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) · Feb 2009
ReviewCarnitine in the treatment of valproic acid-induced toxicity.
Valproic acid (VPA) is a broad-spectrum antiepileptic drug that is now used commonly for several other neurological and psychiatric indications. VPA is usually well tolerated, but serious complications, including hepatotoxicity and hyperammonemic encephalopathy, may occur. These complications may also arise following acute VPA overdose, the incidence of which is increasing. Intoxication usually only results in mild central nervous system depression, but serious toxicity and death have been reported. ⋯ Further controlled, randomized, and probably multicenter trials are required to better delineate the therapeutic and prophylactic roles of l-carnitine and the optimal regimen of administration in the management of VPA toxicity.
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The availability of antidotes is essential and often lifesaving in management of certain poisonings. Surveys conducted in a number of countries have demonstrated inadequate availability of antidotes. Since no similar studies have been published for South Africa, it was decided to investigate the local availability of antidotes. ⋯ Poison information centers should work with local drug coding committees to improve availability of important antidotes.
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Clin Toxicol (Phila) · Dec 2008
Case ReportsObtundation and seizure following ondansetron overdose in an infant.
Ondansetron, an increasingly prescribed 5-HT(3) antagonist used in the management of nausea and vomiting of various etiologies, has a well-established safety profile in therapeutic use. However, little is known about its effects in the setting of an overdose. We describe the first case of severe toxicity in an infant who unintentionally ingested a large quantity of ondansetron. ⋯ Health care providers should recognize the risk for acute toxicity following ondansetron overdose, particularly in infants and toddlers.
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We present a case of a 49-year-old male dentist with myeloneuropathy. He used nitrous oxide frequently in his practice, and denied recreational use. ⋯ The patient was treated with vitamin B12 and l-methionine. A repeat MRI of his cervical spinal cord 3 months after hospital discharge showed complete regression of the hyperintense signal on T2 within the posterior columns.
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Clin Toxicol (Phila) · Dec 2008
2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report.
This report is the 25th Annual Report of the American Association of Poison Control Centers (AAPCC; http://www.aapcc.org) National Poison Data System (NPDS). During 2007, 60 of the nation's 61 U.S. Poison Centers upload case data automatically. The median upload time is 14 [5.3, 55] (median [25%, 75%]) min creating a real-time national exposure database and surveillance system. ⋯ Poisoning continues to be a significant cause of morbidity and mortality in the United States NPDS represents a valuable national resource to collect and monitor U.S. poisoning exposure cases. It offers one of the few real-time surveillance systems in existence, provides useful data, and is a model for public health surveillance.