Colchicine is centuries old, but the line between toxic and nontoxic is still blurry.
See full article...
See full article...
Poison expert allegedly poisoned wife—with a shockingly toxic gout drug
- Thread starter JournalBot
- Start date
A fact (though not the specific substance involved) I often bring up when people rant about GMOs. Before carefully engineered SNPs were the favored tool we literally just blasted plants with mutagenic radiation or chemicals to hopefully get the one or two useful traits we were after (and had no control over the other changes). Lots of important food crop varieties were created this way throughout the 20th century but noooooooo, it's the surgically precise GMOs that get labeled "Frankenfoods" and spark stupid protests and restrictions.
(Edit: in fact, the EU doesn't even require forced mutagenesis crops to be labeled or regulated any differently than regular varieties, but will slap all those restrictions on engineered GMOs.)
Upvote
42
(43
/
-1)
Classic sorry of poisoning death and subsequently catching the criminal. Good to see he went down for this, though in hindsight all the clues are so obvious.
Reminds me of some research a few years ago looking into historical mass murderers. I was quite surprised to learn of the extensive history of FEMALE mass murderers who used poisoning to kill their victims, which were often their kids or entire family, or series of husbands. But then medicine caught up with testing for various toxic substances.
Reminds me of some research a few years ago looking into historical mass murderers. I was quite surprised to learn of the extensive history of FEMALE mass murderers who used poisoning to kill their victims, which were often their kids or entire family, or series of husbands. But then medicine caught up with testing for various toxic substances.
Upvote
8
(8
/
0)
that's all about opportunity. In most households, women prepared the food so if they wanted to kill the whole family, they were ideally "poisitioned" to do so.
Poisoners always think they're going to get away with it, but this guy should have known he would likely get caught.
Upvote
4
(5
/
-1)
Upvote
5
(5
/
0)
When Colcrys came out there was a controversy about it displacing traditional treatment because of the price markup, which was pretty large. Traditional treatment used a higher dose with more side effects. URL Pharma conducted formal clinical trials and obtained FDA approval for a particular dosing regime with monitoring guidelines. That really was an important advance for the use of colchicine. There was a lot of value created by those clinical trials. But as you note, it didn't improve the fundamental nature of the medicine. You do the best you can with what you have.
The low price of colchicine is probably a significant barrier to better medications being developed. The controversy over the pricing of Colcrys showed that there is a lot of price sensitivity.
Upvote
5
(5
/
0)
So the guy is a digital native (30 years old, highly educated), smart enough to get through medical school and do a residency at a world-class academic medical center, and yet dumb enough to not do his internet research on clever ways to kill his wife on a computer that can't be tracked to him.
I am forever astonished at the ways in which criminal intent makes people stupid. It's almost like when they discard their morality, a big piece of their intelligence goes out the window with it.
I am forever astonished at the ways in which criminal intent makes people stupid. It's almost like when they discard their morality, a big piece of their intelligence goes out the window with it.
Upvote
23
(23
/
0)
They also sell Black Cherry caplets as a supplement. It's just black cherries dried and powdered and put into caplets. You can buy them on Amazon. I take two every morning, and it seems to make my flares much less common and less severe. My doc wants to put me on something prescription, but the toxicity of the available meds gives me pause, and my gout isn't severe enough for all that, imo.
Upvote
6
(7
/
-1)
Not positive but I think Colcrys might be a latent effect of the 1938 pure food and drug act. When the act was promulgated most drugs in common use were grandfathered in, but I believe a provision was put in place to encourage actual safety and efficacy testing granting said drugs a window of market exclusivity. DESI drugs they were termed. Very few examples were ever tested but I think another was desipramine, a "blood thinner" (weak evidence!) which was combined with aspirin in the patented drug Aggrenox.
Upvote
6
(6
/
0)
The iPadification of technology, in the service of democratizing access to it, also removes a lot of the technical knowledge needed to be considered a "digital native."
A refrain chanted endlessly from the just-before-you-other-guys generation, and the one just before them, going back to the Eternal September.
Upvote
21
(21
/
0)
Hey, this is very random but as we know the best medical advice can be had anonymously online - I've been suspected of gout a few times, and one time I got some medication (don't remember if it was colchicine) which was incredibly helpful. But in general, if such a condition occurs (it's my toes, mostly), is it helpful or detrimental to try to massage/stretch my toes?
Upvote
3
(4
/
-1)
I suspect the order is the opposite: intelligence falls away and suddenly morality isn’t such an issue anymore.
Upvote
6
(7
/
-1)
If you have gout you will not want to touch the effected area as it is to painful. I keep canned or bottled cherries in the cupboard. At the first indication of any symptoms I take a few cans over a couple of days. For me the symptoms seem to get no worse before quickly disappearing. And there are no side effects. As an added bonus, I like canned cherries.
Upvote
13
(13
/
0)
"The dose makes the poison."
