Journal of toxicology. Clinical toxicology
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Envenomation by arachnids causes significant medical illness worldwide. Scorpion sting is the most important arachnid envenomation causing adult morbidity and pediatric mortality. Important groups of spiders include the widow spiders (Latrodectus spp.), the recluse spiders (Loxosceles spp.), and two spiders confined to single countries: the Australian funnel web spider (Atrax and Hadronyche spp.) and the armed spider (Phoneutria spp.) from Brazil. ⋯ However, three controlled trials demonstrated that antivenom was not effective, but these included few severe cases. Until controlled trials of antivenom in systemically envenomated patients are undertaken, antivenom use appears justified in severe envenomation. Although envenomation from arthropods is common, no antivenoms exist for these, excepting Lonomia caterpillars in South America, and Ixodes paralysis ticks in Australia.
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J. Toxicol. Clin. Toxicol. · Jan 2003
Stability of atropine sulfate prepared for mass chemical terrorism.
Preparedness for chemical terrorism includes the procurement of the appropriate pharmacological antagonists. A large emphasis has been placed on having a sufficient quantity of atropine available to treat patients exposed to acetylcholinesterase inhibitors such as sarin. Severe exposures may necessitate the administration of large amounts of atropine and dictate the need to prepare significant quantities of extemporaneously compounded atropine solution to respond to mass numbers of casualties over the first 24-48 hours postexposure. ⋯ The amount of atropine necessary to treat hundreds to thousands of victims of a chemical attack is immense. The extemporaneous preparation of atropine solution from pharmaceutical-grade powder eliminates concerns about the storage of excessive quantities of atropine. A 1 mg/mL solution is stable for at least 3 days, allowing for use during the most critical treatment periods after exposure.
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Clinical toxinology encompasses a broad range of medical conditions resulting from envenomation by venomous terrestrial and marine organisms, and also poisoning from ingestion of animal and plant toxins. Toxin-related disease is an important cause of morbidity and mortality worldwide, particularly in the tropical and subtropical continents. Snake bite is the single most important toxin-related disease, causing substantial mortality in many parts of Africa, Asia, and the Americas. ⋯ This is now further worsened by a current shortage of antivenom. There is a need for improvement in the preventionand management of toxin-related disease. This will require well-designed studies to define the extent of the problem, initiatives to improve the prevention and management of these conditions, and development of new, and continuation of current, antivenom supplies.
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J. Toxicol. Clin. Toxicol. · Jan 2003
Case ReportsCardiotoxicity associated with intentional ziprasidone and bupropion overdose.
Ziprasidone and bupropion are medications prescribed for mood and behavior disorders. They have apparently safe cardiac safety profiles in both therapeutic and supratherapeutic doses, but recently the Federal Drug Administration has issued a caution regarding ziprasidone use in combination with other drugs that are known to prolong the QTc interval. ⋯ We present a case that underscores the potential cardiotoxicities of these medications. Ziprasidone and bupropion ingestion can be associated with cardiotoxicities that may require several days of aggressive cardiac monitoring and treatment.
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J. Toxicol. Clin. Toxicol. · Jan 2003
Case ReportsCardiotoxicity associated with intentional ziprasidone and bupropion overdose.
Ziprasidone (Geodon) and bupropion (Wellbutrin) are medications prescribed for mood and behavior disorders. They have apparently safe cardiac safety profiles in both therapeutic and supra-therapeutic doses. ⋯ We present a case that underscores the potential cardiotoxicities of these medications. Ziprasidone and bupropion ingestion can be associated with cardiotoxicities that may require several days of aggressive cardiac monitoring and treatment.