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https://www.readbyqxmd.com/read/29336302/-cyclizine-is-sold-in-denmark-as-an-over-the-counter-drug-and-has-serious-side-effects-when-overdosed
#1
Kasper Petersen, Peter Hjorth
Cyclizine is sold in Denmark as an over-the-counter drug and affects not only histaminergic but also muscarinergic, serotonergic and α-adrenergic receptors, with side effects such as respiratory depression and cardiac arrhythmias, leading to fatalities. Due to the numerous side effects, it raises questions concerning the status of cyclizine as an over-the-counter drug. Data of healthcare contacts because of cyclizine intoxication in the 2014-2016 period should be analyzed to further illuminate the health risk of cyclizine poisoning...
January 15, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29322813/opioid-drug-poisonings-in-ohio-adolescents-and-young-adults-2002-2014
#2
Sarah Caupp, Janine Steffan, Junxin Shi, Krista K Wheeler, Henry A Spiller, Marcel J Casavant, Henry Xiang
CONTEXT: Opioids represent a drug class that adolescents and young adults intentionally misuse and abuse. When taken on their own or with other substances in this manner, opioids pose an increased risk of overdose and potential death. OBJECTIVE: To determine trends of opioid drug poisonings among adolescents and young adults in Ohio from 2002 to 2014 using Poison Control Center (PCC) data. METHODS: Data were obtained from Ohio PCCs from 2002 to 2014 for opioid drug poisonings amongst 10-29 year olds...
January 11, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29301012/diagnosis-of-heroin-overdose-in-an-8-year-old-boy-reliable-contribution-of-toxicological-investigations
#3
M Soichot, S Julliand, J Filatriau, A Hurbain, E Bourgogne, A Mihoubi, H Gourlain, B Delhotal-Landes
Toxicological investigations are often required by clinicians in comatose patients with suspected poisoning. However, the usefulness of toxicological analyses to support a diagnosis of acute poisoning is debated among clinicians and the interpretation of laboratory tests is challenging given the wide diversity of analytical techniques available. We report the case of an 8-year-old boy who was admitted to an intensive care unit with severe respiratory depression and neurological impairment. In order to formulate appropriate hypothesizes about the diagnosis and circumstances of intoxication, clinicians consulted toxicologists for a comprehensive toxicological screening...
December 28, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29299212/risk-factors-of-mortality-due-to-acute-opium-poisoning-a-report-from-the-largest-intoxication-referral-center-in-iran
#4
Sahar Rismantab-Sani, Babak Soltani, Siamak Soltani, Azadeh Memarian
Background: Studies have shown that Iran has a high rate of opiate abuse and the most prevalently used is opium. This study was aimed to evaluate risk factors in patients with acute opium intoxication who referred to Loghman Hakim Hospital, Tehran, Iran, in 2011. Methods: A total number of 383 patients with acute opium overdose, who were referred to the Emergency Department of Loghman Hakim Hospital in Tehran during 2011, were enrolled into this descriptive, cross-sectional study...
April 2017: Addiction & Health
https://www.readbyqxmd.com/read/29284225/correlation-between-the-single-high-dose-of-ingested-baclofen-and-clinical-symptoms
#5
Jacek Sein Anand, Maciej Zając, Wojciech Waldman, Andrzej Wojtyła, Przemysław Biliński, Barbara Jaworska-Łuczak
INTRODUCTION AND OBJECTIVES: Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to life-threatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. MATERIAL AND METHODS: 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms...
December 23, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/29245231/higher-efficacy-of-direct-hemoperfusion-using-coated-activated-charcoal-column-for-disopyramide-poisoning-a-case-report
#6
Shigekazu Iguchi, Naotaka Yamaguchi, Hiroki Takami, Takayuki Komatsu, Hirokazu Ookubo, Hajime Sekii, Kenji Inoue, Shinya Okazaki, Iwao Okai, Sonomi Maruyama, Tomohisa Nomura, Manabu Sugita
RATIONALE: Cases of severe disopyramide poisoning are rare and few have been reported. We report a case in which activated-charcoal column hemoperfusion was dramatically effective for life-threatening disopyramide poisoning. PATIENT CONCERNS: A teenage girl who had overdosed on disopyramide (total dose, 4950 mg) was brought to our hospital. She was resuscitated from short period cardiopulmonary arrest and subsequently showed severe cardiogenic shock and ventricular arrhythmia...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29233194/ibuprofen-plasma-concentration-profile-in-deliberate-ibuprofen-overdose-with-circulatory-depression-treated-with-therapeutic-plasma-exchange-a-case-report
#7
Stefanie Geith, Bertold Renner, Christian Rabe, Jochen Stenzel, Florian Eyer
BACKGROUND: Inquiries relating to ibuprofen overdose have more than tripled in the last ten years in our poison control center. Although the vast majority of cases have a benign clinical course, there are few severe or even fatal cases present with refractory circulatory failure. CASE PRESENTATION: We describe a case of a 48 year-old male with suicidal mono-ingestion of approximately 72 g ibuprofen. Despite an initial rapid spontaneous drop in the total ibuprofen plasma concentration (IPC) from 550 to 275 mcg/mL within the first 5 h after admission, the patient developed a circulatory failure, refractory to aggressive fluid resuscitation and high doses of vasopressors...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29232283/levocarnitine-for-the-treatment-of-valproic-acid-induced-hyperammonemic-encephalopathy-in-children-the-experience-of-large-tertiary-care-pediatric-hospital-and-a-poison-center
#8
Miguel Glatstein, Pedro Bonifacio Rino, Silvina de Pinho, Dennis Scolnik, Dikla Pivko-Levi, Christopher Hoyte
BACKGROUND: Although rare, symptomatic hyperammonemia is sometimes associated with valproic acid (VPA), especially in children. L-carnitine (levocarnitine), sometimes classified as an essential amino acid, is vital to mitochondrial utilization of fatty acids and can be helpful in treating this condition. The data supporting this, however, are limited. STUDY QUESTION: The aim of the study was to illustrate the role of L-carnitine in the treatment of patients with VPA-induced hyperammonemic encephalopathy (VPE) at 2 different institutions...
