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) · Sep 2013
Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends.
Seizures may be the presenting manifestation of acute poisoning in children. Knowledge of the etiologic agent, or likely drug-class exposure, is crucial to minimize morbidity and optimize care. ⋯ Antidepressants, and specifically bupropion, are presently the most common medications responsible for pediatric drug-induced seizures requiring medical toxicology consultation in the United States. In teenagers presenting with new-onset seizures of unknown etiology, the possibility of deliberate self-poisoning should be explored, since most drug-induced seizures in this age group resulted from intentional ingestion.
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Clin Toxicol (Phila) · Sep 2013
Controlled Clinical TrialEffect of intravenous lipid emulsion in patients with acute glyphosate intoxication.
Although glyphosate intoxication has been considered minimally toxic in animals, severe toxicity has been observed in humans due to surfactant. We aimed to examine the potential therapeutic effects of intravenous lipid emulsion (ILE) on the patients with acute glyphosate intoxication. ⋯ ILE administration was associated with lower incidence of hypotension and arrhythmia in patients with acute glyphosate intoxication. ILE administration seems to be an effective treatment modality in patients who ingested sufficient amount of glyphosate herbicide that is expected to bring about significant toxicity.
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Clin Toxicol (Phila) · Sep 2013
Review Comparative StudyWater-based solutions are the best decontaminating fluids for dermal corrosive exposures: a mini review.
The intention is to assess whether the fundamental principle ("the solution to pollution is dilution") should be the guide for the initial medical management of corrosive dermal exposures. ⋯ The data support water as the best decontaminating solution. It has been shown to be efficacious in clinical trials, is widely available, and inexpensive.
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Clin Toxicol (Phila) · Sep 2013
Predicting the requirement for N-acetylcysteine in paracetamol poisoning from reported dose.
There is contention over whether reported dose correlates with toxicity in paracetamol poisoning and risk assessment is currently based on serum paracetamol concentration compared to a nomogram, irrespective of reported dose. Objective. To determine if reported dose predicts the need for N-acetylcysteine (NAC). ⋯ Reported dose was a good predictor of a toxic paracetamol concentration and SDAC reduced the probability of the concentration being above the nomogram. These predictions may assist in determining which patients could be started on NAC immediately.
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Clin Toxicol (Phila) · Sep 2013
Multicenter StudyDemographics and outcome of unintentional insulin overdoses managed by three poison centers.
Insulin dosing errors are one of the most dangerous medication issues due to the risk of profound hypoglycemia. The incidence of insulin dosing errors is increasing and there is no standard of care for management location. ⋯ Insulin dosing accidents can be routinely managed at home by PCs and have a low rate of hypoglycemia and adverse outcomes. This suggests that these cases can often be managed at home without referral with a potential benefit in no direct cost to the patient, convenience, and immediacy.