Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
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In a clinical study, healthy subjects were given an antidote to a toxin that may be encountered by emergency physicians. Urine was collected for seven days following administration of the antidote. The drastic dark purple color of the urine on day 1, taken immediately after the antidote was given, is clearly of note.
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Clin Toxicol (Phila) · Jan 2012
Case ReportsIntravenous paracetamol toxicity in a malnourished child.
We present a case of intravenous (IV) paracetamol overdose in a nutritionally malnourished child during hospital admission. A ten-fold IV paracetamol dosing error ocurred, with delayed recognition and treatment resulting in transient hepatotoxicity, with a peak alanine transaminase (ALT) of 1378 IU/L in a 3-year-old child. Our case suggests that hepatotoxicity may occur for lower doses of IV paracetamol compared to oral ingestion, especially in the malnourished, and that a dose less than 150 mg/kg of IV paracetamol should be used to define treatment following overdose in a child with potential nutritional deficiencies.
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Clin Toxicol (Phila) · Jan 2012
Examination of adverse events following black widow antivenom use in California.
Following widow spider (Latrodectus sp.) envenomation, local pain, erythema, abdominal pain, rigidity, hypertension, and diaphoresis can be seen. While an effective specific antivenom (AV) is available, its use is limited due to concern of possible severe allergic reaction. We performed the current study to determine rate of adverse effects and the efficacy of AV in patients treated for widow spider envenomation. ⋯ Our results suggest that Black Widow Spider Antivenin® (Merck) administration is relatively safe with mild to moderate adverse effects seen in only a small percentage of patients. There were no deaths, or severe allergic reactions identified. The retrospective use of poison control system data is a limitation of our study. Further prospective studies are needed to validate our findings and elucidate the full safety profile on this antivenom.
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Clin Toxicol (Phila) · Jan 2012
Review'Legal highs'--novel and emerging psychoactive drugs: a chemical overview for the toxicologist.
'Legal highs' are psychoactive chemicals which are sold from 'head shops', the internet and from street suppliers and may be possessed without legal restriction. An increase in the marketing of these materials has resulted in a corresponding increase in published reports of their adverse effects. However, a lack of primary literature pertaining to their chemistry, pharmacology and toxicology, makes an evaluation of their harm difficult. This review covers the basic chemistry of these novel psychoactive compounds and relates them to endogenous neurotransmitters and existing drugs of abuse. ⋯ 'Legal highs' are gaining in popularity and present clear challenges to toxicologists and society as a whole. Whilst improved use of existing legislation and development of new legislation can be used to reduce the supply of these materials, investment in better education for young people on the harms associated with 'legal highs' is needed.
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Clin Toxicol (Phila) · Jan 2012
Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication.
Plasma paraquat concentration is recognized as the best prognostic indicator in patients with acute paraquat poisoning, but it cannot be measured in many hospitals due to limited medical resources. By contrast, arterial lactate is easily obtainable, even in local hospitals. ⋯ The arterial lactate had a good predictive power in evaluating the prognosis of patients with acute paraquat poisoning. In the case of hospitals without facilities to test plasma paraquat concentration, measurement of the arterial lactate may be a simple and practical tool for assessing the severity of paraquat poisoning.