Clinical toxicology : the official journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
-
Clin Toxicol (Phila) · Jul 2015
Observational StudyTramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely.
Tramadol is a commonly used centrally acting analgesic associated with seizures and suspected to cause serotonin toxicity in overdose. ⋯ Tramadol overdose is associated with seizures and respiratory depression, but is unlikely to cause serotonin toxicity.
-
Clin Toxicol (Phila) · Jul 2015
Review Practice GuidelineMethodology for AACT evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning.
Intravenous lipid emulsion (ILE) therapy is a novel treatment that was discovered in the last decade. Despite unclear understanding of its mechanisms of action, numerous and diverse publications attested to its clinical use. However, current evidence supporting its use is unclear and recommendations are inconsistent. ⋯ The evidence will be appraised using the GRADE system. A thorough and transparent process for consensus statements will be performed to provide recommendations, using a modified Delphi method with two rounds of voting. This process will allow for the production of useful practice recommendations for this therapy.
-
Clin Toxicol (Phila) · Jul 2015
Pneumomediastinum predicts early mortality in acute paraquat poisoning.
In paraquat (PQ) poisoning, death often occurs after the appearance of pneumomediastinum (PM). However, the clinical features and eventual outcome of PM in PQ intoxication remains unclear. ⋯ Early PM, occurring within 8 days, is a specific predictor of mortality in PQ poisoning.
-
Clin Toxicol (Phila) · Jul 2015
ReviewCYP2D6 genetic polymorphisms and their relevance for poisoning due to amfetamines, opioid analgesics and antidepressants.
Cytochrome P450 2D6 (CYP2D6) is a member of the cytochrome P450 (CYP) superfamily involved in the biotransformation of drugs and substances of abuse encountered in clinical toxicology. Among the CYP superfamily, the CYP2D6 gene is considered as the most polymorphic as more than 105 different alleles have been identified so far. CYP2D6 genetic polymorphisms have the potential to affect the toxicity of their substrates. ⋯ Either poor or extensive/ultra-rapid CYP2D6 metabolisers may be exposed to toxic effects of amfetamines, opioid analgesics and antidepressants. In these three categories, the level of evidence is substance dependent, with differences within the same pharmacological class.
-
Drug shortages have significantly increased over the past decade. There are limited data describing how shortages impact medical toxicology of drugs. ⋯ Drug shortages affected a substantial number of critical agents used in the management of poisoned patients. Shortages were often of long duration and for drugs without alternatives. Providers caring for poisoned patients should be aware of current shortages and implement mitigation strategies to safeguard patient care.