Journal of toxicology. Clinical toxicology
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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
Case Reports Clinical TrialNaloxone--for intoxications with intravenous heroin and heroin mixtures--harmless or hazardous? A prospective clinical study.
Naloxone is standard medication for the treatment of heroin intoxications. No large-scale studies have yet been carried out to determine its toxicity in heroin intoxications. ⋯ The short time between naloxone administration and the occurrence of complications, as well as the type of complications, are strong evidence of a causal link. In 1000 clinically diagnosed intoxications with heroin or heroin mixtures, from 4 to 30 serious complications can be expected. Such a high incidence of complications is unacceptable and could theoretically be reduced by artificial respiration with a bag valve device (hyperventilation) as well as by administering naloxone in minimal divided doses, injected slowly.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Five year retrospective evaluation of sulfonylurea ingestion in children.
Oral hypoglycemic medications are frequently used for Type II diabetes and accidental ingestions by children may occur. There are no comprehensive pediatric studies documenting poison center experiences. ⋯ Children ingesting oral hypoglycemics should be admitted to a health care facility for 24 h observation. In this series a single tablet produced hypoglycemia.
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J. Toxicol. Clin. Toxicol. · Jan 1996
Case ReportsDelayed peak serum valproic acid in massive divalproex overdose--treatment with charcoal hemoperfusion.
Increased clearance and apparent clinical improvement in valproic acid overdose has been reported following in-series hemodialysis/hemoperfusion therapy. We report a case of divalproex sodium and chlorpheniramine overdose treated with charcoal hemoperfusion and multiple-dose activated charcoal. ⋯ Enteric coated valproic acid preparations may cause delayed toxicity in overdose, particularly with coingested anticholinergic medications. In our case, charcoal hemoperfusion appeared to increase valproic acid clearance.
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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.