November 22, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29231010/-advance-of-forensic-research-in-insulin-poisoning
#9
REVIEW
F Tong, Y Liang, Q Shi, L Zhang, W H L, Y W Zhou
Insulin as a common clinical hypoglycemic agent can effectively control serves to lower the concentration of blood glucose. However, insulin overdose can lead to death. In the whole fatal cases of insulin overdose, medical accident is the most common, followed by suicide. Though insulin homicide is extremely rare, it deserves great attention. Though there are some researches about insulin poisoning on forensic toxicology and pathology, it is still a difficult task in forensic practice. In this paper, the mechanism of death, pathological changes, detection methods and diagnose criteria of insulin overdose will be discussed in the view of forensic toxicology and pathology...
February 2017: Fa Yi Xue za Zhi
https://www.readbyqxmd.com/read/29219630/fewer-adverse-effects-with-a-modified-two-bag-acetylcysteine-protocol-in-paracetamol-overdose
#10
Richard McNulty, Jia Min Elizabeth Lim, Pramod Chandru, Naren Gunja
OBJECTIVE: Acetylcysteine (NAC), an effective antidote for paracetamol poisoning, is commonly associated with adverse reactions. This has been postulated to be related to the rapid initial infusion rate (150 mg/kg over 1 h) of the traditional three-bag protocol. We hypothesized that a slower rate would result in fewer adverse reactions. Our institution in Western Sydney moved to a modified two-bag protocol in February 2015 - first bag: 200 mg/kg over 4 h (50 mg/kg/h) and second bag: (100 mg/kg over 16 h)...
December 8, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29199901/an-evaluation-of-practitioner-s-experience-of-service-users-seeking-community-detoxification-from-benzodiazepines
#11
Marianne Wall, Sharon Lambert, Aidan Horan
A recent report in Ireland identified that two-thirds of poisoning deaths involved poly drug use with an average of four different drugs involved. Of these, benzodiazepines were the most common drug group involved. Concern has been expressed regarding high levels of benzodiazepine prescriptions globally. Community-based detoxification programs are required, but detoxification is complex with associated high risks, such as overdose. This study utilized a survey to gather the experiences of a range of drug workers in addiction settings in the southern region of Ireland who are tasked with the management of supporting service users who wish to detoxify from benzodiazepines...
December 4, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/29170345/48%C3%A2-calpol-are-we-overdosing-on-blood-tests
#12
Brijesh Patel
BACKGROUND: In February 2012, the Commission on Human Medicines recommended lowering the paracetamol toxicity treatment threshold for all patients. Children between one month and six years of age are physiologically distinct and metabolise paracetamol differently, making them less prone to toxicity. Furthermore, overdose in early childhood is almost exclusively accidental, as opposed to predominately deliberate self harm seen in adults and adolescents. As a result, the use of the new 75 mg/kg ingestion threshold for young children would appear to be of unproven benefit, and is substantially lower than the threshold used in other countries...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170334/37%C3%A2-routine-testing-of-salicylate-levels-in-overdose-patients-still-needed
#13
Elaine Hardy, Clare Toro, Susan Dorrian, Umesh Salanke
INTRODUCTION AND AIMS: Overdose is a common presentation in Emergency Departments (EDs) across the UK. Salicylate poisoning is potentially fatal; however it is becoming increasingly uncommon in the UK. This may be due to restriction of pack sizes in over the counter medicines as well as the use of aspirin as an analgesic being superseded by other NSAIDs, particularly ibuprofen.In conjunction with clinical features of salicylate toxicity, measurement of plasma salicylate concentration can help guide management...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29158734/a-study-of-the-importance-of-clonus-symptoms-in-patients-with-tramadol-poisoning
#14
Fares Najari, Anahita Alizadeh-Ghamsari, Maryam Vahabzadeh, Bita Dadpour, Seyed Reza Mousavi, Ideh Baradaran Kayal
Objectives: Clinical studies to reduce the side effects of tramadol, such as seizure, are necessary. Owing to the high prevalence of tramadol consumption and subsequent complications that result from seizures, the aim of the present study was to find a relationship between clonus and prediction of seizure outcome in patients with tramadol overdose. This can be used to determine the need for essential actions if a significant indicator of preventive medical measures is observed. Methods: In this case-control study, three groups of patients poisoned with tramadol and with marked ankle clonus were evaluated...
