Journal of toxicology. Clinical toxicology
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Lamotrigine is an antiepileptic agent that has been shown to be an effective adjunctive treatment for refractory partial and generalized seizures. It is now licensed in more than 70 countries for this indication. There is very little published material about the effects of acute overdose with lamotrigine. ⋯ We describe the findings in a patient following the deliberate ingestion of a large amount of lamotrigine (stated 4.5 g, absorbed estimated 2.9 g), in excess of that previously described in the literature. The main clinical features were ataxia and rotary nystagmus. Electrocardiogram was unremarkable. Peak measured concentration of lamotrigine was 35.8 mg/L and half-life 19.5 hours, suggesting linear kinetics in overdose.
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J. Toxicol. Clin. Toxicol. · Jan 2000
The hemodynamic effects of cocaine during acute controlled hemorrhage in conscious rats.
Cocaine is often associated with trauma; however, little is known about how its use alters the response to blood loss. The effect of cocaine on hemodynamics following acute hemorrhage was studied in a rat model. ⋯ Although transient, cocaine blunted the hypotensive response to acute controlled hemorrhage and resulted in tachycardia.
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J. Toxicol. Clin. Toxicol. · Jan 2000
Letter Historical ArticleHomeopathic remedies for children: are they cause for concern?
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J. Toxicol. Clin. Toxicol. · Jan 2000
Cardiac and hemodynamic assessment of patients with cocaine-associated chest pain syndromes.
Animal and human experimental studies have yielded conflicted data regarding the effects of cocaine on cardiovascular function. We studied the cardiac and hemodynamic profiles in emergency department chest pain patients following recent cocaine use. ⋯ Most emergency department patients with cocaine-associated chest pain have normal cardiac profiles at the time of presentation. The negative inotropic effects of high doses of cocaine observed in animal models do not appear to be present in patients who develop chest pain after using recreational doses of cocaine.
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J. Toxicol. Clin. Toxicol. · Jan 2000
Case ReportsHigh-efficiency dialysis for carbamazepine overdose.
Carbamazepine intoxication is associated with seizures, coma, arrhythmias, and death. In acute intoxications, charcoal hemoperfusion enhances removal of the drug but is associated with thrombocytopenia, coagulopathy, hypothermia, and hypocalcemia. Alternatively, high-efficiency hemodialysis can be used without the side effects of charcoal hemoperfusion. ⋯ We report an 18-month-old comatose, convulsing child with plasma carbamazepine 27 microg/mL treated with high efficiency hemodialysis. Therapeutic carbamazepine levels were obtained after 4.5 hours of high-efficiency hemodialysis. The patient developed no untoward side effects, improved clinically, and was subsequently discharged home without sequelae. We conclude that high-efficiency hemodialysis is a safe, effective alternative to charcoal hemoperfusion in the pediatric population.