Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 2003
Electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe cocaine intoxication.
Cocaine toxicity causes myocardial depression, malignant dysrhythmias, and sudden death, partially due to cocaine-related myocardial sodium channel blockade. Because of cocaine's ability to block cardiac sodium channels, sodium bicarbonate (NaHCO3) has been proposed as an antidote. The hypothesis of this study was that NaHCO3 would correct cocaine-induced conduction abnormalities and resultant hemodynamic compromise in an animal model simulating severe cocaine intoxication. ⋯ NaHCO3 improved ECG changes secondary to cocaine toxicity and improved myocardial function.
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J. Toxicol. Clin. Toxicol. · Jan 2003
Case ReportsIrreversible ischemic hand following intraarterial injection of zolpidem powder.
Intraarterial injections of crushed oral formulations of drugs may cause acute, severe ischemia, and gangrene. A 24-yr-old woman developed severe ischemia of the right hand following arterial self-injection of a crushed zolpidem tablet. ⋯ Zolpidem tablets contain microcrystalline cellulose, an approved structural element in tablets for humans that has also been found to be a potent embolic agent. Microvascular embolization related to the microcrystalline cellulose may have contributed to the ischemia of the patient's hand.
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J. Toxicol. Clin. Toxicol. · Jan 2003
What are the adverse effects of ethanol used as an antidote in the treatment of suspected methanol poisoning in children?
Ethanol used as an antidote is said to have various adverse effects, particularly in children. The rate of these adverse effects is not known. ⋯ The rate of clinically important adverse effects related to ethanol used as an antidote to treat methanol poisoning in children was either absent or low in a tertiary care pediatric hospital setting. There was no morbidity or mortality associated with ethanol when it was used despite wide variation in ethanol levels. These results suggest that with appropriate monitoring and intravenous glucose intake in a controlled environment such as a pediatric intensive care unit, ethanol therapy does not carry as many risks as currently believed.