Chūdoku kenkyū : Chūdoku Kenkyūkai jun kikanshi = The Japanese journal of toxicology
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Practice Guideline Guideline
[Guidelines for the treatment of acute chemical poisoning-8-symptomatic therapy (1): respiratory management].
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Fatal hypernatremia due to soy sauce ingestion is rare. We describe a 65-year-old woman who became unresponsive after ingesting 1150 ml of soy sauce. ⋯ She was treated successfully with acute hemodialysis and her serum sodium concentration decreased to 146 mEq/l without any significant neurologic complication. We recommend hemodialysis is the best approach to correct severe hypernatremia.
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We have developed guidelines of pharmaceutical activity which describes how pharmacists are actively involved in supporting the initial treatment of poisoning and overdosed patients in the Intensive Care Unit (ICU). These guidelines are derived from the original procedural manual that consisted of protocol charts. The charts provide the pharmacist including ICU staff members with directions for the collection of clinical information and the forms to use for documentation. ⋯ Early participation by pharmacists, by reviewing timely, accurate and competent clinical information enabled the pharmacist to identify the suspected drug from the biological samples obtained. From our experiences, we conclude that this active involvement of pharmacist in the initial treatment of poisoning and overdosed patients in the ICU was both supportive and beneficial to the patient. In addition, the participation of pharmacist as a member of a treatment team provided an excellent opportunity to collaborate with the entire ICU staff members.
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The 68-year-old man took arsenic pasta 1 g (arsenic trioxide 0.45 g) to commit suicide and was admitted 16 hours after ingestion. He developed vomiting and coma, followed by pancytopenia. ⋯ Total arsenic concentrations in serum and urine were 39 ng/ml and 89 ng/ml on admission, respectively. Urine arsenic concentration showed the second peak around 48 hours after admission.