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 2017
Case ReportsSuicide attempt with self-made Taxus baccata leaf capsules: survival following the application of extracorporeal membrane oxygenation for ventricular arrythmia and refractory cardiogenic shock.
Yew intoxication has been known for many years; high dose ingestion of Taxus baccata leads to cardiac toxicity mediated by calcium and sodium channel blocking properties. We present a case report of a patient who attempted suicide after T. baccata ingestion, causing refractory cardiogenic shock requiring temporary circulatory assistance by veno-arterial extra corporeal membrane oxygenation (VA ECMO). ⋯ Our experience suggests that circulatory assistance by VA ECMO and continuous renal replacement therapy seem to be effective safe second-line therapeutic options in critically ill cases of severe yew intoxication with refractory cardiogenic shock due to arrhythmia.
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Clin Toxicol (Phila) · Aug 2017
Comparative StudyAnalysis of intentional drug poisonings using Ohio Poison Control Center Data, 2002-2014.
Pharmaceutical drug poisonings, especially those that are intentional, are a serious problem for adolescents and young adults. Poison control center data is a viable tool to track intentional drug poisonings in near real-time. ⋯ The high report rate of suspected suicides and analgesic class drugs demonstrates the need for preventative measures for adolescents and young adults in Ohio. Any interventions, along with legislative changes, will need to take place in our local communities.
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Clin Toxicol (Phila) · Aug 2017
Case ReportsSupraventricular tachycardia and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA: a case report with quantitative analysis of serum drug concentrations.
AB-FUBINACA and ADB-FUBINACA are structurally similar synthetic cannabinoids with potent CB1 receptor agonistic effects. Very little is known about their pharmacology and toxicology. ⋯ In the context of acute poisoning, the presence of unexplained tachyarrhythmias, confusion, and a negative recreational drug screen should prompt clinicians to consider synthetic cannabinoid toxicity as a differential diagnosis.
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Clin Toxicol (Phila) · Aug 2017
Case ReportsLoperamide metabolite-induced cardiomyopathy and QTc prolongation.
Loperamide is an over-the-counter, peripherally acting, μ-opioid receptor agonist used for the treatment of diarrhea. In recent times users have found that at higher doses, loperamide crosses the blood-brain barrier and reaches central μ-receptors in the brain, leading to central opiate effects including euphoria and respiratory depression. ⋯ During her overdose, her QTc was significantly prolonged at >600 ms. Our case aims to add to the growing body of literature describing life-threatening ventricular arrhythmias associated with loperamide toxicity and further suggests that a metabolite of loperamide, desmethylloperamide, may play a role in the pathogenesis.
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Clin Toxicol (Phila) · Aug 2017
Letter Case ReportsIschemic stroke due to wasp sting: a case report.