2017: Journal of Toxicology
https://www.readbyqxmd.com/read/29138563/squarticles-as-the-nanoantidotes-to-sequester-the-overdosed-antidepressant-for-detoxification
#15
Chun-Han Chen, Tse-Hung Huang, Ahmed O Elzoghby, Pei-Wen Wang, Chia-Wen Chang, Jia-You Fang
The increasing death rate caused by drug overdose points to an urgent demand for the development of novel detoxification therapy. In an attempt to detoxify tricyclic antidepressant overdose, we prepared a lipid nanoemulsion, called squarticles, as the nanoantidote. Squalene was the major lipid matrix of the squarticles. Here, we present the animal study to investigate both the pharmacokinetic and pharmacodynamic effects of squarticles on amitriptyline intoxication. The anionic and cationic squarticles had average diameters of 97 and 122 nm, respectively...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/29135905/unsuccessful-suicide-attempt-with-tiapride
#16
Sylvain Couderc, Hervé Mourou, Caroline Monchaud, Franck Saint-Marcoux
To the best of our knowledge, no case has been published in the literature that reports an overdose of tiapride, either alone or in combination with other drugs. We report a self-poisoning case in an 18-year-old girl, with approximately 10 times the usual daily dose (ie, 2.5 g). Although the blood concentration was 20/30-fold higher than usually observed after therapeutic drug intakes (17,300 mcg/L), the patient remained almost asymptomatic.
December 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29134498/vasoplegic-shock-treated-with-methylene-blue-complicated-by-severe-serotonin-syndrome
#17
Betty S Chan, Therese Becker, Angela L Chiew, Ahmed M Abdalla, Tom A Robertson, Xin Liu, Michael S Roberts, Nicholas A Buckley
INTRODUCTION: Management of severe vasoplegic shock in overdose can be very challenging. We describe a case of severe refractory vasodilatory shock in poisoning where methylene blue (MB) was used with success. However, the patient subsequently developed severe Serotonin Syndrome (SS) as a result of an interaction between serotonergic drugs and MB. CASE REPORT: A 15-year-old male developed severe vasoplegic shock 1.5 hours after overdosing on several different medications including quetiapine slow release, quetiapine immediate release, desvenlafaxine slow release, venlafaxine, amlodipine, ramipril, fluoxetine, promethazine and lithium...
November 13, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29124988/extracorporeal-elimination-of-butalbital-in-acute-aspirin-butalbital-caffeine-codeine-fiorinal-with-codeine-poisoning
#18
Janelle O Poyant, Robert Albright, Jeremy Clain, Govind Pandompatam, Erin F Barreto
BACKGROUND: Butalbital is a small molecule (approximately 220 Da), with 26% protein binding, a 0.8 L/kg volume of distribution, and is eliminated nearly 80% unchanged in the urine. Although hemodialysis has been used to treat overdoses of other barbiturates, the extracorporeal clearance of butalbital is unknown. The objective of this case is to describe the use of extracorporeal therapy to augment elimination of butalbital after an overdose of aspirin 325 mg-butalbital 50 mg-caffeine 40 mg with codeine 30 mg (Fiorinal with Codeine)...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29121712/epidemiologic-incidence-of-rhabdomyolysis-in-opioid-overdose-in-icu-of-poisoning-center-in-iran-2014
#19
Babak Khoshideh, Mohammad Arefi, Mazaher Ghorbani, Samaneh Akbarpour, Fatemeh Taghizadeh
Objectives: The aim of this study is to investigate the clinical, demographical characteristics and some laboratory findings of hospitalized patients with acute opioid toxicity and rhabdomyolysis. Methods: In this cross-sectional study, 354 hospitalized patients were investigated at Baharloo Educational Hospital in Tehran, with acute illicit drug toxicity in 2014. Data was collected by an investigator-made check lists. The collected data and variations (such as mortality rate, demographic data, and renal function tests as well as serum biochemical elements) were analyzed by descriptive statistics and x-square test...
November 8, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/29118002/prevalence-and-risk-factor-for-injury-in-sub-saharan-africa-a-multicountry-study
#20
Megan B Diamond, Shona Dalal, Clement Adebamowo, David Guwatudde, Carien Laurence, Ikeoluwapo O Ajayi, Francis Bajunirwe, Marina A Njelekela, Faraja Chiwanga, Hans-Olov Adami, Joan Nankya-Mutyoba, Robert Kalyesubula, Todd G Reid, David Hemenway, Michelle D Holmes
INTRODUCTION: Injury-related morbidity is a neglected health concern in many low-income and middle-income countries. Most injury data in Africa have been collected from hospital-based studies, and few studies have occurred across multiple countries. Using data from a novel cohort, we examined the prevalence and incidence of serious injuries and associated risk factors across five sites in sub-Saharan Africa (SSA). METHODS: A common baseline and follow-up survey was administered to participants...
November 8, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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