptor, safe for non-prescription use, and to have low abuse potential. However, several cases of fatal cardiac arrhythmias have been reported.1 38-year-old male without prior cardiovascular history, presented to a rural hospital with pre-syncope and lightheadedness. He [...]

Case Presentation: A 67-year-old male with a history of hypertension, coronary artery disease status post-stent placement in 2017, Parkinson’s disease, and prostate cancer status post-open prostatectomy in 2004, presented after being found unresponsive in a hotel room. A bottle labeled “Super Rush,” a nitrite-containing substance, was found nearby. Emergency Medical Services (EMS) reported initial bradycardia, [...]