Jaiva B Larsen

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Scholarly Contributions

Journals/Publications

• Smelski, G., Cardwell, M., & Larsen, J. (2023). Neurotoxic respiratory failure absent following Arizona rattlesnake bites. Toxicon : official journal of the International Society on Toxinology, 224, 107034.
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  Warnings of neurotoxic respiratory paralysis following envenomation by rattlesnakes (Crotalus sp.) have been included in numerous scholarly publications over the past 60 years, resulting in fear and anxiety in the public and among clinicians. We examine the validity of the widespread belief that rattlesnakes in the arid southwestern United States, and particularly the Mohave Rattlesnake (Crotalus scutulatus), pose a significant risk of medically relevant respiratory weakness and paralysis in humans. A retrospective review of 3440 suspected rattlesnake bites reported to the Arizona Poison and Drug Information Center between 1999 and 2020 produced no evidence of respiratory weakness in a region with three species known to express significant amounts of neurotoxin in their venoms: Crotalus concolor, C. tigris, and the more widely distributed C. scutulatus. A literature review produced numerous warnings regarding respiratory paralysis following envenomation by rattlesnakes in our region that either lacked references or cited sources that did not contain strong supportive data. We found no case reports of neurotoxic respiratory weakness following Arizona rattlesnake bites in the literature and such reports in surrounding states were scant. We conclude that neurotoxic respiratory failure in this region following rattlesnake envenomation is extraordinarily rare. All rattlesnake bites should receive the same consideration and critical care, and warnings about significant risk of respiratory failure are unwarranted, regardless of species involved.
• Holzman, S. D., Larsen, J., Kaur, R., Smelski, G., Dudley, S., & Shirazi, F. M. (2021). Death by hand sanitizer: syndemic methanol poisoning in the age of COVID-19. Clinical toxicology (Philadelphia, Pa.), 59(11), 1009-1014.
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  The advent of COVID-19 increased attention to hand hygiene in prevention of disease transmission. To meet the increased demand for hand sanitizer during the pandemic, the US FDA issued an Emergency Use Authorization allowing new manufacturers and importers to enter the market. Some of the newly introduced hand sanitizer products contained methanol in lieu of ethanol or isopropanol. We describe five patients with fatal methanol poisoning resulting from hand sanitizers improperly containing methanol.
• Larsen, J. B., Dudley, S., Shirazi, F., Smelski, G., & Wilson, B. Z. (2021). Use of Crotalidae equine immune F(ab’)2 antivenom for treatment of an Agkistrodon envenomation. Clinical Toxicology, 59(11), 1023-1026. doi:10.1080/15563650.2021.1892718
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  Anavip (F(ab')2AV) is a lyophilized F(ab')2 immunoglobulin fragment derived from horses immunized with venom from Bothrops asper and Crotalus durissus. It was approved by the FDA in 2015 for treatment of North American rattlesnake envenomation but not for Agkistrodon envenomation. Published data regarding the efficacy and safety of Anavip in treating Agkistrodon envenomations is limited. We present a case of a patient treated with Anavip after confirmed Agkistrodon laticinctus envenomation.A 77 year-old man was bitten on his fifth finger by a captive A. laticinctus. He was taken to a local emergency department where he received a 10 vial initial dose of F(ab')2AV for pain and swelling and was transferred. At the receiving facility, his pain had improved and his swelling had not progressed. Over the next 30 h, his platelets declined to 132,000/mm3 and he received an additional 4 vials of F(ab')2AV. The remainder of his course was unremarkable with complete recovery by 3 months.This case provides an additional published datapoint on the use of this F(ab')2AV in the treatment of envenomation by Agkistrodon.
• Larsen, J., Mycyk, M. B., & Thompson, T. M. (2018). Reviewing the Record: Medical Record Reviews for Medical Toxicology Research. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 14(3), 179-181.
• Ori, M. R., Larsen, J. B., & Shirazi, F. M. (2018). Mercury Poisoning in a Toddler from Home Contamination due to Skin-Lightening Cream. The Journal of pediatrics, 196, 314-317.e1.
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  A 17-month-old child presented with hypertension, fussiness, constipation, and arthralgia due to mercury toxicity from a skin-lightening cosmetic used by her mother and grandmother. Blood mercury level was 26 mcg/L and urine level was 243 mcg/g creatinine. She was chelated with succimer. The home was contaminated and needed remediation.
• Shirazi, F. M., Larsen, J. B., Roman, D. M., Roman, D. M., Larsen, J. B., & Shirazi, F. M. (2017). Articles You Might Have Missed. Journal of Medical Toxicology, 13(3), 267-270. doi:10.1007/s13181-017-0620-x

Proceedings Publications

• Larsen, J., Wison, B., & Rinner, G. (2019, October). Spontaneous Resolution of Significant Portal Venous Gas Following Hydrogen Peroxide Ingestion. In North American Congress of Clinical Toxicology (NACCT), 57, 1040.
• Larsen, J., Shirazi, F., & Bosen, K. (2017, January). Characterization of poison center calls from critical access hospitals in rural Arizona. In North American Congress of Clinical Toxicology (NACCT) Clinical Toxicology, 55, 823-824.
• Larsen, J., Shirazi, F., & Cohen, J. (2017, January). Rattlesnake envenomation in a patient with Erhlers-Danlos Syndrome. In North American Congress of Clinical Toxicology (NACCT) Clinical Toxicology, 55, 733.

Poster Presentations

• Aizenberg, A., Shirazi, F., & Larsen, J. (2023, September). Serotonergic Toxidrome after Insufflation of an MDMA Precursor. 2023 North American Congress of Clinical Toxicology. Montreal, Canada: American Academy of Clinical Toxicology.
• Shirazi, F., Larsen, J., Maciulewicz, T., & Thiss, T. (2023, Mar. 31 - Apr. 2). Massive Isolated Topiramate Ingestion with Marked Improvement after Hemodialysis. ACMT Annual Scientific Meeting. San Diego, CA: American Academy of Medical Toxicology (ACMT).
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  poster presentation and published abstract
• Thiss, T., Maciulewicz, T., Larsen, J., & Shirazi, F. (2023, March). Massive Isolated Topiramate Ingestion with Marked Improvement after Hemodialysis. 2023 ACMT Annual Scientific Meeting. San Diego, CA: American Academy of Medical Toxicology.
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  poster presentation and published abstract
• Walter, F. G., Shirazi, F., French, R. N., Larsen, J., Gaither, J. B., Clark, S., Aizenberg, A. M., & Mo, J. E. (2023, Sep. 27 – Oct. 1, 2023).

  The Role of the Poison Center in Emergency Response to a Nitric Acid Transport Spill

  . North American Congress of Clinical Toxicology. Montreal, Quebec, Canada: American Academy of Clinical Toxicology.
• Vu, N., Bryan, W., & Larsen, J. (2020, September). Hydroxychloroquine Overdose: Correlating a Serum Level to Clinical Manifestation. North American Congress of Clinical Toxicology (NACCT). Virtual: American Academy of Clinical Toxicology.
• Wilson, B., Larsen, J., & Smelski, G. (2020, 09). Successful Use of Anavip for Treatment of an Agkistrodon Envenomation. North American Congress of Clinical Toxicology (NACCT). virtual: American Academy of Clinical Toxicology.
• Larsen, J., Kostura, M., Farrell, I. J., & Stolz, U. (2013, March). Predictors of Acute Kidney Injury in A Population of Rhabdomyolysis Patients. Society for Academic Emergency Medicine, Western Regional Meeting. Long Beach, CA: Society for Academic Emergency Medicine.