Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1996
The effect of hypertonic sodium bicarbonate on QRS duration in rats poisoned with chloroquine.
To determine efficacy of hypertonic sodium bicarbonate in narrowing QRS prolongation produced by chloroquine. ⋯ Hypertonic sodium bicarbonate partially reversed sodium channel blockade and resultant QRS interval prolongation produced by chloroquine in rats. These data should be interpreted with caution, given the need to extrapolate to humans and the modest effect of sodium bicarbonate on QRS narrowing.
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J. Toxicol. Clin. Toxicol. · Jan 1996
ReviewRisks of extracorporeal membrane oxygenation: is there a role for use in the management of the acutely poisoned patient?
To review the use of extracorporeal membrane oxygenation in the support of poisoned patients and provide a basis for comparison to other methods of respiratory support for these patients. ⋯ The use of extracorporeal membrane oxygenation for respiratory failure following ingestion has the same limited indications as for other patients with respiratory failure. Data supporting an improvement in outcome are not available. Extracorporeal membrane oxygenation support for reversible cardiac toxicity has a sound basis but clinical experience is limited. Good supportive care for the poisoned patient is essential before considering extracorporeal membrane oxygenation.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Case Reports4-Methylpyrazole and hemodialysis in ethylene glycol poisoning.
Two patients severely intoxicated with ethylene glycol became anuric and were treated by hemodialysis and the antidote, 4-methylpyrazole. On admission, their plasma ethylene glycol concentrations were 0.42 and 3 g/L respectively and no alcohol was detected. The elimination of 4-methylpyrazole in the dialysate represented 45% of the total body elimination. Clearances of 4-methylpyrazole by hemodialysis were 80 mL/min and 52 mL/min respectively. ⋯ In such cases, the authors propose infusion of a 4-methylpyrazole loading dose of 10-20 mg/kg before dialysis and intravenous infusion of 1-1.5 mg/kg/h during the 8-12 hours of hemodialysis to compensate the loss in dialysate.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Review Case ReportsHemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency.
A sixteen year-old-male with a history of glucose-6-phosphate dehydrogenase deficiency ingested an unknown amount of acetaminophen and presented to an emergency department 7.5 h later. He was afebrile. His serum acetaminophen level was 184 micrograms/mL, and his urine toxicologic screen was otherwise negative. Vomiting led to enrollment in a experimental protocol of intravenous N-acetylcysteine. He developed no evidence of subsequent chemical hepatitis but did develop a significant Coomb's negative hemolytic anemia. Hemoglobin on presentation was 14 g/dL and reached a nadir of 9.4 g/dL on admission day 4. ⋯ Patients with glucose-6-phosphate dehydrogenase deficiency who overdose with acetaminophen should be monitored for the possible development of subsequent drug-induced hemolysis.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Review Case ReportsSalicylism from topical salicylates: review of the literature.
Although topical salicylates are widely used, toxicity from this route is rare. ⋯ Her serum salicylate fell to 1.90 mmol/L (26 mg/dL) over a two day period and she regained a normal mental status.