Jeffrey R Suchard

University of California, Irvine, Irvine, California, United States

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Publications (32)108.49 Total impact

  • Jeffrey R. Suchard
    Academic Emergency Medicine 09/2014; 21(9). DOI:10.1111/acem.12465 · 2.20 Impact Factor
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    Jeffrey R Suchard
    Academic Emergency Medicine 01/2011; 18(1):106. DOI:10.1111/j.1553-2712.2010.00956.x · 2.20 Impact Factor
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    Jeffrey R Suchard
    Academic Emergency Medicine 08/2010; DOI:10.1111/j.1553-2712.2010.00844.x · 2.20 Impact Factor
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    Jeffrey R Suchard
    Academic Emergency Medicine 11/2009; DOI:10.1111/j.1553-2712.2009.00578.x · 2.20 Impact Factor
  • Jeffrey R. Suchard
    Annals of Emergency Medicine 10/2009; 54(4):627. DOI:10.1016/j.annemergmed.2009.02.002 · 4.33 Impact Factor
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    Jeffrey R. Suchard, Sergey A. Nizkorodov, Stacy Wilkinson
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    ABSTRACT: The U.S. Consumer Product Safety Commission announced a recall of Aqua Dots (Spin Master Ltd.; Toronto, Canada) on November 7, 2007 due to children becoming ill after swallowing beads from these toy craft kits. Reports suggested that the beads contained 1,4-butanediol (1,4-BD), a precursor to gamma-hydroxybutyrate (GHB), rather than the intended, but more expensive 1,5-pentanediol (1,5-PD). We measured the 1,4-BD and 1,5-PD content of Aqua Dots beads to determine if 1,5-PD had been completely substituted with 1,4-BD by the manufacturer, and if the reported clinical effects from swallowing Aqua Dots beads were consistent with the estimated ingested 1,4-BD dose. In vitro bench research using gas chromatography-mass spectroscopy (GC-MS) was performed. Dilute samples of pure 1,4-BD and 1,5-PD in water were used for the calibration of the GC-MS instrument. We then soaked Aqua Dots beads in water for varying durations, and the resultant solutions were analyzed for 1,4-BD and 1,5-PD content. Aqua Dots beads weighed 79.3 mg each (+/- 0.6 mg, SD), and contained 13.7% (+/- 2.4%, SD) 1,4-BD by weight; this corresponds to a 1,4-BD content of 10.8 mg (+/- 1.9 mg, SD) per bead. No 1,5-PD was detected in any beads. Aqua Dots beads contained a surprisingly high amount (nearly 14%) of extractable 1,4-BD. No 1,5-PD was detected, corroborating reports that this chemical had been completely replaced with a substitute that is metabolized into GHB after ingestion. Reports of ataxia, vomiting, seizure activity, and self-limited coma in children are consistent with the ingestion of several dozen Aqua Dots beads.
    Journal of medical toxicology: official journal of the American College of Medical Toxicology 10/2009; 5(3):120-4. DOI:10.1007/BF03161221
  • Jeffrey R Suchard
    Annals of emergency medicine 08/2009; 54(1):8,11. DOI:10.1016/j.annemergmed.2008.11.022 · 4.33 Impact Factor
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    Jeffrey R Suchard, Thomas A Grotsky
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    ABSTRACT: A 29-year-old man with no history of diabetes ingested over 60 grams of metformin in a suicide attempt. He presented to the emergency department with acute renal insufficiency, severe lactic acidosis, and rapidly-progressive hyperglycemia. The patient's peak serum glucose level of 707 mg/dL is the highest yet reported in a case of metformin toxicity. Treatment included sodium bicarbonate infusion and hemodialysis, but the patient suffered several cardiac arrests with pulseless electrical activity and ultimately expired 25 hours after the ingestion.
    The western journal of emergency medicine 09/2008; 9(3):160-4.
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    Jeffrey R Suchard
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    ABSTRACT: A 37-year-old woman experienced a witnessed generalized seizure in the Emergency Department three hours after ingesting approximately 1400 mg of fluoxetine in a suicide attempt. Although the majority of fluoxetine ingestions are benign, seizures may occur after large intentional overdoses.
