Hashish - made from the resin of the cannabis plant. Doesn’t burn on its own so is usually mixed with herbal cannabis or tobacco to help with ignition. The resin contains THC and other cannabinoids but in higher concentrations than unprocessed cannabis flower. Causes a “high” sensation of perceptual changes, euphoria, and hyperphagia that lasts for 4-6 hours. Negative effects include anxiety, paranoia, impaired motor skills and decrease in short term memory. Studies have linked cannabis with a risk of precipitating psychosis, but the causal relationship is debated. Recreational marijuana can be adulterated with other unidentified drugs or contain synthetic cannabinoids, which can lead to unintended and unpredictable symptoms.

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This herbal oil preparation topically used for muscle pain contains Rheum palmatum, a plant closely related to rhubarb. The primary toxicity of this plant is related to the oxalate compounds, including carboxylic acid, which can form poorly soluble crystals with calcium and other divalent cations. These crystals commonly form in the urinary tract and are associated with kidney stone formation. This particular preparation also contains camphor, which can cause seizures when used in high doses topically, or if ingested, especially in children.

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Herbal Medicated Oil: Topical pain-reliever ointment made with menthol (peppermint oil) and methyl salicylate (oil of wintergreen) which is used for temporary relief of muscle or joint pain caused by strain, sprain, or arthritis. The same active ingredients are sold as Bengay in the US, a popular sports OTC cream. Excessive application can result in first to third degree chemical burns. Dermal absorption of huge quantities of methyl salicylate can result in a clinical picture of salicylate poisoning and has resulted in the death of an athlete in 2007.

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Honey: In the crucial period between button battery ingestion and endoscopic removal, early and frequent ingestion of honey in the household setting and Carafate® in the clinical setting has the potential to reduce injury severity and improve patient outcomes. ("pH‐neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury." Rachel R, Anfang MA, Kris R, Jatana MD, Linn RL, Rhoades K, Fry J, Jacobs IN)

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Geiger counters are used to detect and measure radioactive alpha and beta particles as well as gamma ray emissions. The counter contains a tube of inert gas that becomes charged when colliding with high energy particles releasing ions that create an electric current. This can be registered on a meter, classically through audible clicks. Radiation can rapidly kill cells; most people are exposed to natural radiation from the sun and background rays of 2-3 millisieverts per year.

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Oral sodium bicarbonate would be given to horses before races to delay the fatigue precipitated by acidosis and therefore enhancing performance. In humans, vomiting and diarrhea are common as the body tries to correct the high sodium concentration by pulling water into the digestive tract. Patients can experience symptoms of hypernatremia (seizures, dehydration, kidney failure) as well as metabolic alkalosis (respiratory depression). Image courtesy of Mostafa Sheshtawy. https://www.flickr.com/photos/msheshtawy/.

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Humulin/Insulin: An intermediate-acting insulin used in the treatment of hyperglycemia in diabetes mellitus. It contains both short and intermediate acting insulins to create a steady state glucose level by controlling the basal level of glucose and glucose boluses that occur with meals. Patients who inadvertently inject too much of this product and have renal failure may have longer periods of hypoglycemia due to decreased excretion of the drug. Caution must be taken in intentional and unintentional overdose of Humulin/Insulin to monitor creatinine and the patient's ability to excrete the drug, or hypoglycemic episodes may be prolonged.

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Hyperbaric chambers are utilized in the treatment of carbon monoxide and work by rapidly increasing the pressure gradient of oxygen flow into the tissues and oxygen dependent organs, thus decreasing carbon monoxide diffusion and toxicity. Some research has suggested better neurologic outcomes in cases of severe carbon monoxide toxicity. Another use for hyperbaric chamber treatment includes patients stricken with methemoglobinemia, without hemolysis but who have contraindications to methylene blue treatment, severe G6PD deficiency, or other disease states that may cause hemolysis.

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