The Annals of pharmacotherapy
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To describe a patient with severe thrombocytopenia induced by the administration of phenytoin for prevention of seizures. A review of the literature supplements this case description to alert clinicians to this potentially serious hematologic reaction. ⋯ Due to widespread use of phenytoin, clinicians must recognize the potential for the rare but serious adverse effect of thrombocytopenia, particularly in the neurosurgical population. Confusion, as observed in our patient, makes postoperative evaluation of central nervous system and cognitive function difficult, and can obscure the clinical presentation. At its worst extreme, disruption of platelet function may produce cerebral hemorrhage, which results in long-term functional deficits.
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To report a case of organophosphate poisoning treated with a continuous infusion of pralidoxime chloride. ⋯ A continuous pralidoxime infusion successfully managed the prolonged nicotinic symptoms seen after ingestion of an organophosphate. A continuous infusion of pralidoxime may be particularly useful in cases of organophosphate poisoning when the extent of chemical exposure or quantity of chemical ingested is unknown but potentially toxic and the therapy must be symptomatically managed.