    The western journal of emergency medicine 09/2008; 9(3):154-6.
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    ABSTRACT: Background: Organophosphate (OP) insecticides are widely used in both agricultural and landscape pest control, and the potential for human exposure to these compounds is significant.Objectives: The aims of this study were to investigate the effects of acute poisoning with the OP methamidophos and the effects of antidotal therapy with atropine and pralidoxime on rat thyroid tissue ultrastructure.Methods: In this single-blind, ex vivo study, male Wistar albino rats weighing 220 to 230 g were divided into 4 treatment groups. Group 1 received a median lethal dose of methamidophos (30 mg/kg) via oral gavage. Group 2 received saline via oral gavage and served as the control group for group 1. Group 3 received methamidophos (30 mg/kg) via oral gavage, and after 8 minutes atropine 0.05 mg/kg and pralidoxime chloride (2-FAM) (40 mg/kg) were administered intraperitoneally (IP). Atropine was titrated to reverse signs of cholinergic excess. Group 4 received saline via oral gavage followed by IP injections and served as the control for group 3. Rat thyroid tissues were examined using electron microscopy, and the histologic changes were examined by a histopathologist who was blinded to treatment. All rats were euthanized by intracardiac blood collection. The rats in groups 1 and 2 were euthanized 8 minutes after treatment. The rats in groups 3 and 4 were euthanized 96 hours after treatment.Results: Thirty-four male rats (aged 16 weeks) were included in the study. The rats were grouped accordingly: group 1 (n = 10); group 2 (n = 7); group 3 (n = 10); and group 4 (n = 7). The mean (SD) pseudocholinesterase (FCE) activity was significantly lower in the methamidophos-treated rats (group 1) compared with the corresponding control group (group 2) (32.6 [17.0] vs 579.4 [59.0] U/L, respectively; P < 0.001). PCE activity was significantly higher in rats treated with atropine and 2-PAM (group 3) (392.5 [39.4] U/L; P < 0.001) compared with those not receiving antidotal therapy (group 1). Group 1 experienced changes in thyrocytes and organelles that were not detected in the antidote-treated rats in group 3. These changes included follicular cell nuclei exhibiting an increase in chromatin content, pyknotic nuclei, mitochondrial degeneration, dilated granular endoplasmic reticulum cisternae, reduced microvilli, and intraluminal cellular debris. Within follicular cells, formation of vacuoles filled with fine granular material was noted.Conclusion: Acute OP poisoning was associated with histopathologic effects in rat thyroid tissue that appeared to be mitigated by antidotal therapy in this small animal study. More extensive studies using immunohistochemical methods are needed.
    Current Therapeutic Research 08/2008; 69(4):334-342. DOI:10.1016/j.curtheres.2008.07.001 · 0.45 Impact Factor
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    Jeffrey R Suchard, Edward R Melnick
    Academic Emergency Medicine 10/2007; 14(9):819-24. DOI:10.1197/j.aem.2007.06.019 · 2.20 Impact Factor
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    Jeffrey R Suchard
    The western journal of emergency medicine 09/2007; 8(3):93-5.
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    ABSTRACT: We investigated the ultrastructural effects of the organophosphate compound methamidophos and treatment with atropine and pralidoxime (2-PAM) on rat kidneys. Male Wistar albino rats were assigned to four groups. Group 1 received 30 mg/kg methamidophos, the LD50 for this compound in rats, via oral gavage. Group 2 received only physiologic saline. Group 3 rats received 30 mg/kg methamidophos and were treated with 2-PAM and atropine via intraperitoneal injection when cholinergic symptoms were noted. Group 4 served as a control, and received physiologic saline in equivalent volumes and routes to Group 3. Kidney tissues were prepared for electron microscopic studies. No ultrastructural changes were detected in Group 1 after acute poisoning with methamidophos and in Group 3 treated with antidotes after poisoning. Acute organophosphate poisoning and antidotal treatment in this model are not associated with histopathological changes in the rat kidney but the models with different organophosphate compounds, by administrating the different dosages, may be more illuminative in explaining the effects of these chemicals in kidney.