There's also warfarin which is used to "thin" blood and prevent coagulation for people with heart problems, but in higher doses it is sold as rat poison.
If this sounds weird, consider how many people are killed every year by water.
There's also warfarin which is used to "thin" blood and prevent coagulation for people with heart problems, but in higher doses it is sold as rat poison.
If this sounds weird, consider how many people are killed every year by water.
Upvote
8
(8
/
0)
We had a case here, where a well known restaurant/nightclub blew up. No one was killed.
It was having financial troubles, and the owner jokingly said at a company party, that he would be better off if the place just burned down. A guy whose wife was working there heard him and thought "I can help him out!" So, he broke into the place one night after closing. Disconnected the gas main in the kitchen, then placed a lighted candle in the far end of the building. Couple of hours later BOOM!
The one piece that got him busted, was the tape that he used to make sure the candle didn't fall over. It was called plating tape, and was only used at one place in our city. A circuit board plant where he worked. Used to tape off the rest of the boards when the tips were gold plated. And guess what his job there was? Yup. Ran the gold tip plating line.
Upvote
43
(43
/
0)
There’s a very very small number of folk who manage to get a credential like MD or JD in part through being bright enough, but in part through cheating and/or charming and/or connections and/or bullying, often some of each. The biggest problem underlying such folk is a sense of entitlement, with a side of narcissism. This guy seems to fit that latter bill to a T.
A relative of mine married a charming narcissistic asshole MD between his school graduation and his residency in the army; she was going to move to be with him after a year, after he moved again from a 1-year posting to a 2-year posting, but he already had a nurse girlfriend by Thanksgiving, instead. His family took her side in the divorce, so after the first nurse dumped him, the little shit told nurse #2 that he was an orphan. After that, info on him dried up, as all his college friends dumped him too. Last I looked, he was still licensed, but he got the shittiest military postings before he completed his obligation and resigned from the army. I don’t expect his career to go any better. If things had been a little different and he’d been a poison guy, I’d expect him to have tried something like this. He’s no Musk, but fucking close.
Upvote
10
(12
/
-2)
Upvote
4
(4
/
0)
I don't think you've had gout. Gout is SO painful you can't even touch it without screaming, there is no way one could massage it. Gout is is usually specific to exactly one toe. I've never heard of it impacting multiple toes simultaneously. (It may, I am not a doctor, just a patient who did a lot homework).
If you go to a doctor asking for your foot to be amputated to stop the pain, you might have gout. If you are not sure, you don't have gout.
Upvote
18
(18
/
0)
Lithium is also a problematic medication.
The effective dose is unfortunately very close to the toxic dose, to the point that a couple accidental double-dosings is real likely to put someone on it in the hospital. But happily, we’ve got good assay tests for lithium - show up with the right symptoms and a prescription for it and the assay is the priority test the ER runs, ahead of the routine ones.
There’s a much lesser problem with serotonin toxicity, in the sense that it’s harder to OD on prescription doses if you’re not double-prescribed, but on the other hand there are no good tests for serotonin level in the brain (a test for the blood level in the body is only used in cancer detection) and a lot of street drugs can trigger it. Show up at the ER with a serotonin problem, and if you’re not honest about street drug use or recent prescription changes, and they might chase the wrong symptoms for awhile.
Upvote
6
(6
/
0)
If you have had gout or are at risk due to high levels of uremics in the blood be sure to discuss diet considerations with your Dr and or nutritionist as certain foods definitely increase risk of episodes and severity of flare-ups.
Upvote
5
(5
/
0)
I'm not an American, so pardon my ignorance.
Why would her family need a Gofundme to raise money for legal fees?
The state prosecutor doesn't have billable hours.... Right?
It's not like they need to hire lawyers
Why would her family need a Gofundme to raise money for legal fees?
The state prosecutor doesn't have billable hours.... Right?
It's not like they need to hire lawyers
Upvote
18
(18
/
0)
TBF, having a PhD or MD doesn't automatically make someone smart in everything. Ben Carson or the Florida surgeon general come to mind for me. I think Carson is a brilliant surgeon, but much beyond that, eh.
My old supervisor has a PhD and he sometimes joked that it stood for 'piled higher and deeper'. Some of the ME's I've worked with are the smartest people in the room, another I couldn't figure out how they got to where they did.
I once read a story about the Russian poisoning case involving polonium, and the article mentioned they should've used something like sodium fluoride, but going in loud and sloppy is what they choose - it's like they wanted to show off to the world, as it's not like polonium is found on every street corner.
NaF presence isn't something routinely checked for, and if testing from something like grey top tubes, you're going to expect it to be present. I suppose if a red top tube doesn't clot, that should pop out as something odd.
Fortunately for her family, he is dumb with computers. I am surprised he isn't being charged with 1st degree murder, all seems quite premeditated to me.
Upvote
12
(12
/
0)
Upvote
5
(5
/
0)
Right. There’s no financing of a prosecution in the US.
