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) · Jun 2007
Case ReportsRattlesnake envenomation with neurotoxicity refractory to treatment with crotaline Fab antivenom.
Neurotoxicity following rattlesnake envenomation is reported with certain crotaline species. In some instances, crotaline Fab antivenom therapy that effectively halts progression of local tissue edema and hemotoxicity fails to reverse neurologic venom effects. ⋯ We describe two cases of neurotoxicity following rattlesnake envenomation in which treatment with crotaline Fab antivenom adequately obtained initial control of local swelling and hematologic effects, but neurotoxic venom effects remained refractory to antivenom therapy. This phenomenon is anecdotally recognized following certain crotaline species envenomations.
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Clin Toxicol (Phila) · Jun 2007
Case ReportsReversal of salicylate-induced euglycemic delirium with dextrose.
Salicylate poisoning inhibits Krebs cycle enzymes and uncouples oxidative phosphorylation. Under these circumstances, we hypothesize that CNS glucose supply is sometimes unable to keep up with demand resulting in hypoglycorrhacia and delirium even in the face of serum euglycemia. Supporting this conjecture, we report two euglycemic patients with salicylate-induced delirium who responded to boluses of concentrated dextrose with a prompt improvement in mental status.
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Clin Toxicol (Phila) · Jun 2007
Case ReportsAbrupt awakening phenomenon associated with gamma-hydroxybutyrate use: a case series.
Case reports mention a sudden awakening from GHB-associated coma but do not specify its time course. The aim of the present case series was to investigate the time course of the awakening from GHB intoxication and the relationship to plasma concentrations of GHB and the presence of other drugs. Unconscious (GCS
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Clin Toxicol (Phila) · Jun 2007
Case ReportsUrinary serotonin level is associated with serotonin syndrome after moclobemide, sertraline, and citalopram overdose.
Altered mental status, autonomic dysfunction, and neuromuscular abnormalities are a characteristic triad of serotonin syndrome. No laboratory tests confirm the diagnosis of serotonin syndrome. ⋯ The urinary serotonin level is increased in serotonin syndrome due to a monoamine oxidase inhibitor and selective serotonin-reuptake inhibitors overdose. It is possible that urinary serotonin concentration could be used as a biochemical marker of serotonin syndrome.