    Renal Failure 02/2005; 27(5):623-7. DOI:10.1080/08860220500200536 · 0.78 Impact Factor
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    Jeffrey R Suchard, Catherine J McLaren
    Academic Emergency Medicine 02/2005; 12(1):71-8. DOI:10.1197/j.aem.2004.08.049 · 2.20 Impact Factor
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    ABSTRACT: To determine how knowledgeable physicians are regarding the toxic effects and drug interactions of herbal remedies. An anonymous voluntary demographic survey and 16-question, multiple-choice quiz was distributed at educational meetings of emergency medicine and internal medicine physicians. The primary outcome measures were to determine whether significant associations existed between quiz scores and the amount of clinical experience, or between quiz scores and self-assessed familiarity with the topic of herbal toxicities and adverse herb-drug interactions. A total of 142 surveys and quizzes were completed by 59 attending physicians, 57 resident physicians, and 26 medical students. The mean subject score on the quiz was only slightly higher than would have occurred from random guessing. Neither the amount of the subjects' clinical experience, nor their self-assessed familiarity with herbal toxicities and drug interactions correlated significantly with the score on the quiz. The physicians and medical students surveyed had little training in herbal toxicities and drug interactions. They generally rated their familiarity with these topics as 'poor', and their scores on the quiz bore out this assessment as correct. Educational efforts might improve physician knowledge of the adverse effects of herbal remedies.
    European Journal of Emergency Medicine 09/2004; 11(4):193-7. DOI:10.1097/01.mej.0000134721.72356.f7 · 1.50 Impact Factor
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    Jeffrey Suchard, Scott Rudkin
    The California journal of emergency medicine 07/2004; 5(3):55-9.
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    J. R. Suchard
    Academic Emergency Medicine 02/2004; 11(2):217-217. DOI:10.1197/j.aem.2003.10.006 · 2.20 Impact Factor
  • Jeffrey R Suchard
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    ABSTRACT: Ingestion of cyclic antidepressant medications or prolongation of the electrocardiographic QRS interval are commonly considered as contraindications to the use of physostigmine as an antidote for antimuscarinic toxicity. This dictum seems to stem from a few well-publicized cases in which administration of physostigmine was temporally associated with the development of asystole. Before the report of these cases, physostigmine was more frequently used and had been considered a first-line antidote for both the neurologic and cardiac toxic effects of cyclic antidepressant overdose. This apparent inconsistency, and a resurgence of interest in physostigmine as an antidote, begs the question of the appropriateness of this drug's contraindication in all cyclic antidepressant ingestions. Review of the published clinical and experimental evidence provides little support for the clinical utility of using electrocardiographic criteria or the ingestion of cyclic antidepressants as contraindications to the use of physostigmine.
    Journal of Emergency Medicine 09/2003; 25(2):185-91. DOI:10.1016/S0736-4679(03)00169-0 · 1.18 Impact Factor
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    Jeffrey R Suchard
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    ABSTRACT: A cluster of incidents in which non-tooth-paste products were used to brush teeth prompted a review of all calls to one Poison Control Center (PCC) regarding exposures to dental and oral-care products to determine if any resulted in significant toxicity. Retrospective review of 65,849 calls to one PCC during one calendar year. All inquiries about exposures to substances used as dental or oral-care products were analyzed by a single reviewer for reported adverse effects; including hospital admission or PCC referral for emergent medical evaluation. 798 calls involved exposure to dental or oral-care products, comprising 1.21 % of all calls received. Toothbrushing incidents with non-toothpaste products (122 cases) did not result in any significant recognized toxicity. Twenty-four patients were either referred for emergent medical evaluation (14) or were admitted to the hospital (10). In 23 of these patients (96%), the toxic agent was either an over-the-counter analgesic or a local anesthetic used to treat dental pain. Among PCC calls received regarding dental and oral-care products, over-the-counter analgesics and local anesthetics used for dental pain resulted in the most frequent need for emergent medical evaluation or for hospital admission.
    The California journal of emergency medicine 01/2003; 4(1):10-4.
  • Jeffrey R Suchard, Kimberlie A Graeme
    Pediatric Emergency Care 09/2002; 18(4):295-6. DOI:10.1097/00006565-200208000-00014 · 0.92 Impact Factor