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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Clin Toxicol (Phila) · Nov 2013
Case ReportsProlonged lipemia and pancreatitis due to extended infusion of lipid emulsion in bupropion overdose.
Lipid emulsion is gaining popularity as an antidote for lipophilic drug overdose, and is generally considered safe at doses recommended for antidotal therapy. We report a case of asymptomatic pancreatitis following extended infusion lipid emulsion. ⋯ Large doses of lipid emulsion may result in lipemia, severe hypertriglyceridemia, interference in laboratory analyses, and pancreatitis. This is the third reported adverse event due to lipid emulsion therapy used for overdose.
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Clin Toxicol (Phila) · Nov 2013
Comparative StudyCarbon monoxide exposures in New York City following Hurricane Sandy in 2012.
On October 29, 2012, Hurricane Sandy made landfall and devastated New York's metropolitan area, causing widespread damage to homes and the utility infrastructure. Eight days later, snow and freezing temperatures from a nor'easter storm delayed utility restoration. ⋯ CO exposures following weather-related disasters are a significant public health concern, and the use of fuel-burning equipment is a clear source of storm-related morbidity and mortality. Multiple real-time epidemiologic surveillance tools are useful in estimating the prevalence of CO exposure and poisoning and are necessary to assist public health efforts to prevent CO poisoning during and after disasters.
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Clin Toxicol (Phila) · Sep 2013
Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends.
Seizures may be the presenting manifestation of acute poisoning in children. Knowledge of the etiologic agent, or likely drug-class exposure, is crucial to minimize morbidity and optimize care. ⋯ Antidepressants, and specifically bupropion, are presently the most common medications responsible for pediatric drug-induced seizures requiring medical toxicology consultation in the United States. In teenagers presenting with new-onset seizures of unknown etiology, the possibility of deliberate self-poisoning should be explored, since most drug-induced seizures in this age group resulted from intentional ingestion.
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Clin Toxicol (Phila) · Sep 2013
Review Comparative StudyWater-based solutions are the best decontaminating fluids for dermal corrosive exposures: a mini review.
The intention is to assess whether the fundamental principle ("the solution to pollution is dilution") should be the guide for the initial medical management of corrosive dermal exposures. ⋯ The data support water as the best decontaminating solution. It has been shown to be efficacious in clinical trials, is widely available, and inexpensive.
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Clin Toxicol (Phila) · Sep 2013
Predicting the requirement for N-acetylcysteine in paracetamol poisoning from reported dose.
There is contention over whether reported dose correlates with toxicity in paracetamol poisoning and risk assessment is currently based on serum paracetamol concentration compared to a nomogram, irrespective of reported dose. Objective. To determine if reported dose predicts the need for N-acetylcysteine (NAC). ⋯ Reported dose was a good predictor of a toxic paracetamol concentration and SDAC reduced the probability of the concentration being above the nomogram. These predictions may assist in determining which patients could be started on NAC immediately.