Since he was a doctor, they’re pretty obviously getting ready to sue him and possibly anybody he worked for or who sold him the colchicine. In a civil lawsuit like this, there are plenty of lawyers who would take the case “on spec” - no money up front, lose and the client doesn’t pay anything, win and the client shares 30% of the winnings with the lawyer (if the lawyer doesn’t steal it all, which is the biggest cause of lawyers losing their licenses in the US).
By having up-front money, they can hire a better lawyer AND keep more of the money from the suit (if there is any).
It’s also often sometimes helpful to have a lawyer just to get information on the case from bureaucrats in the government, but they’d need only a few thousand for that, probably, and it seems early for having that kind of fight anyway.
Upvote
17
(17
/
0)
The murderer may well be judgement-proof, he’s reported as having had money issues. And he’s not likely to get much future income.
I mean I guess there’s the equity in the home, which came from life insurance, so it might be worthwhile.
Upvote
7
(7
/
0)
Upvote
3
(3
/
0)
Staying well hydrated also reduces the likelihood of flare-ups, which is why alcohol makes it worse; it's diuretic.
Upvote
6
(6
/
0)
Apple fanboy 101
Ars Tribunus Militum
I read this as if it were a story but a real person went through this. Poor woman.
Upvote
11
(11
/
0)
Glad you got better!
But Allopurinol is not an alternative to Colchicine, it can be administered during a gout flare up but isn’t primary treatment for one. Allopurinol is a preventative to control the level of uric acid in the blood and prevent such flare ups from occurring. Colchicine is for reducing symptoms during an acute gout flare up.
Prednisone is a good alternative to Colchicine but I find Colchicine works best, so I keep some in my medicine cabinet. After reading this article I can’t help wondering if it should have been so easy for me to buy it over the counter.
Upvote
7
(7
/
0)
If you are having a gout attack in your toe, trust me, you are definitely not going to want to touch that toe
Upvote
12
(12
/
0)
Yes, what he said haha. My wife once fluffed the flat sheet on the bed, and the slow, parachute-like descent of a single sheet landing on my toe had me screaming in pain
Upvote
18
(18
/
0)
Upvote
3
(3
/
0)
I have random gout attacks. It SUCKS. And the most frustrating thing is that I avoid all food & drink listed as causing gout, with not even an occasional cheat meal.reading this article, and the number of people reporting about the misery of gout sent me to the representative wikipedia article, and wow that's a serious incentive for some lifestyle changes.
my condolences to the sufferers here.
damn.
Upvote
4
(4
/
0)
vedekhaliwell
Ars Praetorian
Calculators are a must in my line of work as a pharmacist if the script is written Xmg/kg. Most often weights are taken in by the ER staff list lbs not kg, so in the information we get we have to do the quick calculation to kg and then create the Xmg or mcg/KG.
I checked our shelves and colchicine is not on our pharm shelves, and I looked at our ordering system and see it listed as "archaic form, dispense if no other medication is available."
Now could be we are on a new system and old drugs rarely subscribed are on 4 hour order notice (available to be ordered, delivered, and dispense ready within 4 hours).
I checked our shelves and colchicine is not on our pharm shelves, and I looked at our ordering system and see it listed as "archaic form, dispense if no other medication is available."
Now could be we are on a new system and old drugs rarely subscribed are on 4 hour order notice (available to be ordered, delivered, and dispense ready within 4 hours).
Upvote
10
(10
/
0)
Mine has affected both of my big toes at the same time as well as my left ankle and both knees (bursa). I ended up in the ER/urgicare multiple times before it involved my big toe and was finally diagnosed as being gout. And yes it's unbelievably painful, the ankle they thought was a severe sprain and they put me in a cast for 6 weeks. The last major flare I had the pain was so severe that my brain started interpreting it as cold and I was shivering so badly that I was afraid of cracking my teeth (to put it in perspective I fell through a frozen pond and walked home and didn't shiver that hard).
Upvote
11
(11
/
0)
Colchicine is one of the few drugs that scares toxicologists. There other two are clonidine and bupropion. I'm an EM doc, and our tox fellows have told me in cases with reasonable suspicion for ingestion, you should intubate for a full gastric decon (flush their gut with liters of GoLytely until they run clear). If they absorb a lethal dose, there is no treatment that will save them
Upvote
15
(15
/
0)
In 2018, I had a bout of gout AND a kidney stone- AT THE SAME TIME. That’s a recipe for wanting to die. That experience led me to lose 85 pounds over the following year, simply by decreasing my food portions, which I got off to a good start to by being unable to keep anything down for about a week during the dual-pronged unpleasantness.
I’m not suggesting that all gout sufferers are overweight or overeating of course, but I would note that I have not had any recurrence since.
I’m not suggesting that all gout sufferers are overweight or overeating of course, but I would note that I have not had any recurrence since.
Upvote
12
(12
/
0)
Upvote
5
(5
/
0)